Improving care in pregnancy after reproductive loss in women with diabetes: an interdisciplinary exploration of patient experiences and health profess

背景资料：患有糖尿病的妇女怀孕流产、死产或婴儿死亡的风险增加，但通过仔细的怀孕准备可以降低风险。人们对丧失生殖能力后的丧亲过程有了越来越多的认识和理解，然而，现有的指导中缺乏对计划和准备再次怀孕的具体讨论。目前，在理解产后丧亲支持应如何考虑糖尿病的背景下，并与支持准备随后的怀孕联系起来方面存在差距。目的：调查，使用定性方法，经验的角度来看，父母和卫生专业人员对准备怀孕后，生殖损失，在糖尿病的背景下。重点将是从失去婴儿后的产后检查到下一次怀孕的第一次产前预约之间的时期。研究方法：在理学硕士的基础上，博士研究将包括四个综合阶段：1）研究文献综述和出版的关于生育损失后怀孕期间护理的指导; 2）与卫生专业人员的半结构化访谈; 3）与糖尿病妇女及其伴侣的半结构化访谈，他们经历了生育损失并成功完成了另一次怀孕;（4）整合调查结果和制定建议。产出/影响：该研究将进一步发展社会科学对糖尿病背景下生殖损失的理解。与死产和新生儿死亡慈善机构Sands的合作将加强知识转移和研究结果的交流，以改善对妊娠期间或妊娠后不久失去婴儿的糖尿病妇女的支持。

Background: Women with diabetes have an increased risk of pregnancy ending in miscarriage, stillbirth or infant death, but risks can be reduced with careful pregnancy preparation. There has been a growing awareness and understanding of the bereavement process following reproductive loss, however, specific discussion of planning and preparing for another pregnancy is lacking in existing guidance. There is currently a gap in understanding of how postnatal bereavement support should consider the context of diabetes and link with support for preparation for a subsequent pregnancy. Aim: To investigate, using qualitative methods, experiential perspectives of parents and health professionals on preparing for pregnancy after reproductive loss, in the context of diabetes. The focus will be on the period between the postnatal review following the loss of a baby and the first antenatal appointment in the next pregnancy. Methods: Building on the MSc, the doctoral study will comprise four integrated phases: 1) literature review of research studies and published guidance on inter-pregnancy care after reproductive loss; 2) semi-structured interviews with health professionals; 3) semi-structured interviews with women with diabetes, and their partners, who have experienced reproductive loss and have successfully completed a further pregnancy; 4) Integration of findings and recommendation development. Outputs/Impact: The research will further develop social science understandings of reproductive loss in the context of diabetes. Collaboration with Sands, the stillbirth and neonatal death charity, will enhance knowledge transfer and communication of the findings, to improve support for women with diabetes who have lost a baby during or shortly after pregnancy.