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Background Reproductive health (RH), family planning (FP), and managing a high-risk pregnancy should be prioritized in the rheumatology consultation to achieve shared and respectful decision-making [1]. Lack of knowledge of reproductive health and poor communication during the consultation may lead to increased pregnancy complications in patients with ARDs.
Objectives To describe and analyze patients’ experiences with ARDs on reproductive health issues at the clinic of pregnancy and reproductive health in rheumatic diseases (CEER) in Mexico.
Methods A descriptive qualitative study was conducted using semi-structured interviews following an interview guide. Women of childbearing age, suffering from ARD, with different socioeconomic, cultural, disability, and sexual diversity conditions were invited to participate. The face-to-face or virtual interviews were recorded and transcribed. A multidisciplinary team of researchers performed an independent and blinded thematic analysis.
Results Twenty-one patients participated. The age media was 28 years (yrs.), 38% were married, 28.5% were free union and 28.5% were single; 33.3% were pregnant, 38% were in the preconception stage with the desire of pregnancy and 28.5% women who have already had children. The main rheumatologic diagnoses were rheumatoid arthritis (47.6%), systemic lupus erythematosus (47.6%), and mixed connective tissue disease (4.7%).
Three main themes were identified: medications related to pregnancy and lactation, contraceptive methods, and pregnancy planning (Table 1).
Conclusion The experiences of patients with rheumatic diseases were diverse, and the amount of biomedical knowledge of RH issues was limited in FP, decision-making, and prenatal or postnatal care. The patients recognized the relevance of a multidisciplinary team led by their rheumatologist to generate confidence in the quality of information and allow better decision-making according to patients’ beliefs, preferences, and reproductive rights.
Reference [1] UN: United Nations Fund for Population Activities (UNFPA), Informe de la Conferencia Internacional sobre la Población el Desarrollo, El Cairo, 13 de septiembre de 1994, 1995, A/CONF.171/13/Rev.1, available at:
| Theme | Subtheme | Quote |
|---|---|---|
| Medications/ Breastfeeding | Medication | But I don’t know, uh, which medications to take, no“, “… the truth, and I don’t remember “. (27 yrs., AR, pregnant). |
| Breastfeeding | “I know that there is much more myth about (breastfeeding), … I feel that there is a lot of misinformation about it and that there are minimal medications that interfere with breastfeeding” (34 yrs., RA, pregnant). | |
| Contraceptive Methods | Contraception | “I’m not sure, and I don’t know which ones do interfere. I’ve never wondered if arthritis interferes with any method”(23 yrs., RA, pregnant). |
| Factors influencing choice | “My mom helped me to make the decision” “She told me,“If you want to use that one, that’s fine”(20 yrs., SLE, postpartum). | |
| Pregnancy planning | Planning | “Because first, you have to check that everything is okay in your health, they have to make sure that your disease is asleep, that nothing is altered, that everything is under control”(22 yrs., SLE/RA, reproductive age). |
| Heredability | “Well, there is a certain percentage, according to what the geneticist explained when I went to her office. Yes, I knew something about it because my mother has rheumatoid arthritis. …I don’t think it is a fact that I will pass it on to my baby”. (34 yrs., RA, pregnant). | |
| Accompaniment | “Well, that they have all the information about both arthritis and pregnancy because, for me at least, it gives me a lot of comfort to be in the clinic because I know that I have this communication…y then not being with one doctor and then with another and explaining to one what the other one told me. (23 yrs., RA, pregnant). |
All quotes were extracted from interviews conducted in Spanish. Quotes were further translated to English.
Acknowledgements: NIL.
Disclosure of Interests None Declared.
Keywords: Pregnancy and reproduction, Descriptive studies, Quality of life
DOI: 10.1136/annrheumdis-2023-eular.5207