Exploring the perception of women with epilepsy about pregnancy concerns: a qualitative study

Abstract

Background and aimEpilepsy is a common neurological disorder in pregnancy, which is associated with increased maternal and fetal adverse outcomes. This study aimed to explore the reproductive healthcare needs of women with epilepsy before, during and after childbirth.MethodsThis was a qualitative study using a content analysis method. The study population was marital women with epilepsy in reproductive age (15–45 years) referred to Imam Hossein Hospital, Tehran, Iran. Participants were 16 women chosen using purposive sampling with the consideration of maximum variation in sampling. Semi-structured interviews were held with the participants until data saturation was reached. The data were analyzed using the content analysis method. The MAXQDA software, version 2010, was used for the management of data.ResultsThe data analysis led to the development of two categories. The first one is named ‘resilience against threats to safe pregnancy’ and has the following subcategories: (1) real physical complications and perceived (mental) conditions due to unwanted pregnancies, (2) the predisposing factors of anxiety related to safe pregnancy, (3) perceived consequences of pregnancy’, and (4) the approach to encounter perceived consequences of pregnancy. The second category is called ‘adverse experiences under inefficient supportive systems’ and has the following subcategories: (1) the insufficiency of reproductive healthcare services for women with epilepsy, (2) doubt about the advantages and disadvantages of breastfeeding, (3) stigma as a block to the treatment of the postpartum depression, and (4) playing the motherhood role under the shadow of self-esteem to lack of self-esteem.ConclusionIn the prenatal, natal and postnatal duration, because of supportive system disruption and not receiving proper consultation, participants were often worried about not being able to get favorable conditions for safe pregnancy and controlling process of their pregnancy. Therefore, they often experienced unwanted pregnancy. They were also concerned about the adverse fetal outcomes. In postpartum period, they often experienced postpartum depression and were very doubtful about breastfeeding.

Motherhood Experiences of Women With Multiple Sclerosis: A Thematic Meta-Synthesis

“…One of the important findings of our review was that none of the women received support from healthcare professionals on how to provide care for the baby and that they were left alone. In the literature, it was determined that mothers with chronic diseases (Epilepsy, Crohn’s disease, inflammatory bowel disease) similarly felt unprepared for and uninformed about the postpartum period, had poor communication with healthcare professionals, did not receive enough support, and experienced a sense of abandonment during this period (Atarodi-Kashani et al, 2018; Hansen et al, 2022; Julsgaard et al, 2014; Kimura & Ohmori, 2015; Weckesser & Denny, 2013). These findings clearly demonstrate how important postpartum support is for women with chronic diseases such as MS. Healthcare professionals should organize home visits in the postpartum period, individualized care should be planned for the mother and baby and counseling should be given, considering the disability of women with MS.…”

Knowledge, Risk Perception, and Reproductive Decision Making among Women with Epilepsy

“…A qualitative study from Iran have suggested that WwE were doubtful about breastfeeding the child after being educated and their concerns were exacerbated by the physician's inconsistent perspective about breastfeeding. 19 Nine participants (33.3%) have expressed concern about having AEDs and dose adjustments of AEDs (11.1%) during pregnancy. A qualitative study from Norway has revealed that dose adjustments of AEDs were a major concern for the pregnant WWE.…”

“…20 A recent content analysis qualitative study from Iran has advised that drug dose alteration was the anxiety-provoking factor among WwE during pregnancy. 19 A Korean study with the inclusion of 186 WwE has stated that regardless of medical suggestion 58% of WwE were in view of terminating AEDs during an imminent pregnancy, and 25% of WwE were chosen to have fewer children due to their epilepsy. 21,22 Low level pregnancyrelated knowledge was connected with the choice to suspend the AEDs during a future pregnancy and an overstated insight of the children's risk for developing epilepsy was related to have fewer children.…”

Neurological disorders in pregnant women in low- and middle-income countries—Management gaps, impacts, and future prospects: A review perspective

“…32 Pregnant women with epilepsy are especially vulnerable, with one-quarter of women with epilepsy suffering from chronic postpartum depression. 33 The difficulties these women confront postpartum may correlate to a decline in mental health workers and neurologists. 34 According to research conducted by the World Health Organization (WHO), 35 epilepsy specialists provide individualized healthcare to individuals resident in 89% of HICs, as opposed to just 56% of LMICs.…”

“…32 Pregnant women with epilepsy are especially vulnerable, with one-quarter of women with epilepsy suffering from chronic postpartum depression. 33 The difficulties these women confront postpartum may correlate to a decline in mental health workers and neurologists. 34…”