Appendix 5

Becoming pregnant: summaries of the pathways to pregnancy — Joy.

  • 1st Pregnancy: Planned. Attended pre-conception counseling beforehand. ‘… we'd made the decision that we were going to try for a baby and we actually sought advice from … my GP and they put me in contact with [doctor] at the hospital and [doctor] gave me quite a lot of information and we had a pre-conception meeting with her, and she explained to me all the possible problems that we could have because of my diabetes and that we could have with the baby. I found that quite off-putting actually, but we still made the decision to go ahead’. Started taking folic acid and stopped using contraception after pre-conception counseling. Pregnancy resulted in miscarriage, although diabetes was well controlled, ‘… but I was well controlled at the time as well, so I knew … although you still feel it's your fault … you know … I think every woman feels that. I knew it wasn't to do with having my diabetes badly controlled and it was my first pregnancy and it was one of those things …’. However the miscarriage was nevertheless difficult to remember and talk about, ‘To be honest, that's sort of a time that I've blocked out as much as I can because it just wasn't very nice and I can't remember a lot about it at all’.

    Outcome: Miscarriage

  • 2nd Pregnancy: Planned. Took folic acid and kept closer control of diabetes. Was very keen to have baby and tried to minimize risks as much as possible ‘We didn't really want to be childless so it's just a case of … You know what the risks are, so you try and prevent them as much as possible I suppose and that's what we did.’ ‘I needed to have a child and … you know … that's what we wanted’. Pregnancy went well with no complications, despite anxieties. ‘It was a really good pregnancy actually. I kept my diabetes well controlled throughout it and obviously because I'd been warned of the risk. I did feel really good throughout it but like I said, there was just that nagging feeling … you know … there in the back of my mind, you know, is this going to be alright, is that going to be alright? And pretty much up until the 20-week scan I didn't really relax until we'd gone through that process and I knew … that everything was Ok.’

    Outcome: Live birth

  • Pregnancy 3: Planned. Took folic acid prior to pregnancy and stopped using contraception. Insulin had just been changed prior to pregnancy and felt ill for many months, despite diabetes remaining well controlled ‘… this time up until probably a couple of weeks ago I felt really rough most of the way through.’ Decision was made to have another child in order to give current child a sibling. No complications so far.