Appendix 4

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

  • 1st Pregnancy: Was using contraceptive pill. ‘… the first pregnancy I'd only been with my husband about 6 weeks so that was a bit of a shock’. Miscarried at 14/15 weeks.

    Outcome: Miscarriage

  • 2nd Pregnancy: Spoke to practice nurse about possibility of further pregnancy as wanted to be pregnant again ‘… they didn't know what caused the miscarriage and everything, they just said I'd got to keep an eye on my blood sugars and that was basically the only advice I got.’ Stopped contraceptive pill, started taking folic acid.

    Outcome: Miscarriage

  • 3rd Pregnancy: Same actions as before. Checking blood sugars 10 times a day.

    Outcome: Miscarriage

  • 4th Pregnancy: Wanted to become pregnant, feared miscarriage after last three, ‘… we were just told there was no reason other than the diabetes that we'd lost the other three. After they'd done all the blood tests and everything else they said the only reason they could come up with was the fact that my blood sugars weren't controlled enough.’ Received advice from diabetes consultant about controlling blood sugars. No complications.

    Outcome: Live birth

  • 5th Pregnancy: Had been back on contraceptive pill, but came off to try for baby, still taking folic acid. Complications during pregnancy (ketones in urine, oedema). Induced at 37 weeks due to size of fetus, emergency caesarean due to decreased movement of baby.

    Outcome: Live birth

  • 6th Pregnancy: Was taking contraceptive pill, pregnancy discovered by GP when consulting about a different problem. ‘… and she [GP] said ‘well we'll just check your dip stick and all the rest of it and I'll just do a pregnancy test while you're here’ and I thought ‘what do I need one of them for I'm on the pill?’ She went ‘you do know you're pregnant don't you?’ and I just went ‘no, no, no’. Has adjusted insulin and taking iron for anaemia. No complications so far, but wishes to avoid caesarean at all costs, ‘I shall do everything I can to avoid the section’.