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The Fertility Management Experiences of Australian Women with a Non-communicable Chronic Disease: Findings from the Understanding Fertility Management in Contemporary Australia Survey

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Abstract

Introduction Despite the considerable and increasing proportion of women of reproductive age with a chronic non-communicable disease (NCD) and the potential adverse implications of many NCDs for childbearing, little is known about the fertility management experiences of women with an NCD, including their contraceptive use, pregnancy experiences and outcomes, and reproductive health care utilisation. The aim of this study was to investigate the fertility management experiences of women with an NCD and draw comparisons with women without an NCD. Method A sample of 18–50 year-old women (n = 1543) was randomly recruited from the Australian electoral roll in 2013. Of these women, 172 women reported a physical, chronic non-communicable disease: diabetes, arthritis, asthma, hypertension, heart disease, thyroid disorders, and cystic fibrosis. Respondents completed an anonymous, self-administered questionnaire. Factors associated with fertility management were identified in multivariable analyses. Results Women who reported having an NCD were significantly more likely than women who did not report an NCD to have ever been pregnant (75.9 vs. 67.5%, p = 0.034), have had an unintended pregnancy (33.47 vs. 25.5%, p = 0.026), and have had an abortion (20.3 vs. 14.2%, p = 0.044); they were less likely to consult a healthcare provider about fertility management (45.0 vs. 54.4%, p = 0.024). Similar proportions were using contraception (48.8 vs. 54.5%, p = 0.138). Conclusion The findings have implications for healthcare providers and women with an NCD and highlight the importance of addressing possible assumptions about the inability of women with an NCD to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care.

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References

  • Australian Bureau of Statistics. (2011a). 4820.0.55.001—Diabetes in Australia: A Snapshot, 2007–08. In ABS (Ed.). Canberra.

  • Australian Bureau of Statistics. (2011b). 4843.055.001- Arthritis and Osteoporosis in Australia: A Snapshot, 2007-08, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4843.0.55.0012007-08?OpenDocument.

  • Australian Bureau of Statistics. (2012). 1301.0—Year Book Australia, 2012 from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/1301.0~2012~Main%20Features~Health%20status~229.

  • Australian Bureau of Statistics. (2013a). 2011 Census, from http://www.censusdata.abs.gov.au/census_services/getproduct/census/2011/quickstat/2?opendocument&navpos=220.

  • Australian Bureau of Statistics. (2013b). 4364.0.55.002—Australian Health Survey: Health Service Usage and Health Related Actions, 2011–12 Retrieved September 2014, 2014, from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/E334D0A98272E4DCCA257B39000F2DCF?opendocument.

  • Australian Bureau of Statistics. (2014). Australia based data for Sex, Basic Community Profile Table B01, for 2011 Census, 2014, from http://stat.abs.gov.au/Index.aspx?DataSetCode=ABS_CENSUS2011_B06, http://stat.abs.gov.au/Index.aspx?DataSetCode=ABS_CENSUS2011_B01

  • Australian Bureau of Statistics. (2015). 4338.0—Profiles of Health, Australia, 2011–2013 Heart Disease, from http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4338.0~2011-13~Main%20Features~Heart%20disease~10005.

  • Australian Bureau of Statistics. (2016). Births, Australia, 2015 Retrieved 15 November 2016, from http://www.abs.gov.au/AUSSTATS/abs@.nsf/second+level+view?ReadForm&prodno=3301.0&viewtitle=Births,%20Australia~2015~Latest~08/11/2016&&tabname=Past%20Future%20Issuesprodno=3301.0&issue=2015&num=&view=&.

  • Australian Centre for Asthma Monitoring. (2007). Asthma in Australia: Findings from the 2004–2005 National Health Survey. Canberra: AIHW.

    Google Scholar 

  • Australian Institute of Health and Welfare. (2009). Chronic disease and participation in work. Canberra: AIHW.

    Google Scholar 

  • Australian Institute of Health and Welfare. (2010). Diabetes in pregnancy: its impact on Australian women and their babies. Diabetes series no. 14. Cat. no. CVD 52. Canberra: AIHW.

    Google Scholar 

  • Australian Institute of Health and Welfare. (2011). Chronic diseases Retrieved 21 March 2012, 2012, from http://www.aihw.gov.au/chronic-diseases/.

  • Avis, N. E., Crawford, S., & Manuel, J. (2004). Psychosocial problems among younger women with breast cancer. Psycho-oncology, 13(5), 295–308. https://doi.org/10.1002/pon.744.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2015). Contraception. How effective are birth control methods? Retrieved 11 September 2015, 2015, from http://www.cdc.gov/reproductivehealth/unintendedpregnancy/contraception.htm#.

  • Chor, J., Rankin, K., Harwood, B., & Handler, A. (2011). Unintended pregnancy and postpartum contraceptive use in women with and without chronic medical disease who experienced a live birth. Contraception, 84(1), 57–63. https://doi.org/10.1016/j.contraception.2010.11.018.

    Article  PubMed  Google Scholar 

  • Chuang, C. H., Velott, D. L., & Weisman, C. S. (2010). Exploring knowledge and attitudes related to pregnancy and preconception health in women with chronic medical conditions. Maternal and Child Health Journal, 14(5), 713–719.

    Article  PubMed  PubMed Central  Google Scholar 

  • Cottrell, D. (2015). Prevention and treatment of psychiatric disorders in children with chronic physical illness. Arch Dis Child, 100(4), 303–304.

    Article  PubMed  Google Scholar 

  • Crawshaw, M. A., & Sloper, P. (2010). ‘Swimming against the tide’—the influence of fertility matters on the transition to adulthood or survivorship following adolescent cancer. European Journal of Cancer Care, 19(5), 610–620. https://doi.org/10.1111/j.1365-2354.2009.01118.x.

    Article  CAS  PubMed  Google Scholar 

  • Cystic Fibrosis Australia. (2013). Cystic Fibrosis in Australia 2013: 16th Annual Report. Baulkham Hills, NSW: Australian Cystic Fibrosis Data Registry Unit.

  • Eisenberg, D., Stika, C., Desai, A., Baker, D., & Yost, K. (2010). Providing contraception for women taking potentially teratogenic medications: A survey of internal medicine physicians’ knowledge, attitudes and barriers. Journal of General Internal Medicine, 25(4), 291–297.

    Article  PubMed  PubMed Central  Google Scholar 

  • Elborn, J., Shale, D., & Britton, J. (1991). Cystic fibrosis: Current survival and population estimates to the year 2000. Thorax, 46, 881–885.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fair, A., Griffiths, K., & Osman, L. M. (2000). Attitudes to fertility issues among adults with cystic fibrosis in Scotland. Thorax, 55(8), 672–677. https://doi.org/10.1136/thorax.55.8.672.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fisher, K., & Charnock, D. (2003). Partnering and fertility patterns: analysis of the HILDA Survey, Wave 1. Paper presented at the HILDA Conference 2003, Melbourne, VIC.

  • Gray, M., Qu, L., & Weston, R. (2008). Fertility and family policy in Australia. In A. I. o. F. Studies (Ed.), Research Paper No. 41. Melbourne: Australian Institute of Family Studies.

    Google Scholar 

  • Greydanus, D., Pratt, H., & Patel, D. (2012). Concepts of contraception for adolescent and young adult women with chronic illness and disability. Disease-a-Month, 58(5), 258–320.

    Article  PubMed  Google Scholar 

  • Hämeen-Anttila, K., Kokki, E., Lupattelli, A., Nordeng, H., Jyrkkä, J., Vainio, K., et al. (2015). Factors associated with the need for information about medicines among pregnant women—A multinational internet-based survey. Research in Social and Administrative Pharmacy, 11(2), 297–302.

    Article  PubMed  Google Scholar 

  • Holing, E., Beyer, C., Brown, Z., & Connell, F. (1998). Why don’t women with diabetes plan their pregnancies? Diabetes Care, 21(6), 889–895.

    Article  CAS  PubMed  Google Scholar 

  • Holton, S., Fisher, J., & Rowe, H. (2011a). To Have or Not to Have? Australian Women’s Childbearing Desires, Expectations and Outcomes. Journal of Population Research, 28(4), 353–379.

    Article  Google Scholar 

  • Holton, S., Hammarberg, K., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., … Fisher, J. (2016a). Men’s fertility knowledge and childbearing attitudes, desires and outcomes: findings from the Understanding fertility management in contemporary Australia survey. International Journal of Men’s Health, 15(3), 215–228. https://doi.org/10.3149/jmh.1503.215.

    Google Scholar 

  • Holton, S., Kirkman, M., Rowe, H., & Fisher, J. (2012). The childbearing concerns and related information needs and preferences of women of reproductive age with a chronic non-communicable health condition: a systematic review. Women’s Health Issues, 22(6), e541–e552.

    Article  PubMed  Google Scholar 

  • Holton, S., Rowe, H., & Fisher, J. (2011b). Women’s health and their childbearing expectations and outcomes: a population-based survey from Victoria, Australia. Women’s Health Issues, 21(5), 366–373.

    Article  PubMed  Google Scholar 

  • Holton, S., Rowe, H., Kirkman, M., Jordan, L., McNamee, K., Bayly, C., … Fisher, J. (2016b). Long-acting reversible contraception: Findings from the Understanding Fertility Management in Contemporary Australia survey. The European Journal of Contraception & Reproductive Health Care, 21, 116–131. https://doi.org/10.3109/13625187.2015.1052394.

    Google Scholar 

  • Janevic, M., Rosland, A., Wiitala, W., Connell, C., & Piette, J. (2012). Providing support to relatives and friends managing both chronic physical illness and depression: The views of a national sample of U.S. adults. Patient Education and Counseling, 89(1), 191–198.

    Article  PubMed  PubMed Central  Google Scholar 

  • Johannesson, M., Carlson, M., Brucefors, A. B., & Hjelte, L. (1998). Cystic fibrosis through a female perspective: Psychosocial issues and information concerning puberty and motherhood. Patient Education and Counseling, 34(2), 115–123.

    Article  CAS  PubMed  Google Scholar 

  • Katz, P. P. (2006). Childbearing decisions and family size among women with rheumatoid arthritis. Arthritis Care and Research, 55(2), 217–223.

    Article  PubMed  Google Scholar 

  • National Heart Foundation of Australia. (2012). High Blood Pressure Statistics: Fact sheet.

  • Neuman, G. (2014). Counselling a patient with chronic illness before pregnancy. Journal of Population Therapeutics and Clinical Pharmacology, 21(3), e520–e525.

    PubMed  Google Scholar 

  • Peate, M., Meiser, B., Friedlander, M., Zorbas, H., Rovelli, S., Sansom-Daly, U.,.. . Hickey, M. (2011). It’s now or never: fertility-related knowledge, decision-making preferences, and treatment intentions in young women with breast cancer-An Australian Fertility Decision Aid Collaborative Group Study. Journal of Clinical Oncology. https://doi.org/10.1200/JCO.2010.31.2462.

    PubMed  Google Scholar 

  • Roos, N., Kieler, H., Sahlin, L., Ekman-Ordeberg, G., Falconer, H., & Stephansson, O. (2011). Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. BMJ 343, d6309.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rowe, H., Holton, S., Kirkman, M., Bayly, C., Jordan, L., McNamee, K., … Fisher, J. (2016). Prevalence and distribution of unintended pregnancy: The Understanding Fertility Management in Australia National Survey. Australian and New Zealand Journal of Public Health, 40(2), 104–109. https://doi.org/10.1111/1753-6405.12461.

    Article  PubMed  Google Scholar 

  • Sawyer, S. M., Phelan, P. D., & Bowes, G. (1995). Reproductive health in young women with cystic fibrosis: Knowledge, behavior and attitudes. Journal of Adolescent Health, 17(1), 46–50.

    Article  CAS  PubMed  Google Scholar 

  • Thewes, B., Meiser, B., Rickard, J., & Friedlander, M. (2003). The fertility- and menopause-related information needs of younger women with a diagnosis of breast cancer: A qualitative study. Psycho-oncology, 12(5), 500–511.

    Article  PubMed  Google Scholar 

  • Veevers, J. (1973). The social meanings of parenthood. Psychiatry Research, 36(3), 291–310.

    CAS  Google Scholar 

  • Walkom, E., Loxton, D., & Robertson, J. (2013). Costs of medicines and health care: A concern for Australian women across the ages. BMC Health Services Research, 13(1).

  • Weston, R., Qu, L., Parker, R., & Alexander, M. (2004). ‘It’s not for lack of wanting kidsA report on the Fertility Decision Making Project. Melbourne: Australian Institute of Family Studies.

    Google Scholar 

  • Woollett, A. (1991). Having Children. In A. Phoenix & A. Woollett (Eds.), Motherhood: Meanings, practices and ideologies (pp. 47–65). Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Woollett, A., & Marshall, H. (2000). Motherhood and Mothering. In J. Ussher (Ed.), Women’s health (pp. 312–319). Leicester: Brit Psych Soc.

    Google Scholar 

  • World Health Organization. (2002). Innovative Care for Chronic Conditions: Building Blocks for Action. Retrieved from http://www.improvingchroniccare.org/downloads/who_innovative_care_for_chronic_conditions.pdf.

  • Zanagnolo, V., Sartori, E., Trussardi, E., Pasinetti, B., & Maggino, T. (2005). Preservation of ovarian function, reproductive ability and emotional attitudes in patients with malignant ovarian tumors. European Journal of Obstetrics & Gynecology and Reproductive Biology, 123(2), 235–243.

    Article  Google Scholar 

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Acknowledgements

The researchers are grateful to Dr Karen Wynter for assistance with data management and Dr Thach Tran for statistical advice, and thank all respondents for their generous participation.

Funding

This research was supported by an Australian Research Council Linkage Project Grant (LP100200432) with funding and in-kind contributions from Family Planning Victoria, Melbourne IVF, The Royal Women’s Hospital, and the Victorian Department of Health and Human Services. JF is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship.

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Correspondence to Sara Holton.

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Holton, S., Thananjeyan, A., Rowe, H. et al. The Fertility Management Experiences of Australian Women with a Non-communicable Chronic Disease: Findings from the Understanding Fertility Management in Contemporary Australia Survey. Matern Child Health J 22, 830–840 (2018). https://doi.org/10.1007/s10995-018-2454-9

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