Investigating Women’s Experiences of Asthma Care in Pregnancy: A Qualitative Study

Abstract

Background : Most asthmatic women have normal pregnancies and complications are infrequent when their asthma is well-controlled. Symptom control and medical treatment are concerning to pregnant asthma suffers, as is the impact that their illness and treatment might have on their unborn baby. The aim was to investigate in a qualitative study the thoughts and feelings of women’s experiences of asthma in pregnancy. Twenty-two women with asthma who had a pregnancy within two years were asked to participate. Seven women were interviewed when data saturation was achieved. Interviews were transcribed and analysed using the ‘Framework’ Method, independently analysed by two researchers and consensus reached concerning the construction of themes.The key themes that emerged were Asthma and pregnancy; Pregnancy and post-natal experiences; and Health professionals.These findings are globally interesting because of the prevalence of maternal asthma and they illustrate participants’ experiences concerning their asthma care and their views on its improvement. Pregnant asthmatic women have concerns about their care and treatment which might be alleviated by outreach, joint working between respiratory doctors and nurse specialists, midwives and General Practice nurses. Targeted educational activities could form a part of this care delivery.

Women’s experiences of personalised support for asthma care during pregnancy: A systematic review of the literature

“…The final papers included in the review consisted of two qualitative papers (see Table 3 ) that scored 90% [ 19 ] and 100% [ 14 ] respectively, and three quantitative papers (see Table 4 ) with scores ranging between 86 and 96%. The authors decided to include all papers scoring 60% or above, with only two papers in the initial assessment process not meeting this quality standard.…”

“…Lim et al [ 19 ] and Chamberlain et al [ 14 ] conducted interview-based qualitative research with purposive samples of women (23 and seven participants respectively). Chamberlain et al [ 14 ] interviewed women who had delivered their babies within two years of the interview, using ‘Framework Analysis’ to construct themes from the qualitative data they recorded.…”

“…There is a wealth of research about managing physiological aspects of asthma and pregnancy including pharmacological interventions [ 12 ], and non-pharmacological interventions including education, progressive muscle relaxation and Fraction of Exhaled Nitric Oxide have also been researched, although the evidence base needs larger, high quality trials before results can be described as definitive [ 13 ]. However, there is a paucity of research examining pregnant asthmatic women’s experiences of their care, or the influence that healthcare professionals such as nurses and midwives can make, despite evidence that women’s asthma care in pregnancy is variable [ 14 ]. In order to explore these issues, we conducted this systematic review, the aim of which is to answer the question ‘What are women’s experiences of asthma care, its management and education, during pregnancy?’…”

Managing asthma in pregnancy

“…A similar qualitative study was reported from the UK, in which seven women with asthma who had been pregnant within the previous 2 years were interviewed [ 33 ]. Four of these seven women reported a worsening of asthma symptoms during pregnancy, and these women expressed feelings of fear, panic and anxiety surrounding exacerbations, and a lack of understanding that some of their symptoms were due to asthma rather than the pregnancy itself.…”

“…The perception was that midwives did not know much about asthma and concentrated more on issues surrounding the pregnancy. In addition, two women described delays in obtaining care when they had exacerbations of asthma requiring admission to hospital [ 33 ]. More work is needed to clarify the priorities of pregnant women themselves with regard to their asthma management in pregnancy.…”