Operationalizing and Examining Family Planning Vigilance in Adult Women With Type 1 Diabetes

Abstract

OBJECTIVEBecause unplanned pregnancies could cause maternal-fetal complications for women with diabetes, family planning vigilance (FPV) is imperative. The aims of this article are to operationalize and describe FPV and examine the associations among FPV behaviors and diabetes self-care management (DSM) and health outcomes of women with type 1 diabetes (T1D).RESEARCH DESIGN AND METHODSRetrospective data were used from a follow-up study of adult women with T1D who participated as adolescents in a preconception counseling (PC) intervention trial and matched comparison women with T1D who did not receive the adolescent PC intervention. Participants completed online questionnaires regarding family planning behaviors, DSM, and clinical and reproductive health outcomes.RESULTSParticipants (N = 102) were, on average, 23.7 years old (range 18–38) and 98.0% were white, 82.2% had some college, 25.8% were married, and 11.8% had biological children. Of those sexually active (n = 80, 78.4%), 50% were contraceptive vigilant and 11% were FPV (i.e., being contraceptive vigilant, receiving PC, and initiating discussions with health care professionals). Among FPV behaviors, only receiving PC and initiating discussion with health care professionals were correlated (r = 0.29, P = 0.010). Compared with nonvigilant women, contraceptive vigilant and FPV women used more effective contraceptive methods (P = 0.025) and experienced less diabetic ketoacidosis (P = 0.040) and hospitalizations (P = 0.064), whereas FPV women were aware of PC (P = 0.046) and younger when they received PC (P < 0.001). FPV components were associated with DSM and health outcomes (P < 0.05).CONCLUSIONSWomen with diabetes should be FPV, but few were. FPV women were more likely to have PC earlier and better health outcomes, supporting early PC intervention.

Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association

“…Living with and self-managing diabetes can be expected to impact all life-course decisions for PWD and their partners. PWD may question whether intimate partnering and biological parenthood are viable in the context of their health status (108). High-quality relationships with and diabetes management support from intimate partners improve diabetes-specific and general quality of life, self-management behaviors, and metabolic outcomes (7).…”

Reducing Risk for Gestational Diabetes Mellitus (GDM) Through a Preconception Counseling Program for American Indian/Alaska Native Girls: Perceptions From Women With Type 2 Diabetes or a History of GDM

“…18-20 Findings from the randomized controlled trial testing READY-Girls suggest those women who received PC at an early age were more vigilant with family planning. 21 Soliciting support from mothers to assist in delivering accurate information regarding reproductive health to their daughters was also identified as being beneficial. 22 Researchers Charron-Prochownik and Moore have assembled a new team to develop and test a culturally appropriate PC theory-based intervention entitled Stopping GDM, by adapting the original READY-Girls program, to be completed during a 5-year period.…”

Ten Years of Experience in Contraception Options for Teenagers in a Family Planning Center in Thrace and Review of the Literature

“…Diabetics have a greater risk of complications in pregnancy as well as congenital disorders which makes it almost essential to seek pregnancy after restoring to normal glucose levels [ 45 , 46 ]. According to a recent Cochrane review comparing between hormonal and non-contraceptive diabetic women, only three studies related to this subject [ 47 , 48 , 49 ].…”