Providing effective maternity care for women affected by fibromyalgia

Abstract

Fibromyalgia is a condition for which information is not readily accessible in midwifery or obstetric text books. This 'invisible disability' can have detrimental implications for all aspects of maternity care. From the physiology and psychology of fibromyalgia during the antenatal through to the postnatal period, this article highlights key issues which can have a hidden but significant impact on the maternity experience of w om en w ith fibro these issues and suggests ways in which midwives can improve the quality of the care given to women affected with this condition. Key points• Fibromyalgia is a physiological and psychosocial affective condition • Facilitating informed decision making for women with cognitive • dysfuntion is an ongoing challenge • Midwives caring for women with fibromyalgia should remember that these women requires a multi-dimensional intraprofessional approach to improve their experiences of maternity care. IntroductionFibromyalgia is a non-inflammatory rheumatologic disorder characterized by chronic widespread musculoskeletal pain, fatigue, depression, cognitive dysfunction and non-restorative sleep (Starlanyl and Copeland, 2001). Rheumatologic disorders include clinical problems which involve joints, soft tissues and allied conditions of connective tissues. Fibromyalgia is thought to amplify pain causing the body to exaggerate light, vibration, smells and to interpret these sensations anywhere along the spectrum from discomfort to unbearable pain ( Table 1). As with rheumatoid arthritis and systemic lupus erythematosus, fibromyalgia is classed as a syndrome rather than a disease.The World Health Organization (2008) estimated the prevalence of fibromyalgia to be between 3-6% of the world's population, while Arthritis Care UK (2010) stated that fibromyalgia will affect 1 in 50 people at some point in their lives, although it is most likely to occur during the ages of 25-55 years and affects Denyse King Lecturer in Midwifery dking@ bournemouth.ac.uk