Vanessa Pinfold, Ceri Dare, Sarah Hamilton, Harminder Kaur, Ruth Lambley, Vicky Nicholls, Irene Petersen, Paulina Szymczynska, Charlotte Walker and Fiona Stevenson
The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.
Abstract
Purpose
The purpose of this paper is to understand how women with a diagnosis of schizophrenia or bipolar disorder approach medication decision making in pregnancy.
Design/methodology/approach
The study was co-produced by university academics and charity-based researchers. Semi-structured interviews were conducted by three peer researchers who have used anti-psychotic medication and were of child bearing age. Participants were women with children under five, who had taken anti-psychotic medication in the 12 months before pregnancy. In total, 12 women were recruited through social media and snowball techniques. Data were analyzed following a three-stage process.
Findings
The accounts highlighted decisional uncertainty, with medication decisions situated among multiple sources of influence from self and others. Women retained strong feelings of personal ownership for their decisions, whilst also seeking out clinical opinion and accepting they had constrained choices. Two styles of decision making emerged: shared and independent. Shared decision making involved open discussion, active permission seeking, negotiation and coercion. Independent women-led decision making was not always congruent with medical opinion, increasing pressure on women and impacting pregnancy experiences. A common sense self-regulation model explaining management of health threats resonated with women’s accounts.
Practical implications
Women should be helped to manage decisional conflict and the emotional impact of decision making including long term feelings of guilt. Women experienced interactions with clinicians as lacking opportunities for enhanced support except in specialist perinatal services. This is an area that should be considered in staff training, supervision, appraisal and organization review.
Originality/value
This paper uses data collected in a co-produced research study including peer researchers.
Details
Keywords
IN order to be able to discriminate with certainty between butter and such margarine as is sold in England, it is necessary to carry out two or three elaborate and delicate…
Abstract
IN order to be able to discriminate with certainty between butter and such margarine as is sold in England, it is necessary to carry out two or three elaborate and delicate chemical processes. But there has always been a craving by the public for some simple method of determining the genuineness of butter by means of which the necessary trouble could be dispensed with. It has been suggested that such easy detection would be possible if all margarine bought and sold in England were to be manufactured with some distinctive colouring added—light‐blue, for instance—or were to contain a small amount of phenolphthalein, so that the addition of a drop of a solution of caustic potash to a suspected sample would cause it to become pink if it were margarine, while nothing would occur if it were genuine butter. These methods, which have been put forward seriously, will be found on consideration to be unnecessary, and, indeed, absurd.