258250 Reproductive decision making in women with epilepsy: A qualitative investigation

Tuesday, October 30, 2012 : 8:50 AM - 9:10 AM

Amanda Dennis, DrPH, MBE , Ibis Reproductive Health, Cambridge, MA
Background: Epilepsy, a chronic disorder characterized by seizure occurrence, affects approximately one million women in the US. Though most pregnancies for women with epilepsy are uneventful, medications used to prevent seizures can increase the risk of fetal malformations and changes brought about by pregnancy, birth, and parenthood can affect the frequency of seizures.

Purpose: To explore how women with epilepsy make decisions about when, if, and how to become mothers.

Methods: In-depth telephone interviews were conducted with 30 women with epilepsy. Interviews were recorded, transcribed verbatim, and coded in ATLAS.ti.

Results: The two primary factors women reported considering when making reproductive decisions were the potential for their medications to impact pregnancy outcomes and the potential for pregnancy and child rearing to impact seizure occurrence. Balancing these concerns was difficult for many women and exacerbated by stigmatization of reproduction among people with epilepsy, segregation of ob/gyn and neurological care, and social pressures to be ‘perfect' mothers, which women often felt unable to be. However, support from partners and other women with epilepsy helped women feel confident in making preferred reproductive decisions. Additionally, healthcare providers emerged as important resources for providing balanced information about pregnancy-related risks, which made many women feel optimistic about the outcomes of their reproductive decisions.

Conclusion: The challenges women with epilepsy encounter when balancing neurological and reproductive concerns can be mitigated by support from peers, partners, and healthcare providers. These findings highlight opportunities for meeting the reproductive decision making needs of women with epilepsy and other chronic conditions.

Learning Areas:
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) By the end of the session, participants will be able to discuss the epilepsy-specific factors that women with epilepsy weigh when making decisions about when, if, and how to become mothers. 2) By the end of the session, participants will be able to identify what factors facilitate and impede informed reproductive decision making for women with epilepsy.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the principal investigator of the study and have been the principal or co-principal investigator on multiple studies focused on women's reproductive health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.