EXPloring attitudes and factors influencing reproductive Choices in renal Transplant patients (EXPeCT-study)
M.C. van Buren, D.K. Beck, P. de Haan, J. van de Wetering, E.K. Massey
Chair(s): M.J. Wessels & J.M. Wierdsma
Thursday 9 march 2017
9:12 - 9:24h
at Willem Pijperzaal
Categories: Parallel - Verpleegkundig
Parallel session: Parallelsessie X – Verpleegkundig
The number of renal transplantations (RTX) among young women is increasing. Therefore the number of women who have the desire to have children after transplantation is also rising, despite the possible complications for both mother and child. While most literature focuses on the medical outcomes of pregnancy after transplantation, this qualitative study aims to explore the motives for pregnancy after transplantation and the psychosocial and medical factors considered. Furthermore, we explored the experience of being pregnant and raising children after RTX.
Women who were transplanted between 2008-2013 and became pregnant after transplantation were eligible for inclusion. These women were matched with women who had not been pregnant but were the same age (± 5 yrs) and transplanted at the same time (± 2 yrs). Semi-structured interviews were conducted and transcribed ad verbatim. Directed content analysis was carried out to identify general themes .
Between 01-01-2008 and 31-12-2013, 137 women £ 45 yrs were transplanted in our center. We invited 37 women, of which 20 women were willing to participate in the interviews. Preliminary analysis identified the following themes: physical loss; concerns about being able to take care of a child because of tiredness after RTX, but also loss of a child. Guilt was mentioned for different reasons, towards nephrologists for wanting to risk their renal transplant for a pregnancy, but also towards their children who will grow up with a sick mother. Calculating risks and trying to lower them was important because they want to stay in control. Information about pregnancy and RTX was minimal if women did not initiate a discussion with their nephrologist. Trust in their body to become pregnant was mentioned, and the difficulty discussing their desire to have children. One was dissuaded not to get pregnant by their nephrologist and did not dare to talk about it ever again. Two factors were identified as being crucial in the decision whether or not to become pregnant: the guidance/advice they received from the professional and the support from their social network.
Conclusion:
Preliminary results show that discussing with the doctor the wish to conceive is of great importance and should be handled with care. Young women after transplantation with or without a desire to have children find it difficult to talk about this with their nephrologist. Because this threshold can be high for these women we suggest that the nephrologist or nurse practitioner pro-actively discusses this issue with every women in the child-bearing age to afford effective education and guidance.
