In the first study of its kind, Dr Lydia French and colleagues from the University of Bristol interviewed women and their partners to find out about their experiences of antenatal care following successful fertility treatment.
Research, published today [1 September] in the British Journal of General Practice, indicates that early pregnancy is a particularly anxious time for these couples because of the possibility of pregnancy loss, and because they struggle to adjust and plan for parenthood.
Couples reported gaps in their care, in terms of the time gap between being discharged from secondary care and being seen in primary care, and in terms of the difference between the intense monitoring they had received in the fertility clinic and the regular, but less frequent care they received from their practice midwife.
Women also reported that they experienced difficulties in articulating their feelings of low mood to both peers and practitioners, and felt unable to complain because they thought they should be ‘grateful’ for being pregnant.
Dr Lydia French, from the Centre for Academic Primary Care at the University of Bristol, led the research. She said: “These are important messages for general practice and the antenatal care of women who have conceived after infertility treatment.
“The combination of early pregnancy, few pregnancy symptoms, anxiety over possible loss of the pregnancy, and women’s lack of trust in their body to maintain the pregnancy, in some cases, had led to couples presenting at early pregnancy clinics, accident and emergency centres, or paying for private scans.
“It was also evident that both men and women found it difficult to prepare for childbirth and parenthood because they feared losing the pregnancy. This, combined with feeling different to the normal birth population, made some couples reluctant to join antenatal classes.”
The study concluded that the needs of couples who conceive through fertility treatment are not addressed at a policy level.
It highlighted the need for GPs and midwives to be aware of couples’ previous infertility history and suggests they should receive their first standard antenatal appointment soon after being discharged from the fertility clinic.
This research also recommends that healthcare practitioners should encourage couples who have conceived through fertility treatment to attend antenatal classes, and to talk about their experiences in order to let go of their previous infertility status and focus on becoming parents.
Findings regarding couples’ tendency to silence negative or ambivalent feelings in pregnancy should also be a concern for health practitioners.
The research was funded by the South West GP Trust.
‘Antenatal needs of couples following fertility treatment: a qualitative study in primary care’ by Lydia RM French, Debbie J Sharp and Katrina M Turner in British Journal of General Practice.
About the study
Researchers interviewed 20 participants (12 females and eight male partners), aged between 35 and 39, from three fertility clinics in the south of England when their pregnancy had reached 28 weeks’ gestation. It was their first pregnancy.