ArticleHealth expectations : an international journal of public participation in health care and health policy2024
Lost in the System: Responsibilisation and Burden for Women With Multiple Long-Term Health Conditions During Pregnancy.
Article in Health expectations : an international journal of public participation in health care and health policy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The prevalence of mental health-related multimorbidity during pregnancy: a systematic review and meta-analysis.BMC public health · 2026Pooled it
- Maternity care bundle for UK women with multiple long-term health conditions: coproduction workshops.BMJ open · 2026Article
- 'It Was a Bit of a Now or Never Situation': Experiences of Preconception Care and Support for Women With Multiple Long-Term Health Conditions.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Clinical decision-making and care pathways for people with multiple long-term conditions admitted to hospital: a scoping review.BMJ open · 2025Article
- Prevalence and patterns of pre-existing multimorbidity in pregnancy in Northern Ireland: a population-based, retrospective study using linked routinely collected healthcare data.BMC pregnancy and childbirth · 2025Article
- Views of knowledge users on recurrent miscarriage services and supports in the Republic of Ireland: a qualitative interview study.BMJ open · 2025Article
- Recommendations for conducting qualitative research on multiple long-term conditions (MLTC) from a qualitative methods community of practice.Journal of multimorbidity and comorbidityArticle
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Authors and funding
9 authors.
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Abstract
introductionOver a fifth of pregnant women are living with multiple long-term health conditions, which is associated with increased risks of adverse outcomes for mothers and infants. While there are many examples of research exploring individuals' experiences and care pathways for pregnancy with a single health condition, evidence relating to multiple health conditions is limited. This study aimed to explore experiences and care of women with multiple long-term health conditions around the time of pregnancy.
methodsSemistructured interviews were conducted between March 2022 and May 2023 with women with multiple long-term health conditions who were at least 28 weeks pregnant or had had a baby in the last 2 years, and healthcare professionals with experience of caring for these women. Participants were recruited from across the United Kingdom. Data were analysed using thematic analysis.
resultsFifty-seven women and 51 healthcare professionals participated. Five themes were identified. Women with long-term health conditions and professionals recognised that it takes a team to avoid inconsistent care and communication, for example, medication management. Often, women were required to take a care navigation role to link up their healthcare providers. Women described mixed experiences regarding care for their multiple identities and the whole person. Postnatally, women and professionals recognised a downgrade in care, particularly for women's long-term health conditions. Some professionals detailed the importance of engaging with women's knowledge, and recognising their own professional boundaries of expertise. Many participants described difficulties in providing informational continuity and subsequent impacts on care. Specifically, the setup of care systems made it difficult for everyone to access necessary information, especially when care involved multiple sites.
conclusionPregnant women with long-term health conditions can experience a substantial burden of responsibility to maintain communication with their care team, often feeling vulnerable, patronised, and let down by a lack of acknowledgement of their expertise. These results will be used to inform the content of coproduction workshops aimed at developing a list of care recommendations for affected women. It will also inform future interventional studies aimed at improving outcomes for these women and their babies. PATIENT OR PUBLIC CONTRIBUTION: Our Patient and Public Involvement group were involved in the design of the study and the analysis and interpretation of the data, and a public study investigator was part of the author group.
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