Use of contraception by women with type 1 or type 2 diabetes mellitus: 'it's funny that nobody really spoke to me about it'

Abstract

Objectives: To understand factors which promote or discourage use of contraception in women with diabetes mellitus (DM). To identify contraceptive knowledge, skills and attitudes of health professionals involved in diabetes care.

Methods: The research formed part of a larger mixed methods study and included a questionnaire survey (107 women with DM) and semi-structured qualitative interviews with women with DM (n = 16) and diabetes specialists (n = 16). Analysis was by SPSS and NVivo 7.

Results: Two main themes emerged: Contraceptive provision and advice and Choice of contraceptive methods. There was incongruence in views between the diabetes specialists and women with DM in relation to advice and use of contraception. Many diabetes specialists felt unqualified to give advice and saw general practitioners as contraception providers. There was low use of long-acting reversible contraceptives, and women used 'natural' methods in their wish to 'avoid taking hormones or chemicals'.

Conclusions: Despite awareness of the need to plan pregnancies to avoid poor outcomes, women with DM are likely to receive little advice about their contraceptive options. Contraception should evidently be a legitimate part of diabetes care and diabetes specialists require training to enable them to assist women in making their own informed choices.