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Abstract: TH-PO748

A Qualitative Study to Understand Contraceptive Use in Women With Kidney Disease

Session Information

Category: Women's Health and Kidney Diseases

  • 2100 Women's Health and Kidney Diseases

Authors

  • Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
  • Gudsoorkar, Priyanka, University of Cincinnati, Cincinnati, Ohio, United States
  • Vyas, Prema D., Texas Christian University, Fort Worth, Texas, United States
  • Pensak, Meredith J., University of Cincinnati, Cincinnati, Ohio, United States
Background

Pregnancy in women with kidney disease is not uncommon and is associated with adverse maternal and fetal outcomes. The use of contraception in women with kidney disease remains low. Little is known about patients’ experiences regarding contraceptive use with kidney disease.

Methods

The qualitative approach included five focus group discussions (n=13) among women of reproductive age between 18-44 years from a large academic center with a history of kidney disease. Participants shared their experiences and perceptions of contraceptive use, including barriers and facilitators. Interviews were audio-recorded, transcribed, analyzed by two independent reviewers, and coded using a thematic analysis approach.

Results

Five major themes emerged in the analyses emerged. ‘Knowledge gap’ reflected variability ranging from low to considerable understanding regarding reproductive health including knowledge about impaired fertility with kidney disease, use of teratogenic medications that may lead to birth defects, and risk of adverse pregnancy outcomes. ‘Lack of counseling’ was attributed to time constraints and inadequate counseling by physicians regarding contraceptive use. Women stressed the importance of needing to advocate for one’s own reproductive health, and family and spousal support. ‘Lack of interdisciplinary approach’ involved a lack of coordination of care between nephrologists and gynecologists regarding contraceptive use. Interestingly, a few transplant recipients were better informed about contraceptive use due to follow-up by multidisciplinary transplant teams. ‘Insufficient educational resources' referred to the unavailability of educational materials to guide contraception discussion, resulting in a lack of trust in the medical system, and an increase in the utilization of the internet for health information. The final theme, ‘need for research’ highlighted that not enough importance is placed on family planning. Women expressed the fear of unintended pregnancy and frequent decisional conflicts between their own and their baby’s health.

Conclusion

Participants with kidney disease reported emotional challenges with reproductive health care and a lack of counseling for contraceptive use. A critical need exists to bridge the knowledge gap for women with kidney disease and the interdisciplinary care approach.

Funding

  • Other NIH Support