Study suggests couples need better antenatal care following fertility treatment

Couples who have
successfully conceived following fertility treatment need additional antenatal
care and support, new research from the University of Bristol has found. Two
per cent of all births in the UK are a result of fertility treatments such as
IVF and an increasing body of evidence suggests the needs of these parents are
often not adequately addressed, leaving them feeling abandoned in some cases. 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 on 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
Centrefor 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.