Abstract
Background
Medicine use during pregnancy is becoming increasingly common, both internationally and in Aotearoa New Zealand. The term “medicine” has been used broadly in this study to include prescription and over-the-counter medicines; complementary and alternative medicines, including herbal and traditional medicines such as rongoā rākau (Māori herbal medicine); vitamin and mineral supplements; and vaccines. As pregnant women are regularly excluded from clinical trials, there are substantial knowledge gaps surrounding medicine safety and dosage in pregnancy. To support women in making informed decisions about medicine use during pregnancy, it is important to have a good understanding of their views, experiences, decision-making behaviours, and medicine information-sharing preferences. However, few qualitative studies have explored these issues in Aotearoa New Zealand, and most of the existing literature focuses on vaccines.
Aims
1. To explore the views and experiences of women in Aotearoa New Zealand regarding the use and safety of medicines during pregnancy, including the factors that influence their decision-making.
2. To explore what information women in Aotearoa New Zealand would like to have available to support them in making informed decisions about using medicines during pregnancy, and their preferences for how they receive that information.
Methods
An exploratory-descriptive qualitative approach was chosen to explore the study’s aims. Women living in the Otago region who had recently had a live birth were recruited using purposive and snowball sampling techniques. Efforts were made to recruit equal numbers of Māori, Pasifika, and non-Māori non-Pasifika participants to achieve a diverse participant sample. The data collection methods were semi-structured individual interviews and one focus group session. These were audio-recorded and transcribed verbatim by a professional transcription service. The Framework Method was used to guide the thematic analysis of the data and generate the final themes and subthemes.
Results
A total of 19 participants were recruited for the study; 13 participated in a semi-structured individual interview, and six participated in a focus group. A total of six themes and 16 subthemes were identified regarding women’s views and experiences of medicine use during pregnancy and the factors that influenced their decision-making. The six themes were:
pregnancy is a journey, uncertainty, trust, respect, options, and information.
Irrespective of medicine type, participants wanted to be well-informed about the potential harms and benefits of a medicine and be actively involved in treatment decisions. This was helped by having trusting, respectful relationships with healthcare professionals and being given treatment options. However, informed decision-making was hindered by receiving misinformation and insufficient, conflicting, or overwhelming amounts of information.
Conclusions
This research offers important insights into the views, experiences, and information-sharing preferences of women in Aotearoa New Zealand regarding medicine use during pregnancy. The study findings highlight the need for increased access to consistent, trustworthy, evidence-based information about medicine use during pregnancy. Furthermore, the findings identify important areas for improving medicine information-sharing and service delivery, including upholding Te Tiriti o Waitangi obligations, ensuring that the midwifery workforce is adequately trained to inform and support pregnant women regarding medicine use during pregnancy, increasing the number of Māori and Pasifika midwives, creating a centralised information source for pregnant women, and facilitating the sharing of medicine information in community settings.