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Identification and management of eating disorders in pregnancy: a multi-method study of maternity and health visiting services

Bye, Amanda Margaret; (2020) Identification and management of eating disorders in pregnancy: a multi-method study of maternity and health visiting services. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Pregnant women with current and past eating disorders (ED) have heightened risk of adverse maternal and infant outcomes, so it is imperative women are identified and receive enhanced care during and after pregnancy to promote optimal outcomes. However, following recent changes to the classification of ED, it is unclear how many pregnant women have had ED and research is needed to understand the barriers to their care in maternity and health visiting services. A multi-method approach, comprising of four studies, was employed to: (1) investigate the prevalence of ED in pregnant women; and (2) explore the barriers to care from the perspectives of women, midwives and health visitors. Study one found the prevalence of ED before and during pregnancy were 8.8% and 6.7%, respectively, using a self-report questionnaire in 1,022 pregnant women. Study two estimated population prevalence for lifetime and current ED of 15.3% (95% CI, 11.80-19.71%) and 1.4% (95% CI, 0.64-3.35%), respectively, using diagnostic interviews in 543 pregnant women. Study three, which collated survey data from 103 pregnant and postnatal women, found disclosure of ED was low due to perceptions of poor awareness, stigma, lack of continuity in carer and limited capacity in maternity services. Study four, using a two-phased design with questionnaires (N = 265) and focus groups (N = 33) in midwives and health visitors, found the main barriers to identifying and caring for women with ED were insufficient training and related practice. The findings indicate a significant proportion of pregnant women will have had ED, yet women will often be poorly identified and receive inadequate care in maternity and health visiting services. Future research should aim to develop strategies that address the barriers identified in this research to improve care for pregnant and postnatal women with ED to promote optimal outcomes for mother and child.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Identification and management of eating disorders in pregnancy: a multi-method study of maternity and health visiting services
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2020. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
URI: https://discovery.ucl.ac.uk/id/eprint/10103275
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