Long-acting reversible contraception or ‘LARC’ describes contraceptive methods that you don’t need to use every day. This includes the copper intrauterine device (also known as the ‘coil’), progestogen-only intrauterine system (also known as the ‘hormonal coil’), progestogen-only injectable contraceptives (‘depo’) and subdermal implants (‘implant’). I recently mentioned another group conducting research on provision of long acting contraceptives. Looks like it’s a hot topic this year!
LARC is popular as it’s a highly effective method of preventing pregnancy. For some people it can be a positive option, but there are concerns that some may experience pressure to use LARC, or may find it difficult to get removed. Researchers from Lancaster University, working with the British Pregnancy Advice Service (BPAS), are studying LARC in the UK.
If you’ve been encouraged to use LARC, are over 13 and living in the UK, the researchers would love to talk to you!
For more information, please read the attached documents:
Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI
I took part in the Big Birthas Parenting Science Gang as a Parent Scientist. I helped to decide the research question, design the methods we would use, and undertake some of the analysis.
When the project ended, we Parent Scientists had the data and the findings, but needed to decide what to do with them. My day job is a doula and researcher, and I’m passionate about choices in birth for all, regardless of BMI. Some of the stories women had shared with us were heartbreaking; stories of choice and power taken away, and of upset and trauma as a result.
Some of the stories were also uplifting, when women took power back; asserting their rights to make choices and decisions about themselves, their bodies, and their babies. Women had shared so much, giving time and investing themselves by telling their stories. I want to make sure we do justice to that.
One way I can do that is to present our findings to a diverse range of audiences. In my day job, I frequently present research to conferences of academics, so I applied to the Medical Sociology Conference. Hosted by the British Sociological Association, it is a brilliant event which focuses not on what we do within health care, but how we do things, why we do things, and how we could do health care better.
My talk was accepted, in a format called Pecha Kucha. These presentations allow you to present 20 slides, and talk about each one for 20 seconds. It’s a challenging format because it makes you really focus on the key points you want to make. There is no room for waffle!
I wrote the both the initial application and the presentation collaboratively with Big Birthas and several of the other Parent Scientists, using the Facebook group to refine ideas and try things out, in the same way we had used it during the Parenting Science Gang project. It was lovely to have that very supportive and equal way of working. This is quite different from the creation of most other academic and medical presentations.
The high BMI ‘box’
I chose to focus on one of our findings, the idea of the ‘high BMI box’. Many women explained how, once in this category, BMI was the only thing anyone seemed interested in. They described having serious medical conditions ignored. One woman explained how the difference between her starting weight in her two pregnancies was objectively only 7 pounds, but in one this was ‘normal BMI’, while the other saw her put into the ‘high BMI box’. She eloquently described the differences this made to her care.
Programme excerpt about our research at the Medical Sociology Conference:
Big Birthas: unpacking ‘choice’ for pregnant women with a high-BMI
What does it mean to be labelled as having a high-BMI whilst pregnant? How does this label affect women’s experiences of navigating maternity services?
This presentation is based on a novel user-led Citizen Science collaboration between Big Birthas (peer information and support service) and Parenting Science Gang (Wellcome Trust funded user-led citizen science project).
The results described complex journeys, where interactions with healthcare professionals revolved around conversations of BMI-related risks to the exclusion of other factors, and ignored other events of the pregnancies.
Women also reported disrespectful and shaming language from healthcare professionals, and conflict if they asserted a decision that was not in line with the healthcare professional’s views.
This led some women to decline care that they actually wanted, or avoid attending appointments, to avoid conflict or denial of choice; a consequence which was particularly apparent when we examined how those women chose to approach their second pregnancies.
The presentation and our research at the Medical Sociology Conference was well received. Questions after the talk asked about both the Parenting Science Gang methodology, our methodology, and our findings. People spoke about how our research overlaps with work they are doing.
The Parenting Science Gang’s project is over, but the journey of the stories we collected is not. Next, I am hoping to work with some of the other Parent Scientists to turn our findings into a piece that can be published in a midwifery journal. Watch this space…
Dr Mari Greenfield
Academic researcher in maternity care, doula, birth activist. Special interests in traumatic birth and LGBTQ experiences.
Huge thanks to Mari for bringing our research to a wider audience, and for writing up the experience too!
Would you like to write a guest post for Big Birthas? Have you got experiences or a perspective that the Big Birthas audience might be interested in? Do you have a birth story you want to share? Please get in touch via the Contact Big Birtha page.
This aims to identify the most important questions for future pregnancy research in the UK. It is part of a wider study on pregnancy research funding. You can choose what matters most to you from the suggested research questions.
The aims of the study are to review current research funding in the UK and to identify pregnancy research needs, priorities and gaps which should be addressed in the future. The researchers have organised the questions into different areas (e.g. managing conditions such as gestational diabetes, mental health, etc). Every question is optional: if you do not want to give an answer, you can just skip the question.
Why are they seeking so many different people’s views?
The researchers particularly want to hear from women and their partners, from researchers already conducting pregnancy research, and from health care professionals working in maternity services. Collating all these views is important when it comes to defining future priorities; this survey hopes to identify the research questions that are most relevant to and might affect different groups of people.
How long will it take to complete the survey?
If you provide answers to all questions, it should take you about 15 minutes to complete.
Pregnancy is a time of information and advice overload. But is that information always delivered in the best and most helpful way? Are the messages consistent? Have you ever left a meeting with a health care professional feeling confused, or frustrated, or upset? Our voices and our experiences matter, so please, if you have a few minutes, follow the survey link and tell your story.
It’s great that we’re seeing so many researchers and surveys asking for our perspective lately; it’s the first step to making ourselves heard.
To take part, you need to be:
Living in the UK
Have been pregnant in the last 5 years (or are currently pregnant)
What The WRISK Project/Survey Hopes To Achieve
This survey hopes to learn more about women’s experiences of advice and information given before and during pregnancy. It’s open to anyone who has been pregnant in the last 5 years, irrespective of how that pregnancy ended.
Women who are planning a pregnancy or who are pregnant receive many public health messages that are intended to guide their decision making. For example, they receive advice about what to eat, drink, how much they should weigh, and what medications they should or shouldn’t take. These messages are intended to improve outcomes for babies and mothers.
However, there is growing concern that messages do not always fully reflect or explain the evidence base underpinning them, and that negotiating the risk landscape can sometimes feel confusing, overwhelming, and disempowering. This may negatively affect women’s experiences of pregnancy and motherhood, and be exacerbated by a wider culture of parenting that tends to blame mothers for all less-than-ideal outcomes in their children.
The survey is particularly keen to capture the experiences of women whose voices often go unheard; including BAME women, those receiving welfare benefits, and younger/older women.
The project will draw on your insights to understand and suggest improvements for the communication of risk messages in pregnancy.
Please share this survey amongst your networks and across all of your social media platforms. We want to reach as many people as possible!
Who Is/Are WRISK?
The WRISK Project is led by the British Pregnancy Advisory Service (BPAS), in conjunction with Cardiff University, funded by Wellcome. Membership of the project oversight group includes representation from many different organisations involved with pregnancy, which includes Big Birthas.