Adults With Congenital Heart Disease And Family Planning Decisions
Osteen, Kathryn A.
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Adults with CHD are living longer into adulthood than ever before, which increases the possibility of childbearing. Researchers have focused on the physiology and risks associated with contraception and pregnancy, but miss the personal stories surrounding these decisions. The adult with CHD has concerns about contraception, pregnancy, childbirth, and passing CHD on to offspring. The purpose of this qualitative narrative study is to describe the personal stories of adults with CHD and their family planning decisions.Narrative inquiry, guided by the Roy adaptation model, was chosen for this study because it is appropriate to describe the reproductive decisions of adults with CHD. Eligible participants included adults between the ages of 18 and 49 diagnosed with mild, moderate, or severe CHD, living in the United States (US), and English speaking. A single in-depth, semi-structured interview was completed. After transcription of the interview, the researcher and a consultant with qualitative experience performed structural and thematic analysis. Interviews continued until saturation of themes was obtained.The final sample included 17 adult females, between 24 and 41 years of age, living in 10 U.S. states. The majority of participants were White, married, and had severe types of CHD. Family planning decisions occurred in phases through their lives, from becoming sexually active to giving birth. The phases included contraception, discovering childbearing options, deciding if/when to have children, pregnancy, and feelings about family planning decisions.Family planning is an ongoing process for adults with CHD. They desire more information regarding family planning issues and decisions. To maximize the health of the adult with CHD, family planning should be incorporated into primary care. Greater understanding of adult experiences with family planning will be useful in future educational efforts for the adult with CHD and their healthcare providers.