Blood Pressure Self-Monitoring in Pregnancy (BuMP) feasibility study: a qualitative analysis of women's experiences of self-monitoring

Lisa Hinton, Katherine L. Tucker, Sheila M. Greenfield, James A. Hodgkinson, Lucy Mackillop, Christine McCourt, Trisha Carver, Carole Crawford, Margaret Glogowska, Louise Locock, Mary Selwood, Kathryn S. Taylor, Richard J. McManus

Research output: Contribution to journalArticlepeer-review

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Abstract

Background
Hypertensive disorders in pregnancy are a leading cause of maternal and fetal morbidity worldwide. Raised blood pressure (BP) affects 10% of pregnancies worldwide, of which almost half develop pre-eclampsia. The proportion of pregnant women who have risk factors for pre-eclampsia (such as pre-existing hypertension, obesity and advanced maternal age) is increasing. Pre-eclampsia can manifest itself before women experience symptoms and can develop between antenatal visits. Incentives to improve early detection of gestational hypertensive disorders are therefore strong and self-monitoring of blood pressure (SMBP) in pregnancy might be one means to achieve this, whilst improving women’s involvement in antenatal care. The Blood Pressure Self-Monitoring in Pregnancy (BuMP) study aimed to evaluate the feasibility and acceptability of SMBP in pregnancy.

Methods
To understand women’s experiences of SMBP during pregnancy, we undertook a qualitative study embedded within the BuMP observational feasibility study. Women who were at higher risk of developing hypertension and/or pre-eclampsia were invited to take part in a study using SMBP and also invited to take part in an interview. Semi-structured interviews were conducted at the women’s homes in Oxfordshire and Birmingham with women who were self-monitoring their BP as part of the BuMP feasibility study in 2014. Interviews were conducted by a qualitative researcher and transcribed verbatim. A framework approach was used for analysis.

Results
Fifteen women agreed to be interviewed. Respondents reported general willingness to engage with monitoring their own BP, feeling that it could reduce anxiety around their health during pregnancy, particularly if they had previous experience of raised BP or pre-eclampsia. They felt able to incorporate self-monitoring into their weekly routines, although this was harder post-partum. Self-monitoring of BP made them more aware of the risks of hypertension and pre-eclampsia in pregnancy. Feelings of reassurance and empowerment were commonly reported by the women in our sample.

Conclusions
SMBP in pregnancy was both acceptable and feasible to women in this small pilot study.
Original languageEnglish
Article number427
Pages (from-to)1-9
Number of pages9
JournalBMC Pregnancy and Childbirth
Volume17
DOIs
Publication statusPublished - 19 Dec 2017

Bibliographical note

Acknowledgements
This article represents independent research commissioned by the NIHR SPCR. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. RM receives support from NIHR Professorship (NIHR-RP-02-12-015) and the NIHR Oxford Collaboration for Leadership in Applied Health Research and Care. LL receives support from Oxford NIHR Biomedical Research Centre and is part of the NIHR Oxford Collaboration for Leadership in Applied Health Research and Care and the NIHR Diagnostic Evidence Co-operative Oxford. We also wish to acknowledge the invaluable contribution of Paula Cole and Ursula Saunders, patient representatives, and Carla Betts who provided administrative support to the study. This work would not have been possible without the help of the clinical research networks at Birmingham Women’s Hospital and in Oxford and Banbury. Most importantly this work relied on the women who participated in the wider BuMP study and in particular the women who agreed to be interviewed for this qualitative study.

Funding
This study was funded through a grant from the National Institute for Health Research (NIHR) National School for Primary Care Research (SPCR) (SPCR project No. 171).

Keywords

  • Pregnancy
  • Blood pressure
  • Self-monitoring
  • Hypertension
  • Pre-eclampsia
  • Qualitative
  • Women’s experiences

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