{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:17:12Z","timestamp":1789586232349,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/W014432\/1"],"award-info":[{"award-number":["MR\/W014432\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Over a fifth of pregnant women are living with multiple long\u2010term health conditions, which is associated with increased risks of adverse outcomes for mothers and infants. While there are many examples of research exploring individuals' experiences and care pathways for pregnancy with a single health condition, evidence relating to multiple health conditions is limited. This study aimed to explore experiences and care of women with multiple long\u2010term health conditions around the time of pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semistructured interviews were conducted between March 2022 and May 2023 with women with multiple long\u2010term health conditions who were at least 28 weeks pregnant or had had a baby in the last 2 years, and healthcare professionals with experience of caring for these women. Participants were recruited from across the United Kingdom. Data were analysed using thematic analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010seven women and 51 healthcare professionals participated. Five themes were identified. Women with long\u2010term health conditions and professionals recognised that\n                      <jats:italic>it takes a team<\/jats:italic>\n                      to avoid inconsistent care and communication, for example, medication management. Often, women were required to take a\n                      <jats:italic>care navigation<\/jats:italic>\n                      role to link up their healthcare providers. Women described mixed experiences regarding care for their\n                      <jats:italic>multiple identities and the whole person.<\/jats:italic>\n                      Postnatally, women and professionals recognised a downgrade in care, particularly for women's long\u2010term health conditions. Some professionals detailed the importance of engaging with women's knowledge, and recognising their own professional\n                      <jats:italic>boundaries of expertise<\/jats:italic>\n                      . Many participants described difficulties in providing\n                      <jats:italic>informational continuity<\/jats:italic>\n                      and subsequent impacts on care. Specifically, the setup of care systems made it difficult for everyone to access necessary information, especially when care involved multiple sites.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pregnant women with long\u2010term health conditions can experience a substantial burden of responsibility to maintain communication with their care team, often feeling vulnerable, patronised, and let down by a lack of acknowledgement of their expertise. These results will be used to inform the content of coproduction workshops aimed at developing a list of care recommendations for affected women. It will also inform future interventional studies aimed at improving outcomes for these women and their babies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Our Patient and Public Involvement group were involved in the design of the study and the analysis and interpretation of the data, and a public study investigator was part of the author group.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.14104","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T03:18:32Z","timestamp":1718335112000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Lost in the System: Responsibilisation and Burden for Women With Multiple Long\u2010Term Health Conditions During Pregnancy"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5260-4450","authenticated-orcid":false,"given":"Stephanie J.","family":"Hanley","sequence":"first","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham West Midlands UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0029-397X","authenticated-orcid":false,"given":"Sharon","family":"McCann","sequence":"additional","affiliation":[{"name":"Health Services Research Unit University of Aberdeen Aberdeen Aberdeenshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2332-5452","authenticated-orcid":false,"given":"Siang Ing","family":"Lee","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham West Midlands UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6989-2180","authenticated-orcid":false,"given":"Zoe","family":"Vowles","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health Guy's and St. Thomas' NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9908-0773","authenticated-orcid":false,"given":"Rachel","family":"Plachcinski","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham West Midlands UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6816-1279","authenticated-orcid":false,"given":"Krish","family":"Nirantharakumar","sequence":"additional","affiliation":[{"name":"Institute of Applied Health Research University of Birmingham Birmingham West Midlands UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6841-8601","authenticated-orcid":false,"given":"Mairead","family":"Black","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women's Health Research University of Aberdeen Aberdeen Aberdeenshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8109-1930","authenticated-orcid":false,"given":"Louise","family":"Locock","sequence":"additional","affiliation":[{"name":"Health Services Research Unit University of Aberdeen Aberdeen Aberdeenshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3559-7922","authenticated-orcid":false,"given":"Beck","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Health Sciences University of Warwick Warwick West Midlands UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-022-04442-3"},{"key":"e_1_2_11_3_1","first-page":"128","article-title":"A Retrospective Audit of the Socio\u2010Demographic Characteristics and Pregnancy Outcomes for All Women With Multiple Medical Problems Giving Birth at a Tertiary Hospital in the UK in 2016","volume":"126","author":"D'Arcy R.","year":"2019","journal-title":"BJOG"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5888\/pcd15.170397"},{"key":"e_1_2_11_5_1","unstructured":"M.Knight K.Bunch R.Patel et al. 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