{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,13]],"date-time":"2026-11-13T18:13:05Z","timestamp":1794593585625,"version":"4.9.1"},"reference-count":39,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"unspecified","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,10]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To explore the experiences and perspectives of female patients with autoimmune rheumatic diseases (ARDs) regarding sexual and reproductive health, including contraception, family planning, and pregnancy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Qualitative descriptive study using semi-structured interviews.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Specialised rheumatology clinic in a tertiary hospital in Monterrey, Mexico.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>21 female patients aged 18\u201349 with a confirmed ARD diagnosis who were receiving care at the clinic. Participants were selected using convenience sampling, ensuring diversity in age, disease type and stage, socio-economic and cultural background, sexuality and disability status. All participants completed the study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Four main themes emerged from the analysis. First, participants expressed confusion and concern about the safety and effectiveness of contraceptive methods in the context of their disease and treatment. Second, many participants shared anxiety about infertility, heredity and the risks of pregnancy associated with their ARDs, leading to uncertainty in pregnancy planning. Third, there was concern about the safety of medications during pregnancy and breastfeeding, indicating a lack of guidance and information from healthcare providers. Lastly, patients often deferred decision-making about contraception and medication to their rheumatologists but recognised the importance of a multidisciplinary care approach for comprehensive sexual and reproductive health management.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The study revealed that women with ARDs experience significant challenges and unmet needs related to sexual and reproductive health, particularly in understanding safe contraception, pregnancy planning and medication use during pregnancy and lactation. These findings emphasise the need for rheumatologists to provide clearer guidance on these issues and collaborate closely with gynaecologists and other specialists to ensure comprehensive, patient-centred care. Enhancing communication and education strategies in rheumatology consultations could address these gaps and improve the sexual and reproductive health outcomes and decision-making processes of women with ARDs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086351","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T00:56:35Z","timestamp":1738112195000},"page":"e086351","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Sexual and reproductive health from the perspective of patients with autoimmune rheumatic diseases in Mexico: a qualitative study"],"prefix":"10.1136","volume":"15","author":[{"given":"Cassandra Michelle","family":"Skinner-Taylor","sequence":"first","affiliation":[{"name":"Rheumatology, Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Perez-Barbosa","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abraham Yair","family":"Lujano-Negrete","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Ar\u00e9valo-Nieto","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Eugenia","family":"Corral-Trujillo","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Aguilar-Leal","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3600-9313","authenticated-orcid":false,"given":"G\u00e9nesis Guadalupe","family":"Sandoval-Torres","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Rodr\u00edguez-Ruiz","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie Gabriela","family":"Rios-Medina","sequence":"additional","affiliation":[{"name":"Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaranta","family":"Manrique de Lara","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital General de M\u00e9xico \"Dr. Eduardo Liceaga\", Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9714-2109","authenticated-orcid":false,"given":"Dionicio Angel","family":"Galarza-Delgado","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital Universitario. Dr. Jos\u00e9 Eleuterio Gonz\u00e1lez, Monterrey, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5188-7375","authenticated-orcid":false,"given":"Ingris","family":"Pelaez-Ballestas","sequence":"additional","affiliation":[{"name":"Rheumatology, Hospital General de M\u00e9xico \"Dr. Eduardo Liceaga\", Mexico City, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"key":"2025101811013853000_15.1.e086351.1","doi-asserted-by":"crossref","first-page":"2453","DOI":"10.1007\/s10067-023-06652-2","article-title":"Construction and validation of a reproductive behavior questionnaire for female patients with rheumatic diseases","volume":"42","author":"Perez-Barbosa","year":"2023","journal-title":"Clin Rheumatol"},{"key":"2025101811013853000_15.1.e086351.2","unstructured":"World Health Organization . Contraception. Available: https:\/\/www.who.int\/health-topics\/contraception#tab=tab_1 [Accessed 01 Oct 2024]."},{"key":"2025101811013853000_15.1.e086351.3","doi-asserted-by":"crossref","DOI":"10.1097\/RHU.0000000000002140","article-title":"Reproductive Health in the Post Roe v. Wade Era","volume":"30","author":"Ramsey-Goldman","year":"2024","journal-title":"J Clin Rheumatol"},{"key":"2025101811013853000_15.1.e086351.4","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1007\/s00296-020-04679-1","article-title":"Reproductive health counseling and contraceptive use in Mexican women with rheumatic diseases: a cross-sectional study","volume":"41","author":"Skinner-Taylor","year":"2021","journal-title":"Rheumatol Int"},{"key":"2025101811013853000_15.1.e086351.5","doi-asserted-by":"crossref","first-page":"1194","DOI":"10.1002\/acr.24249","article-title":"Exploring the Preferences of Women Regarding Sexual and Reproductive Health Care in the Context of Rheumatology: A Qualitative Study","volume":"73","author":"Wolgemuth","year":"2021","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.6","doi-asserted-by":"crossref","unstructured":"Rodrigues L , Alves VLP , Sim-Simc MMF , et al . Perceptions of women with systemic lupus erythematosus undergoing high-risk prenatal care: A qualitative study. Midwifery 2020;87. doi:10.1016\/j.midw.2020.102715","DOI":"10.1016\/j.midw.2020.102715"},{"key":"2025101811013853000_15.1.e086351.7","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1002\/acr.24870","article-title":"Digital Narratives of Living With Lupus: Lived Experiences and Meanings for Latin American and Latino Patients and Their Families","volume":"75","author":"Colmenares-Roa","year":"2023","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.8","unstructured":"United Nations Department of Public Information . Platform for Action and Beijing Declaration. Fourth World Conference on Women, Beijing, China. New York, NY, United Nations, 1995."},{"key":"2025101811013853000_15.1.e086351.9","unstructured":"Gillham B . The Research Interview. Continuum Ed. London, 2000."},{"key":"2025101811013853000_15.1.e086351.10","first-page":"1","article-title":"The Ethnographic Interview: An Interdisciplinary Guide for Developing an Ethnographic Disposition in Health Research","volume":"0","author":"Trundle","year":"2024","journal-title":"Qual Health Res"},{"key":"2025101811013853000_15.1.e086351.11","doi-asserted-by":"crossref","first-page":"39039913","DOI":"10.1111\/1756-185X.15271","article-title":"Reproductive health and pregnancy clinic for patients with rheumatic diseases: A multidisciplinary-care model description","volume":"27","author":"Perez-Barbosa","year":"2024","journal-title":"Int J Rheum Dis"},{"key":"2025101811013853000_15.1.e086351.12","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"2025101811013853000_15.1.e086351.13","unstructured":"Catherine P , May N . Qualitative Research in Health Care. BMJ Ed. London, 2016."},{"key":"2025101811013853000_15.1.e086351.14","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1097\/AOG.0000000000000279","article-title":"Receipt of prescription contraception by commercially insured women with chronic medical conditions","volume":"123","author":"DeNoble","year":"2014","journal-title":"Obstet Gynecol"},{"key":"2025101811013853000_15.1.e086351.15","first-page":"120","article-title":"Experiences of Iranian female patients with systemic lupus erythematosus: A qualitative study","volume":"36","author":"Moghadam","year":"2021","journal-title":"Arch Rheumatol"},{"key":"2025101811013853000_15.1.e086351.16","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1002\/acr.20402","article-title":"Contraceptive counseling and use among women with systemic lupus erythematosus: a gap in health care quality?","volume":"63","author":"Yazdany","year":"2011","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.17","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1002\/acr.24639","article-title":"Patient Experiences of Systemic Lupus Erythematosus: Findings From a Systematic Review, Meta-Summary, and Meta-Synthesis","volume":"74","author":"Petrocchi","year":"2022","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.18","doi-asserted-by":"crossref","DOI":"10.1186\/s12891-015-0657-4","article-title":"Understanding the information needs of women with rheumatoid arthritis concerning pregnancy, post-natal care and early parenting: A mixed-methods study","volume":"16","author":"Ackerman","year":"2015","journal-title":"BMC Musculoskelet Disord"},{"key":"2025101811013853000_15.1.e086351.19","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1038\/ncprheum0484","article-title":"Therapy Insight: guidelines for selection of contraception in women with rheumatic diseases","volume":"3","author":"Sammaritano","year":"2007","journal-title":"Nat Rev Rheumatol"},{"key":"2025101811013853000_15.1.e086351.20","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1002\/acr.23724","article-title":"Contraception Use Among Reproductive-Age Women With Rheumatic Diseases","volume":"71","author":"Birru Talabi","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.21","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1002\/acr.24803","article-title":"Frequency of Contraception Documentation in Women With Systemic Lupus Erythematosus and Rheumatoid Arthritis Within the Rheumatology Informatics System for Effectiveness Registry","volume":"75","author":"Clowse","year":"2023","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.22","doi-asserted-by":"publisher","DOI":"10.1002\/art.38097"},{"key":"2025101811013853000_15.1.e086351.23","doi-asserted-by":"crossref","first-page":"322","DOI":"10.4103\/injr.injr_79_20","article-title":"Pregnancy counseling in rheumatic diseases: Where science meets the steps","volume":"16","author":"Balakrishnan","year":"2021","journal-title":"Indian J Rheumatol"},{"key":"2025101811013853000_15.1.e086351.24","first-page":"1775","article-title":"Concordance of disease severity among family members with ankylosing spondylitis?","volume":"31","author":"Brophy","year":"2004","journal-title":"J Rheumatol"},{"key":"2025101811013853000_15.1.e086351.25","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1016\/j.jbspin.2018.12.002","article-title":"\u201cDisease knowledge index\u201d and perspectives on reproductive issues: A nationwide study on 398 women with autoimmune rheumatic diseases","volume":"86","author":"Andreoli","year":"2019","journal-title":"Joint Bone Spine"},{"key":"2025101811013853000_15.1.e086351.26","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.210785"},{"key":"2025101811013853000_15.1.e086351.27","doi-asserted-by":"crossref","DOI":"10.1186\/s13075-021-02704-7","article-title":"\u201cThe medications are the decision-makers\u2026\u201d Making reproductive and medication use decisions among female patients with rheumatoid arthritis: a constructivist grounded theory","volume":"24","author":"Rebi\u0107","year":"2022","journal-title":"Arthritis Res Ther"},{"key":"2025101811013853000_15.1.e086351.28","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004081","article-title":"Family planning and pregnancy issues for women with systemic inflammatory diseases: patient and physician perspectives","volume":"4","author":"Chakravarty","year":"2014","journal-title":"BMJ Open"},{"key":"2025101811013853000_15.1.e086351.29","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1002\/acr.23872","article-title":"Perspectives of Adult Rheumatologists Regarding Family Planning Counseling and Care: A Qualitative Study","volume":"72","author":"Birru Talabi","year":"2020","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025101811013853000_15.1.e086351.30","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.220348"},{"key":"2025101811013853000_15.1.e086351.31","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(22)00254-7"},{"key":"2025101811013853000_15.1.e086351.32","doi-asserted-by":"crossref","DOI":"10.1186\/s12884-022-04498-1","article-title":"Pregnancy planning health information and service needs of women with chronic non-communicable conditions: a systematic review and narrative synthesis","volume":"22","author":"Hammarberg","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"2025101811013853000_15.1.e086351.33","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1007\/s10067-023-06609-5","article-title":"Sociocultural and moral narratives influencing the decision to vaccinate among rheumatic disease patients: a qualitative study","volume":"42","author":"Manrique de Lara","year":"2023","journal-title":"Clin Rheumatol"},{"key":"2025101811013853000_15.1.e086351.34","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.reuma.2023.05.003","article-title":"Termination of pregnancy in lupus nephritis: A bioethical analysis with the integrative method","volume":"20","author":"Cano-G\u00e1mez","year":"2024","journal-title":"Reumatol Clin (Engl Ed)"},{"key":"2025101811013853000_15.1.e086351.35","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.reuma.2014.11.005","article-title":"Clinical practice guidelines for the management of pregnancy in women with autoimmune rheumatic diseases of the Mexican College of Rheumatology. Part I","volume":"11","author":"Saavedra Salinas","year":"2015","journal-title":"Reumatol Clin"},{"key":"2025101811013853000_15.1.e086351.36","doi-asserted-by":"publisher","DOI":"10.1002\/art.41191"},{"key":"2025101811013853000_15.1.e086351.37","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209770"},{"key":"2025101811013853000_15.1.e086351.38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0263910","article-title":"Identities of women who have an autoimmune rheumatic disease [ARD] during pregnancy planning, pregnancy and early parenting: A qualitative study","volume":"17","author":"Williams","year":"2022","journal-title":"PLoS ONE"},{"key":"2025101811013853000_15.1.e086351.39","first-page":"55","article-title":"Nuevas maternidades o la deconstrucci\u00f3n de la maternidad en M\u00e9xico","volume":"30","author":"S\u00e1nchez Bringas","year":"2004","journal-title":"Debate Fem"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-086351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T18:01:49Z","timestamp":1760810509000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-086351"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":39,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,28]]},"published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1136\/bmjopen-2024-086351"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-086351","relation":{"has-part":[{"id-type":"doi","id":"https:\/\/doi.org\/10.1136\/bmjopen-2024-086351.supp1","asserted-by":"subject"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]}}}