Starting a family when you have inflammatory arthritis: can a co-production approach to creating pre-conception health improve the sustainability of NHS services?

One in ten women who have recently given birth in the UK report having a long-term limiting illness (LTLI). While most of these women will have healthy pregnancies, there are some increased risks, such as a higher rate of early births (10.9% with LLTI having premature births vs. 6.8% without), lower breastfeeding rates (25.6% of babies breastfeeding beyond three months vs. 33.4%), and increased chances of children developing a LTLI by age seven years (12% vs. 6.2%). Inflammatory arthritis (including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitisis) is one of the conditions that affect women of childbearing age. Women face important and complicated decisions, such as whether they want children, when, options for contraception, and whether to change/stop medications before trying to get pregnant. Women with inflammatory arthritis currently struggle to get enough information and support with these decisions.

This project aims to find out whether a co-production approach to healthcare for women with inflammatory arthritis who are considering pregnancy could improve the sustainability of NHS services. In co-producing health, women would become more empowered and active in making decisions about their care. The researcher will work in partnership with a Stakeholders Group (women, their partners, and health professionals) to co-develop an intervention. The intervention will focus on helping women and their health professionals co-create health by sharing decisions, taking into account women's wishes and desires in relation to starting (or enlarging) a family. Interviews with 30 women, partners, and health professionals will inform what should be included in the intervention package and how it should be provided (to whom, when and by what format). The intervention will be piloted with 20 women who are using local Rheumatology services. Feedback will be gathered on how the intervention worked, whether it was useful, and how it could be rolled out.