9th Conference European Sociological Association

RN22 Sociology of Risk and Uncertainty

2009-09-04 09:00:00 2009-09-04 10:30:00 Friday, 4 September 09:00 - 10:30 Everyday Life and the Life Course I Building I, 2E2

The phenomenon of preparing for pregnancy challenged by risk: a case study of a woman with epilepsy.

Women with epilepsy preparing for pregnancy must balance individual seizure risk alongside general health risks. The societal premise that healthy women deliver healthy babies who grow into healthy infants and adults, rests on the assumption that the women have consciously expressed pregnancy intentions, access health care prior to conception, and make necessary health changes that will reduce potential adverse pregnancy outcomes.

The additional challenge for women with epilepsy is that a balance needs to be struck between reducing seizure risk (which often requires ongoing antiepileptic drug therapy throughout childbearing years) whilst minimising teratogenic risks to the unborn child.

Access to preconception counselling and recommendations to plan pregnancy are internationally recognised as ideal opportunities to intervene by assessing risk, providing pregnancy risk information, and promoting health interventions with the goal of reducing adverse pregnancy outcome.

This paper will present a case study from an interpretive phenomenological research project exploring how women with epilepsy perceive risk information and make personal decisions when contemplating pregnancy. A 30 year old woman with epilepsy was followed throughout her involvement in preconception counselling. Data were collected by observation of a hospital clinic visit and follow-up with an in-depth interview. The complexity of this woman?s reproductive life with epilepsy, her need to interpret personal seizure risk and treatment decisions, alongside her future pregnancy desires will be presented. The case demonstrates the social context of pregnancy intention and risk awareness, the utility of risk information and the health behaviour-related actions arising from a preconception counselling visit.

Analysis reveals how women with epilepsy are shaped by their social world of work and finance, of relationships and by their personal view of motherhood, which places responsibility on them to be the gatekeeper of risk. Women are typically presented with risk information during routine clinical review; however, the opportunity to contextualise individual risk within a woman?s life is seen to fall outside of the experience of preconception counselling. The context of how women with epilepsy make decisions will be interpreted alongside the literature on reflexive judgements in which future pregnancy desires are judged subjectively.