Family planning behaviours among women with diabetes mellitus: a scoping review.

Introduction: Diabetes mellitus in pregnancies is associated with adverse outcomes both for the mothers and babies. Postponing pregnancy in unoptimized conditions and stabilisation of glucose should be prioritized. This scoping review is aimed to determine the scope and at the same time map the types of evidence available that is related to family planning behaviours among women with diabetes mellitus, with a particular focus on their factors which influence family planning usage and subsequently enable the identification of knowledge gaps in preventing unintended pregnancies among this high-risk population. Methods: This scoping review is guided by the methodological framework by Arksey and O'Malley's and Prisma-ScR checklist. PubMed, EBSCO and OVID were searched for empirical studies between 2000 and February 2022 using the search terms "family planning", "contraceptive" and "diabetes mellitus". Data were summarized according to the study characteristics and levels of factors influencing family planning behaviours. Results: Thirty-five articles that met the eligibility criteria included 33 quantitative studies, one qualitative study and one mixed-methods study. The prevalence of family planning methods used by women with diabetes mellitus varied ranging from 4.8 to 89.8% among the studied population. Women with diabetes mellitus were reported to be less likely to utilise any family planning methods compared to women without diabetes mellitus. Conclusions: Most of the evidence to date on family planning behaviours among women with diabetes mellitus focuses on the role of individual level sociodemographic factors. Few studies focused on exploring determinants at multiple levels. In this review we found that there is limited evidence on disease control and pregnancy intention in relation to their family planning practices. Future studies with more clinical and contextual factors are needed to guide the strengthening of family planning services for high-risk group women specifically for women with diabetes mellitus. Plain English summary: As the prevalence of diabetes mellitus is increasing globally, more women in reproductive age group are living with diabetes mellitus. Pregnant women with uncontrolled diabetes mellitus have higher risk for complications, both to the mothers and the baby. Therefore, it is very important that family planning needs of women with diabetes mellitus are met. This review is aimed to identify what is known and not known about the factors influencing family planning behaviours among women with diabetes mellitus. We searched three databases for studies published from 2000 to February 2022. Our review included 35 articles and nearly all of the studies were quantitative, with one qualitative and one mixed-methods study. Among the studies that compared between women with diabetes mellitus and without diabetes mellitus, less women with diabetes mellitus were using family planning. Some papers also include the reasons or barriers for using family planning among the studied population. Majority of the articles described sociodemographic were factors related to family planning usage, while only few studies explored beyond individual factors. Little information on the clinical profile of the women with diabetes mellitus were known. Future research should examine clinical and other non-individual factors influencing family planning among this particular group of women as sexual and reproductive health in general is very much influenced by cultural or healthcare system factors. [ABSTRACT FROM AUTHOR]