"If I'm not getting oxygen, neither is my baby": A qualitative study of Australian women's experiences of asthma management in pregnancy.

Background: Optimal management of asthma during pregnancy is an important element in improving maternal and neonatal outcomes. Asthma effects 12.7 % of pregnant women in Australia. Despite consistent management recommendations available via clinical practice guidelines for asthma in pregnancy, pregnant women with asthma are not receiving guideline recommended care. This study builds on previous research and aims to explore the asthma management experiences of pregnant women with asthma. Specifically, to gain insight into pregnant women's understanding of their asthma; previous and current exposure to asthma education; and attitudes towards their asthma management and medication use.

Methods: This qualitative descriptive study involved individual semi-structured interviews with pregnant women with asthma. Data were transcribed and analysed using content analysis. The participants were recruited from those enrolled in the Breathing For Life Trial (BLT), an RCT of inflammation-guided asthma management in pregnancy versus usual care.

Results: A total of 24 women were interviewed between June 2018 and May 2020. Three main themes: "Did not think asthma was an issue", "If I'm not getting oxygen in then neither is my baby" and "Beyond pregnancy care" were identified along with 9 sub-themes which showed asthma knowledge, attitude and medication adherence variation depending on experiences with asthma management.

Conclusions: This study highlighted the varied experiences of this cohort of pregnant women with asthma and identified the need for ongoing consistent asthma management to improve the knowledge, attitude, and medication adherence of women with asthma before during and after pregnancy, and in turn improve maternal and neonatal outcomes.