Background 
Support for self-care is one of the essential services under the new contract for Community Pharmacy¹. Mothers are major users of self-care for their families, and influence their children’s’ self-care choices into young adulthood.; hHowever, daughters themselves becoming mothers themselves show more autonomy². It is proposed that mothers’ self-care actions are influenced by the intense exposure to many sources of health-related information from peri-conception into motherhood. Most studies of advice and information used by women at this stage in their lives have focussed on specific sources, rather than taking a holistic perspective. The authors’ ongoing, prospective, qualitative study aims to explore the sources used by women from pregnancy into the early months after the birth. Preliminary findings relating to access to these sources are discussed.

Method 
A repeated diary/interview method was chosen to maximise recall of events. Twenty pregnant women were recruited, including women expecting their first child and women who were already mothers. Participation was sought from pregnant women under the care of a single NHS Trust, with expected delivery dates within a two-month period, under the care of a single NHS Trust, to minimise differences in information available. Sampling was purposive, based on responses to a self-completion questionnaire. Participants kept diaries of health problems, actions and sources of advice for themselves and/or their infant over three two-week periods: in the third trimester, and at three months and eight months post-natally. Participants were prompted to report all sources, whether as personal contacts, or impersonal sources such as reading material and the Internet. Each diary period was followed by semi-structured face-to-face interviews exploring the experiences described. Interviews were audio-taped, transcribed and analysed for emerging themes.

Findings 
Participants described many sources of advice and information for self-care for themselves and their infants. All sought information reactively in response to current problems, usually from individuals. Midwives and health visitors were commonly cited health care professionals (HCPs), and lay contacts with recent personal experience of pregnancy or motherhood were often used. All visited pharmacies, but not always to obtain self-care advice. Most consulted impersonal sources proactively for general interest or in anticipation of potential situations, some also describing reactive use. Additional unsolicited information was received passively from personal sources, the media and advertising. Access issues affecting source choice included lack of a car, telephone, or Internet connection, and limited opening hours or clinic times. Some had enhanced access to HCPs at work or socially. Access changed with time: maternity leave increased the time available for reading and personal contacts, particularly for first-time mothers, but reduced access to the Internet for some. Following the birth, time available for proactive information-seeking decreased. Advice and literature provided by HCPs were not always consistent. 

Discussion 
Women use a wide range of sources other than community pharmacies for self-care information and advice in pregnancy and early motherhood. Access issues including lifestyle changes affect their choice of source, which may be inappropriate. Providers of self-care advice to pregnant women and mothers of infants need to be aware of other sources available, and the information that these provide. 

References

1. The New Contract for Community Pharmacy 2004. Aylesbury: Pharmaceutical Services Negotiating Committee, 2004.

2. Gray N, Gardner H, Cantrill J, Noyce P.  'Mummy will make it better': influence on the product choice of young adults in the UK when buying over-the-counter medicines.  International Journal of Customer Relationship Management 2000;3:186-94.