Diabetes and pregnancy: women’s opinions about the care provided during the childbearing year

Anderberg, Eva; Berntorp, Kerstin; Crang-Svalenius, Elizabeth

doi:10.1111/j.1471-6712.2008.00614.x

Cited by 14 publications

(15 citation statements)

References 29 publications

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“…Our results are consistent with other studies that have found that postpartum women feel inadequately prepared for the postpartum period [3, 16–18]. Women in our maternal focus groups also expressed dissatisfaction with the communication and preparation they had received for discharge.…”

Section: Discussionsupporting

confidence: 91%

Views of Women and Clinicians on Postpartum Preparation and Recovery

Martin

Horowitz

Balbierz

et al. 2013

Matern Child Health J

122

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To explore important domains of women’s postpartum experiences as perceived by postpartum mothers and obstetricians/midwives, and to investigate how postpartum care could enhance patient preparation for the postpartum period. Qualitative research study was conducted to explore women’s and clinicians’ perceptions of the postpartum experience. Four focus groups of postpartum women (n = 45) and two focus groups of obstetric clinicians (n = 13) were held at a large urban teaching hospital in New York City. All focus groups were audio recorded, transcribed, and analyzed using grounded theory. Four main themes were identified: lack of women’s knowledge about postpartum health and lack of preparation for the postpartum experience, lack of continuity of care and absence of maternal care during the early postpartum period, disconnect between providers and postpartum mothers, and suggestions for improvement. Mothers did not expect many of the symptoms they experienced after childbirth and were disappointed with the lack of support by providers during this critical time in their recovery. Differences existed in the major postpartum concerns of mothers and clinicians. However, both mothers and clinicians agreed that preparation during the antepartum period could be beneficial for postpartum recovery. Results from this study indicate that many mothers do not feel prepared for the postpartum experience. Study findings raise the hypothesis that capturing patient-centered domains that define the postpartum experience and integrating these domains into patient care may enhance patient preparation for postpartum recovery and improve postpartum outcomes.

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Section: Discussionsupporting

confidence: 91%

Views of Women and Clinicians on Postpartum Preparation and Recovery

Martin

Horowitz

Balbierz

et al. 2013

Matern Child Health J

122

View full text Add to dashboard Cite

show abstract

“…This review found that such information was not always available to women, in particular those living in rural communities [28]. A study investigating opinions about care during pregnancy, childbirth and postnatally among women with T1DM and gestational diabetes found that staff in different areas of care might need more knowledge about diabetes to reduce the risk of women receiving inadequate/incorrect information [49]. The authors concluded more effort must be expended on procedures and written materials, to ensure that women are better prepared and that the information flow throughout the care chain is reliable.…”

Section: Discussionmentioning

confidence: 99%

Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review

Rasmussen

Hendrieckx

Clarke

et al. 2013

BMC Pregnancy Childbirth

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BackgroundLife transitions often involve complex decisions, challenges and changes that affect diabetes management. Transition to motherhood is a major life event accompanied by increased risk that the pregnancy will lead to or accelerate existing diabetes-related complications, as well as risk of adverse pregnancy outcomes, all of which inevitably increase anxiety. The frequency of hyperglycaemia and hypoglycaemia often increases during pregnancy, which causes concern for the health and physical well-being of the mother and unborn child. This review aimed to examine the experiences of women with T1DM focusing on the pregnancy and postnatal phases of their transition to motherhood.MethodsThe structured literature review comprised a comprehensive search strategy identifying primary studies published in English between 1990–2012. Standard literature databases were searched along with the contents of diabetes-specific journals. Reference lists of included studies were checked. Search terms included: ‘diabetes’, ‘type 1’, ‘pregnancy’, ‘motherhood’, ‘transition’, ‘social support’, ‘quality of life’ and ‘psychological well-being’.ResultOf 112 abstracts returned, 62 articles were reviewed in full-text, and 16 met the inclusion criteria. There was a high level of diversity among these studies but three common key themes were identified. They related to physical (maternal and fetal) well-being, psychological well-being and social environment. The results were synthesized narratively.ConclusionWomen with type 1 diabetes experience a variety of psychosocial issues in their transition to motherhood: increased levels of anxiety, diabetes-related distress, guilt, a sense of disconnectedness from health professionals, and a focus on medicalisation of pregnancy rather than the positive transition to motherhood. A trusting relationship with health professionals, sharing experiences with other women with diabetes, active social support, shared decision and responsibilities for diabetes management assisted the women to make a positive transition. Health professionals can promote a positive transition to motherhood by proactively supporting women with T1DM in informed decision-making, by facilitating communication within the healthcare team and co-ordinating care for women with type 1 diabetes transitioning to motherhood.

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“…The significance of this approach, which we may refer to as an outside approach, is a finding that corresponds with the results of other studies. 10,25,26 We found that the women valued the visible and audible part of the consultation: being able to actually see their baby on the screen and hear its heartbeat with the Doppler. As noted by Berg and Honkasalo, 27 women with a high-risk pregnancy more easily lose touch with their own body and accept objective knowledge that is more correct and valuable.…”

Section: The Outside and Inside Approachmentioning

confidence: 90%

Being in an oasis: a restorative and reassuring place - women’s experiences of a valuable antenatal diabetes midwifery consultation

2013

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The prevalence of diabetes in the childbearing population is increasing globally. Pregnant diabetic women are considered to be at high risk, and thus require specialized, multidisciplinary prenatal care in which midwives play an integral part. These women's views and experiences of encounters with midwives during diabetes care have not yet been investigated. Our aim was to use an exploratory interpretive approach to investigate the experiences of pregnant women and their perceptions towards the meaning of prenatal consultation provided by midwives in the prenatal care team. A purposive sample was recruited from four hospital-based prenatal diabetes outpatient clinics in the urban areas of Norway: 10 pregnant women (5 primiparous, 5 multiparous) aged 28-45 and diagnosed with different types of diabetes. Data from semi-structured interviews were transcribed and subjected to thematic analysis. Three main themes emerged: being in an open atmosphere, being seen as a person, and being reassured. Together, these themes created a construct that we labeled being in an oasis-a restorative and reassuring place. The counterpoint of this view was a more negative perspective described as having insufficient time, feelings of being objectified and rushed, and diseaseoriented care. The women valued the focus on surveillance in the consultations, although at their best, the midwife-woman encounters complemented and counteracted the iatrogenic effect of the biomedical focus in specialist prenatal care. However, the organization of care may have contributed to and created feelings of suffering, as these women had limited scope for addressing their concerns in the consultation. We conclude that these consultations are complex co-created activities in which interpersonal aspects of the midwifewoman encounters, such as the midwives' openness and responsiveness to the women, seem to be significant in developing a personal approach.

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Diabetes and pregnancy: women’s opinions about the care provided during the childbearing year

Abstract: Satisfaction with care was shown. A discussion about the implication of informed choice with both staff and mothers are needed. Sharper implementation of the diabetes-care-chain was also an area for improvement.

Cited by 14 publications

References 29 publications

Views of Women and Clinicians on Postpartum Preparation and Recovery

Views of Women and Clinicians on Postpartum Preparation and Recovery

Psychosocial issues of women with type 1 diabetes transitioning to motherhood: a structured literature review

Being in an oasis: a restorative and reassuring place - women’s experiences of a valuable antenatal diabetes midwifery consultation

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