Pregnancy and diabetes - a hermeneutic phenomenological study of women's experiences

Abstract

The aim of this article is to describe women's experiences of being pregnant and having insulin-dependent diabetes mellitus (IDDM), particularly regarding what the crucial elements of the experience are during pregnancy. A qualitative method with a hermeneutic phenomenological approach was used. The subjects were 14 pregnant women with IDDM, of whom eight were primiparous and six multiparous. They were interviewed during pregnancy concerning their experience of 'being controlled by blood glucose levels for the child's sake'. The child makes demands, with consequences which are divided into two main themes: objectification, including loss of control and an awareness of having an unwell 'risky body'; and exaggerated responsibility, including constant worry, constant pressure and constant self-blame. The results present a challenge to every midwife, physician or other health professional involved in the care of pregnant women with diabetes. They have an important role in mediating understanding of how risks to such women during pregnancy and childbirth can be minimized by normalizing the blood glucose level. At the same time, they should point out the fact that most women with IDDM today have healthy babies. This could reduce negative feelings. The women should also be supported and encouraged in the normal transition to motherhood.

Sexuality and childbearing as it is experienced by women living with HIV in Sweden: a lifeworld phenomenological study

“…The strong demand for taking responsibility for the unborn baby is not only a phenomenon for HIV-positive women, but has also been found in women living with type 1 diabetes (Berg & Hotikasalo, 2000). A strong sense of responsibility has also been described in women living with chronical diseases, where pregnancy is described as a balancing act, weighing one’s own desires against the risks for both one’s own and the child’s health (Tyer‐Viola & Lopez, 2014).…”

Pregnancy and Diabetes: How Women Handle the Challenges

“…One such study describes how, for the unborn child's sake, pregnant women are controlled by blood-glucose levels (Berg & Honkasalo, 2000). Blood glucose is experienced as a personified object benefiting and constantly reminding the mother of the coming child.…”

“…The woman is objectified, feeling a loss of control and an awareness of having an unwell, high-risk body. She also expresses exaggerated responsibility, including constant worry, pressure, and self-blame (Berg & Honkasalo, 2000).…”

Reprioritizing life: a conceptual model of how women with type 1 diabetes deal with main concerns in early motherhood

“…This is related to the increased risks for the expected child, including malformations, accelerated gestational weight, and adverse outcomes during childbirth and the neonatal period (Inkster et al, 2006; Kinsley, 2007; Persson, Norman, & Hanson, 2009). To minimize the risks, the women during pregnancy have to struggle for normoglycaemia more or less 24 hours a day, 7 days a week, and are often filled with worries, pressure, and guilt for not living optimally (Berg & Honkasalo, 2000; Rasmussen et al, 2013). During pregnancy, they are usually provided frequent follow-up at the antenatal clinic, and their glycaemic control is thoroughly monitored in order to deliver a healthy baby.…”