An Indigenous and Western paradigm to understand gestational diabetes mellitus: Reflections and insights

2020 ◽  
pp. 147675032096082
Author(s):  
Joanne Whitty-Rogers ◽  
Brenda Cameron ◽  
Vera Caine

Indigenous women face many barriers to maternal care during pregnancy in Canada. A participatory study was conducted in two First Nations Communities in Nova Scotia, Canada to gain new knowledge about Mi’kmaw women’s experiences of living with gestational diabetes mellitus (GDM). Relational ethics helped guide this journey. In this paper we describe how Indigenous and Western approaches were used to understand Mi’kmaw women’s experiences with GDM. It was important to us that the research methodology facilitated building relationship and trust. This led to an openness and willingness of the women to express their concerns and offer ways to address GDM in their communities. The challenges of blending Indigenous approaches with Western research are also discussed in the paper. The foundational principles that were used during this research included: 1) Staying true to my word; 2) Mutual Trust; 3) Mutual Respect; 4) Being Flexible; 5) Being Non judgemental; 6) Working in partnership; 7) Taking time to explain; 8) Promoting autonomy; and 9) Genuine connectiveness. The findings revealed that the research assisted the Mi’kmaw women in understanding their experiences in new ways and helped to build capacity so that they could take action to improve their health, while sustaining their Mi’kmaw culture.

2015 ◽  
Vol 28 (4) ◽  
pp. 285-292 ◽  
Author(s):  
Catherine Kilgour ◽  
Fiona Elizabeth Bogossian ◽  
Leonie Callaway ◽  
Cindy Gallois

Author(s):  
Karoline Kragelund Nielsen ◽  
Thilde Vildekilde ◽  
Anil Kapur ◽  
Peter Damm ◽  
Veerasamy Seshiah ◽  
...  

Gestational diabetes mellitus (GDM) is associated with a range of adverse pregnancy outcomes as well as increased risk of future type 2 diabetes and cardiovascular disease. In India, 10%–35% of pregnant women develop GDM. In this study, we investigated women’s experiences with the dietary and pharmaceutical treatment for GDM in rural and urban Tamil Nadu, India. Semi-structured interviews were conducted with 19 women diagnosed with GDM. Data were analyzed using qualitative content analysis. Three overall aspects were discovered with several sub-aspects characterizing women’s experiences: emotional challenges (fear and apprehension for the baby’ health and struggling to accept a treatment seen as counterintuitive to being safe and healthy), interpersonal challenges (managing treatment in the near social relations and social support, and coordinating treatment with work and social life), and health system-related challenges (availability and cost of treatment, interaction with health care providers). Some aspects acted as barriers. However, social support and positive, high-quality interactions with health care providers could mitigate some of these barriers and facilitate the treatment process. Greater efforts at awareness creation in the social environment and systemic adjustments in care delivery targeting the individual, family, community and health system levels are needed in order to ensure that women with GDM have the opportunity to access treatment and are enabled and motivated to follow it as well.


BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0104
Author(s):  
Johanne Holm Toft ◽  
Inger Økland ◽  
Christina Furskog Risa

BackgroundWomen with gestational diabetes mellitus (GDM) have a tenfold increased risk of developing diabetes, and a high risk of recurrent GDM. Endorsing the life-course approach aiming to prevent disease and promote health across generations, the Norwegian GDM guideline recommends follow-up in primary care after delivery, with information on the increased risks, lifestyle counselling, and annual diabetes screening. Few reports exist on Norwegian women’s experiences of GDM follow-up. AimTo elucidate women’s experiences with follow-up of GDM in pregnancy and after delivery, and to explore their attitudes to diabetes risk and motivation for lifestyle changes. Design & settingQualitative study in primary care in the region of Stavanger, Norway. MethodSemi-structured in-depth interviews were conducted 24–30 months after delivery with 14 women aged 28–44 years, with a history of GDM. Data were analysed thematically. ResultsMost women were satisfied with the follow-up during pregnancy; however, only two women were followed-up according to the guideline after delivery. In most encounters with GPs after delivery, GDM was not mentioned. To continue the healthy lifestyle adopted in pregnancy, awareness of future risk was a motivational factor, and the women asked for tailored information on individual risk and improved support. The main themes emerging from the analysis were as follows: stigma and shame; uncertainty; gaining control and finding balance; and a need for support to sustain change. ConclusionWomen experienced a lack of support for GDM in Norwegian primary care after delivery. To maintain a healthy lifestyle, women suggested being given tailored information and improved support.


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