Abstract
BackgroundWomen with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. It is therefore of utmost importance to consider their need for specific support, early postpartum as well as in daily life after discharge from maternity care. Few studies have investigated these aspects of healthcare. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes.MethodsA hermeneutic reflective life world research approach was used in this qualitative study. Data was gathered through audio-recorded focus group discussions and individual interviews with 23 women with type 1 diabetes, 6-24 months after childbirth. After verbatim transcription, the text was analyzed in order to identify themes of meaning and a conclusive interpretation of the explored phenomenon.ResultsExperiences of extraordinary exposure challenged the women with type 1 diabetes in their transition to early motherhood. The exposure included a struggle with breastfeeding, although with a driving force to succeed. Everyday life was filled with uncertainty and unpredictability related to one's own unstable glycemic control and the women down-prioritized their own needs in favor of the child. A feeling of being disconnected from professional care further contributed to the experiences of extraordinary exposure.ConclusionIn early motherhood women with type 1 diabetes have a great need for support in managing daily life postpartum, which requires contemporary approaches to overlap insufficient linkage between health care professionals in maternity and child health care, and diabetes care.
Highlights
Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding
The quotes are marked as individual interview (I:1-4) or focus group (FG:1-6)
Methodological considerations Combining the strengths of focus groups with those of conducting individual interviews which might contribute with more detailed, deep descriptions can yield different layers of data which complement each other [35]
Summary
Women with type 1 diabetes face several challenges during pregnancy, childbirth and in relation to breastfeeding. The aim of this study was to explore experiences after childbirth regarding breastfeeding, glycemic control, support and well-being in women with type 1 diabetes. Stringent glycemic control increases the incidence of severe hypoglycemia [5,6] This considered, it is not surprising that pregnant women with diabetes experience a higher degree of anxiety, worry, pressure and ambivalence compared to. In our previous study we explored women’s need for and experiences of professional support during pregnancy and childbirth. The women with type 1 diabetes received and valued increased attention from health care professionals during pregnancy. They considered the attention as being directed towards the health of the unborn baby and not their own health. The women expressed increased vulnerability if the professionals’ diabetes specific competence and support was insufficient and if the diabetes organization was disconnected, i.e. lacking communication or collaboration between the antenatal care and the regular diabetes clinic [13]
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