Experiences of women with type 2 diabetes during the pre-pregnancy, pregnancy and postpartum periods: a systematic review of qualitative studies

Abstract

Aim: to explore the experiences of women with type 2 diabetes prior to, during and after pregnancy.

Methods: six databases were systematically searched in September 2023. Qualitative studies involving women of childbearing age living with type 2 diabetes in the pre-pregnancy, pregnancy and postpartum periods were included. A thematic synthesis was conducted to inductively generate themes related to the experiences of women with type 2 diabetes. Descriptive themes were mapped to the Socio-Ecological Model to generate analytical themes relating to the personal, interpersonal and organisational level impacts that underlie women's experiences. Study quality was assessed using the CASP checklist for qualitative studies.

Results: eleven papers from seven countries met the inclusion criteria. Four themes containing six subthemes were generated. At a personal level, women prioritised their desire to plan a family over 'family planning'; however, once pregnant they were fearful for the future health of their children. At the interpersonal level, women reported that their self-efficacy was influenced by family and socio-cultural factors which often lacked diabetes-specific information. At the organisational level, women described a fragmented healthcare system and felt that healthcare professionals' unfamiliarity with the reproductive health needs of women with type 2 diabetes resulted in ineffective integration into their diabetes care.

Conclusion: the provision of appropriate care to women with type 2 diabetes prior to and during pregnancy is inadequate, leaving them vulnerable to increased health risks and emotional distress. Innovative ways are needed to embed reproductive healthcare into mainstream diabetes management for women with type 2 diabetes prior to and post-pregnancy.

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