MODIAB-pregnancy & birth

MODIAB-pregnancy

 

The need of insulin for all women during pregnancy successively increases up to 2-3 times. Achieving maternal normoglycemia is the most important factor for giving birth to a healthy child. In four qualitative interview studies the meaning of life during pregnancy and childbirth has been illuminated [1-3, 5]. Everyday life is a demanding struggle towards normoglycemia with frequent hypoglycaemic episodes, stress, worry and insecurity. The women feel “controlled by the blood glucose levels” for the unborn child´s sake who “makes demands” to be born healthy [1]. This situation is made worse when care providers show lack of competence and when paying more attention towards the unborn child than to the pregnant women themselves [2]. The women´s experiences of dealing with life circumstances are summarized as a construct of duality: “to master or to be enslaved” [3]. Women receiving care in a disconnected diabetes care organization do feel as messengers between different care providers. Need of support from other women having diabetes and being in similar situations is expressed [4]. In a cross sectional study performed in early pregnancy 168 participating women reported relatively high scores of self-efficacy in diabetes management and moderate scores of general wellbeing. A higher capability of self-efficacy in diabetes management correlated positively with self-perceived health and general wellbeing and negatively with hypoglycemia worry and diabetes distress. It was suggested that well-being and diabetes management could be supported by strengthening the women’s capability to achieve glycemic goals and their comprehensibility in relation to the treatment. This needs to be studied further. During childbirth both trust and distrust in care providers’ specific diabetes obstetric competence are experienced [5].

Publications

  1. Berg M, Honkasalo ML. Pregnancy and diabetes–a hermeneutic phenomenological study of women’s experiences. J Psychosom Obstet Gynaecol. 2000;21(1):39-48.
  2. Berg M, Sparud-Lundin C. Experiences of professional support during pregnancy and childbirth – a qualitative study of women with type 1 diabetes. BMC Pregnancy Childbirth. 2009;9(1):27.
  3. Berg M. Pregnancy and Diabetes: How Women Handle the Challenges. J Perinat Educ. 2005;14(3):23-32.
  4. Linden K, Sparud-Lundin C, Adolfsson A, Berg M. Well-Being and Diabetes Management in Early Pregnant Women with Type 1 Diabetes Mellitus. Int. J. Environ. Res. Public Health 2016; 13, 836.
  5. Sparud-Lundin C, Berg M. Extraordinary exposed in early motherhood – a qualitative study exploring experiences of mothers with type 1 diabetes. BMC Womens Health. 2011;11:10.

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