Expectations and experiences regarding family planning, pregnancy, and motherhood in women with type 1 diabetes - A qualitative study.

BACKGROUND

Optimal treatment and support in family planning for women with type 1 diabetes (T1D) and follow-up during pregnancy are important, however, there is limited knowledge from the women's perspective on their considerations of family planning, pregnancy, and motherhood.

OBJECTIVES

To explore expectations and experiences of family planning, pregnancy, and motherhood among women with T1D.

DESIGN

We employed a qualitative study design with semi-structured interviews.

METHODS

We conducted semi-structured individual interviews (June to November 2022) with 17 women with T1D aged 18-45 at a diabetes outpatient clinic in Norway. We analyzed the data using thematic analysis.

RESULTS

Four main themes, each with sub-themes, linked to a timeline from planning the pregnancy to becoming a mother were identified: (1) Existential considerations in family planning; (2) Ambiguous information sources and the need for individualized guidance about pregnancy and T1D; (3) Preparations for pregnancy and balancing uncertainties during pregnancy; and (4) Motherhood intertwined with diabetes. Overall, the women expressed a need for support in handling and managing their glucose control in the phase of family planning, during pregnancy, and when preparing for the role of mother.

CONCLUSION

Women with T1D reported many worries and concerns related to family planning, pregnancy, and motherhood, and thus, individualized information and support related to diabetes and reproductive health should be an integrated part of follow-up care. Women with T1D seem to have high expectations and strong commitment to their diabetes self-management during pregnancy, conditional on support and guidance from health care providers (HCPs). A sensitive approach from HCPs in clinical consultations is vital to meet the individual woman's need for support. More research about reproductive health in women with T1D is needed, especially regarding how motherhood and diabetes intersect in everyday life.