Misconceived expectations: Aboriginal women's experiences with gestational diabetes mellitus in the urban context of Winnipeg, Manitoba
Tait Neufeld, Hannah
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More North American Aboriginal women are being diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the association of a number of health problems with GDM, there have been few evaluations of GDM prevention projects. Nor have investigators looked at Aboriginal women’s understandings of GDM in an effort to develop appropriate and effective health strategies. A qualitative investigation was therefore proposed to describe the experiences of Aboriginal women with GDM. The study began with unstructured interviews and focus groups with 25 advisors such as maternal care providers and community representatives working with Aboriginal women. Semi-structured explanatory model interviews were then conducted with 29 Aboriginal women in Winnipeg, the capital city of Manitoba, Canada. Fixed-response interviews were also administered and analyzed using cultural consensus analysis to determine whether or not shared cultural understandings existed among the Aboriginal women participants. Results of the consensus analysis revealed biomedical understandings were the most commonly shared. A more variable response was associated with women’s personal interpretations of GDM, leading to weak consensus overall. Thematic analysis of the semi-structured interviews illustrated the fear, anxiety and frustration many participants experienced with GDM. Women discussed their emotional reactions alongside negative relationships with food and other prescribed lifestyle treatments. These perspectives, combined with results from the group of advisors, pointed to communication and cultural barriers which may limit the quality of prenatal care received. Collectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy and emotional security towards effective management practices. Research contributing to a more comprehensive understanding of Aboriginal women’s experiences with GDM is also required, to provide further perspective for diabetes prevention and positive change.