Attendance for Postpartum Glucose Tolerance Testing Following Gestational Diabetes among South Asian Women in Australia: A Qualitative Study

Objective: To conduct an in-depth exploration of the experiences of and perspectives on postpartum Glucose Tolerance Test (GTT) screening of South Asian women diagnosed with GDM in Melbourne, Australia. Design: Using an exploratory qualitative methodology, this study was carried out in two phases: the first phase involved face-to-face in-depth interviews with 17 recent immigrant women from South Asia. In the second phase 23 GDM diagnosed women were interviewed. Setting: All interviews were conducted at a place and time of the women’s choice. Participants: Thirty-three of 40 South Asian women who were interviewed antenatally after GDM diagnosis also participated in telephone interviews conducted between nine and 52 weeks postpartum. Findings: Women were aware that they had an increased risk of developing Type 2 diabetes but a number of barriers caused them not to attend, or to postpone their postpartum GTT screening, such as: lack of physical and emotional support after birth, busyness of daily life, and traveling overseas after birth. Women found it difficult to maintain dietary and exercise recommendations after birth, largely because health messages were not conveyed in a culturally appropriate manner, which led to discontinuation of lifestyle adopted in pregnancy after GDM diagnosis. Key Conclusions: Despite difficulties, South Asian women with previous GDM eventually presented for postpartum GTT screening and follow-up care within six-nine months of birth. Although awareness of follow-up and risk of Type 2 diabetes was high, some women found it extremely difficult to continue with the changes to diet and exercise they had adopted in pregnancy. Implications for Practice: Women and their families should be provided with culturally appropriate advice in pregnancy relating to lifestyle modification and again at discharge after birth so that they are able to maintain and continue with the changes after birth.