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Healthcare Experiences of Low-Income Women with Prior Gestational Diabetes

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Abstract

Introduction An important yet understudied component of postpartum type 2 diabetes risk reduction among high risk women is experiences with the healthcare system. Our objective was to describe the healthcare experiences of a diverse, low-income sample of women with prior GDM, including their suggestions for improving care. Methods Focus groups were conducted among African American, Hispanic, and Appalachian women who were diagnosed with GDM within the past 10 years. Participants were recruited from community and medical resources. Twelve focus groups were conducted, four within each race-ethnic group. Results Three broad themes were identified around barriers to GDM care, management, and follow-up: (1) communication issues; (2) personal and environmental barriers; and (3) type and quality of healthcare. Many women felt communication with their provider could be improved, including more education on the severity of GDM, streamlining information to be less overwhelming, and providing additional support through referrals to community resources. Although women expressed interest in receiving more actionable advice for managing GDM during pregnancy and for preventing type 2 diabetes postpartum, few women reported changing behaviors. Barriers to behavior change were related to cost, transportation, and competing demands. Several opportunities for improved care were elucidated. Discussion Our findings suggest that across all racial and ethnic representations in our sample, low-income women with GDM experience similar communication, personal, and environmental barriers related to the healthcare they receive for their GDM. Considering the increased exposure to the health care system during a GDM-affected pregnancy, there are opportunities to address barriers among women with GDM across different race-ethnic groups.

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Acknowledgements

The authors thank the following individuals for their technical assistance with this study: Danielle Michael; Jackie Hicks; Stephanie Cedeño; Sierra Mullen.

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Authors and Affiliations

  1. The Ohio Department of Health, 246 North High Street, Columbus, OH, 43215, USA

    Reena Oza-Frank, Elizabeth Conrey, Jo Bouchard & Cynthia Shellhaas

  2. Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA

    Elizabeth Conrey

  3. College of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH, 43210, USA

    Cynthia Shellhaas

  4. Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA, 30322, USA

    Mary Beth Weber

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  1. Reena Oza-Frank
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  2. Elizabeth Conrey
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Correspondence to Reena Oza-Frank.

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Oza-Frank, R., Conrey, E., Bouchard, J. et al. Healthcare Experiences of Low-Income Women with Prior Gestational Diabetes. Matern Child Health J 22, 1059–1066 (2018). https://doi.org/10.1007/s10995-018-2489-y

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