Now Australia-first research sets the stage for a new way forwards.
“The experience of stigma can put emotional well-being, physical health and engagement in self-care all at risk,” says Dr Elizabeth Holmes-Truscott, Deputy Director of the Australian Centre for Behavioural Research in Diabetes (ACBRD) at Deakin University’s Institute for Health Transformation. The ACBRD is a partnership between Deakin University and Diabetes Victoria.
Dr Holmes-Truscott was diagnosed with gestational diabetes during her own pregnancy, and has first-hand experience of the blame and shame surrounding the condition.
“Our new research provides a clear picture of the experiences and impacts of stigma among women with gestational diabetes in Australia,” she says.
“With this important foundation, now we can move towards developing ways to better support women with this very common condition of pregnancy.”
Gestational diabetes affects one in six pregnant women in Australia every year. It’s a metabolic condition, diagnosed when higher than normal blood glucose levels first appear during pregnancy.
While gestational diabetes resolves after delivery of the baby, it’s important the condition is managed through diet, exercise and/or medication to reduce the risk of complications for mum and baby.
Gestational diabetes can result in high birth weight, pre-term birth and even stillbirth. Women are more likely to experience C-section delivery and are at elevated risk of high blood pressure, pre-eclampsia and future diabetes. Importantly, there’s also a significant emotional toll reported by women with gestational diabetes.
In conducting their research, Dr Holmes-Truscott and colleagues interviewed women with current or recent gestational diabetes.
The women reported stigma to be driven by stereotypes and blame, and linked with societal norms regarding motherhood and pregnancy, media messaging, as well as inflexible and inconsistent healthcare policies.
“Women with gestational diabetes may avoid healthcare support due to their experiences of stigma from doctors, but also internalised stigma, such as self-blame or negative feelings linked with their own expectations of pregnancy and motherhood,” says Dr Holmes-Truscott.
One study participant reported: “The stereotype part is that you are an unhealthy person, generally. So your lifestyle is unhealthy and that’s caused you to have gestational diabetes… And that kind of moral implication of gluttony and sloth.”
Another participant reported: “The stigma that you receive from the medical profession as soon as you’re diagnosed… it’s like you’ve lost credibility.”
While new national clinical guidance on the screening and diagnosis of gestational diabetes recognises the harms of stigma, actionable recommendations to address it are lacking.
Looking ahead, the researchers are exploring future initiatives in stigma-free diabetes care. They call on health professionals to take the Pledge to End Diabetes Stigma.
The new study is published with open access in the journal Diabetic Medicine, with co-authors from Deakin University, Diabetes Victoria and Monash University.
Read the full research paper titled: Exploring the social experiences, stigma and discrimination, faced by women with gestational diabetes: A collaborative qualitative study and item-pool development
Read more about Dr Elizabeth Holmes-Truscott‘s research.
