Keywords

Type 1 Diabetes, Pregnancy, Empowerment, Self-determination, Guided Self-Determination, Grounded theory, Life skills, motivation, Glycemic control, Motherhood

Abstract

Background:
International focus on lowering pregnancy related complications in women with type 1 diabetes has improved the outcome for both mother and child remarkably. However, research has shown that pregnancy is an extremely demanding and vulnerable time for this group of women and that glycemic levels deteriorate after birth. Little is known of the factors influencing the glycemic control in the post-birth period and this particular period seems unexplored. Therefore, the aim of this study was to explore and illuminate the potential factors influencing glycemic control after birth in women with type 1 diabetes.

Method:
Grounded Theory was applied to explore the pregnancy journey among postpartum women with pre gestational type1 diabetes. The women were theoretically sampled from 2007-2016. For two of the first ten sampled women, self-determined motivation seemed to improve the journey, why we subsequently explored the importance of self-determined motivation by sampling seven women with presumed higher self-determined motivation from earlier guided self-determination interventions.

Results:
A total of 17 women aged 20-45 years with pre gestational type1 diabetes were included in the study. A five-stage theory was developed with a core category, “Also for my sake,” explaining how greater self-determined motivation increased the women’s ability to manage the challenges of pregnancy and having a newborn. They 1) more easily achieved the green light for pregnancy; 2) perceived pregnancy as enjoyable and manageable; 3) had only a short child-first stage with less attention to their diabetes; 4) recognized and managed a child-or-me dilemma; and 5) achieved a child-and-me balance by prioritizing their long-term health and glucose management.

Conclusion:
Higher self-determined motivation before pregnancy seems to ease the pregnancy journey, with a potential positive long-term impact on glucose control.

Citation

Hye-Knudsen K, Krogslund KW, Dobson L and Zoffmann V. “Also For My Sake”: A Grounded Theory on the Motivation of Women with Type 1 Diabetes during the Journey of Pregnancy. SM J Gynecol Obstet. 2017; 3(2): 1024s.