Exploring Mi'kmaq Women's Experiences with Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is characterized by a carbohydrate intolerance that is diagnosed in pregnancy. In recent years, the incidence of diabetes has increased with one in eight First Nations women reporting the development of this condition. Diabetes is three to five times more common among First Nations people than the general population. Women diagnosed with GDM have an increased risk of developing glucose intolerance later in life, with approximately 50% developing Type II diabetes within 15 years. Hypertensive disorders, higher caesarean section rates, higher rates of spontaneous preterm delivery, pre-eclampsia, and hypoglycemia are some complications associated with this condition. In addition to physiological complications, there are a number of social and political contexts which affect Aboriginal women and their families during pregnancy. Since there is a paucity of research exploring First Nations women's experiences with GDM, a participatory study was conducted for the purpose of providing new knowledge about First Nations women's experiences with GDM. Participatory and Indigenous principles informed and guided this study. Conversational interviews with nine Mi'kmaq women who experienced GDM in addition to talking circles with the participants and other community members were conducted. A hermeneutic phenomenological approach was used to search for essential and peripheral themes and the women's life experiences were interpreted in terms of life existentials of lived space, lived body, lived time, and lived relation as a framework to present the findings. Four themes emerged which included a) Uncovering the Experiences of GDM, b) Barriers Limiting Access to Health Care c) Social Support During Pregnancy, and d) Feeling Compelled To Take Action. Based on these findings using the social determinants of health (SDOH) as a framework, the women's stories inform health care providers about the complexities of Mi'kmaq women's lives. Implications for policy changes, education, clinical practice, and research are addressed.