Exploring the social experiences, stigma and discrimination, faced by women with gestational diabetes: A collaborative qualitative study and item-pool development.

AIM

To explore experiences of stigma related to gestational diabetes (GDM) among Australian women and collaboratively develop a comprehensive item pool to assess experienced and internalised GDM-specific stigma.

METHODS

A GDM Lived Experience Advisory Group (G-LEAG; n = 4) informed all aspects of a two-phase qualitative research process. Phase 1 included semi-structured online interviews with 20 women with current or recent GDM. Reflexive thematic analysis identified drivers and facilitators, markers, manifestations, impacts and protective mechanisms of GDM stigma. Findings informed the development of an item pool, debriefed and refined with a subset of 10 participants in Phase 2 interviews.

RESULTS

All participants perceived, experienced, anticipated and/or internalised GDM-specific stigma. They perceived GDM-specific stigma to be driven by stereotypes and blame, and facilitated by societal norms regarding motherhood and pregnancy, media messaging, as well as inflexible and inconsistent healthcare policies. They reported social, emotional and self care impacts, as well as perceived loss of autonomy in clinical care. They proposed potential protective mechanisms, including social and healthcare support, self-belief and self-compassion, and community awareness. In cognitive debriefing interviews, women reported that the draft items comprehensively covered their experiences of GDM-specific stigma and offered suggestions for refinement, resulting in a 74-item pool.

CONCLUSIONS

Findings provide rich insights into the experiences and impacts of stigma among women with GDM in Australia and resulted in a co-designed GDM-specific stigma item pool. The item pool is ready for psychometric assessment and item reduction, which will enable future quantification of the occurrence, impacts and mechanisms of GDM-specific stigma.