Postnatal experiences and perspectives on future pregnancies among women with type 1 diabetes- a qualitative study.

OBJECTIVE: Women with type 1 diabetes (T1D) tend to have fewer children and the postnatal period can be particularly challenging, as the rapid decline in pregnancy-induced insulin resistance often complicates diabetes management. The aim of this study was to explore postnatal experiences of women with T1D and their perspectives regarding future pregnancies. METHODS: This qualitative study is part of the "Reproductive health in diabetes and prediabetes-study". Individual interviews using a semi-structured interview guide were conducted with 17 women with T1D, with or without pregnancy experience, aged 18-45 years. For the present analysis, we included a sub-sample of eight women who had previously given birth. Data were analysed employing thematic analysis. RESULTS: Three themes were identified, each with two corresponding sub-themes. 1) The women faced challenges in early postnatal diabetes management, dealing with unpredictable blood glucose and hypoglycaemia. 2) They expressed a sudden shift in the level of diabetes support after birth and that the health care providers at the maternity ward lacked diabetes competence. 3) Although they did not want diabetes to affect family planning, they acknowledged that T1D complicated their lives and influenced their pregnancy timing. CONCLUSION: Women with T1D experienced considerable challenges in postnatal diabetes management, primarily due to unpredictable blood glucose levels and insufficient postnatal follow-up. These findings highlight the importance of more systematic and individualized postnatal support. Moreover, the impact of diabetes on family planning underscores the need for comprehensive information and tailored guidance in reproductive health decision making.