South Asian Women's Perspectives and Recommendations on Gestational Diabetes Care and Postpartum Type 2 Diabetes Prevention in Aotearoa New Zealand: A Qualitative Study.

South Asian (SA) women in New Zealand face a disproportionately high risk of developing gestational diabetes mellitus (GDM) and subsequent Type 2 diabetes (T2D). Despite this elevated risk, significant gaps exist in culturally appropriate care for GDM and long-term postpartum follow-up. This qualitative study explored the experiences of SA women to identify the gaps and barriers encountered during and after GDM in transitioning from antenatal GDM care to postpartum primary healthcare and seek suggestions for improvement. To inform culturally responsive care strategies that can reduce the risk of progression to T2D after GDM, 30 semi-structured in-depth interviews were conducted with SA women diagnosed with GDM within the past 5 years. Participants were recruited through purposive sampling across New Zealand. Interviews were transcribed verbatim and analysed using an inductive thematic approach. Six key themes with sub-themes were developed: (1) awareness and education; (2) culturally tailored resources; (3) community support; (4) moving backwards to an unhealthy lifestyle; (5) preventing T2D; and (6) improving GDM and postpartum care. Participants advocated for prepregnancy or early counselling, community-based education to reduce stigma, culturally relevant dietary guidance, subsidised follow-up healthcare providers and structured long-term postpartum follow-up. The emotional burden of GDM and inconsistent healthcare communication were also prominent concerns. The findings highlight the need for integrated, culturally congruent and continuous care models for SA and ethnicities at high risk during and after GDM. Incorporating women's suggestions based on their lived experiences into service design may improve postpartum health outcomes and reduce future risk of GDM and T2D.