‘No sugar’, ‘no junk food’, ‘do more exercise’ – moving beyond simple messages to improve the health of Aboriginal women with Hyperglycaemia in Pregnancy in the Northern Territory – A phenomenological study

• Published in: Women and birth : journal of the Australian College of Midwives 2021-11, Vol.34 (6), p.578-584
• Main Authors: Kirkham, R., King, S., Graham, S., Boyle, J.A., Whitbread, C., Skinner, T., Rumbold, A., Maple-Brown, L.
• Format: Article
• Language: English
• Subjects: Female; gestational diabetes; health education; health literacy; Health Services, Indigenous; health workforce; Humans; hyperglycaemia in pregnancy; Hyperglycemia - prevention & control; maternal health; Maternal Health Services; Northern Territory; Pregnancy; Sugars
• ISSN: 1871-5192; 1878-1799; 1878-1799
• DOI: 10.1016/j.wombi.2020.10.003

Globally, rates of hyperglycaemia in pregnancy are highest among Indigenous women. The highest prevalence has been documented among Aboriginal women in the Northern Territory of Australia. Despite knowledge of this for over two decades, there has been very limited examination of the specific needs and experiences of Aboriginal women regarding this condition. How do Aboriginal women with hyperglycaemia in pregnancy understand and experience this condition, and how can their care be improved? A phenomenological methodology underpinned semi-structured in-depth interviews with 35 Aboriginal women and seven health professionals across the Northern Territory. Data were inductively analysed. The findings revealed that in general, participants in this study could recite simple health messaging regarding diabetes (e.g. ‘no sugar’), but many lacked in-depth knowledge and this affected the management of their condition. Nevertheless, many identified pregnancy as a powerful motivator for change, signalling scope to improve health messaging. Women consistently expressed the need for diabetes education that was culturally appropriate, a clear desire for maternity care that was family-centred, based on respectful relationships with the same care provider, and respected Aboriginal ways of knowing and being. Existing health messaging around hyperglycaemia in pregnancy has limited reach with Aboriginal women in the Northern Territory. Reducing the burden of hyperglycaemia in pregnancy among these women requires a sustained commitment to redesign of maternity and diabetes care to incorporate the cultural and social context of women’s lives.