“To be honest, no one cares”: an ethnographic study of postpartum perceptions and practices after gestational diabetes in Vietnam

Gestational diabetes mellitus (GDM) may adversely affect the long-term health of mother and child, as the condition puts both at risk for developing type 2 diabetes (T2D). Maintaining healthy behaviors/habits and undergoing a postpartum oral glucose tolerance test (OGTT) are validated strategies to prevent T2D as well as other long-term health issues among women with previous GDM. There is a need for more knowledge about how women with previous GDM perceive their health risks and practice self-care in the postpartum period, particularly in low- and middle-income settings. This ethnographic study investigates how women with GDM in Vietnam perceive their diagnosis and practice self-care in the postpartum period, focusing on examining the interplay between postpartum maternal responsibilities, family support, and healthcare system engagement. In-depth ethnographic interviews were carried out with 20 mothers who were three to six months postpartum after experiencing GDM in their most recent pregnancy. The interviews were held in the participants’ homes, using a phenomenological approach to explore their experiences and analyze the data. Three themes emerged from the analysis as particularly pertinent to women’s self-care after GDM: (1) Lack of routine postnatal care and T2D screening in the healthcare system; (2) The mother’s attention and priorities in the postpartum period; (3) and Family expectations and cultural norms shape women’s postpartum health behaviors. The mothers and their family members showed a low-risk perception of GDM’s long-term risks, influenced by traditional customs and insufficient information from the healthcare system. As a result, many women viewed their T2D screening postpartum as insignificant. Prioritizing their own health and practicing postpartum GDM self-care were highlighted as challenging, as the child’s development became the whole family’s primary concern. This study provides insights into mothers’ postpartum experiences following pregnancies with GDM, highlighting the barriers to GDM-compliant postpartum self-care. Addressing GDM self-care information gaps within the health care system, coordinating health care follow-ups for mother and child, and engaging family members in communication programs can support women in continuous postpartum care practices. NCT05744856. (Registration Date: 2023-02-15 and Last Update Posted: 2024-04-30)