SELF-MANAGEMENT AND BREASTFEEDING IN WOMEN WITH PREEXISTING TYPE 2 DIABETES MELLITUS FROM THAILAND

The prevalence of type 2 diabetes mellitus (T2DM) is rising at a younger age, leading to an increased number of pregnant women with preexisting T2DM. Although traditional beliefs and practices influence diabetes management and breastfeeding, recommendations integrating Thai cultural beliefs in maternal care are lacking. The purpose of this dissertation is to describe diabetes self-management in pregnancy and breastfeeding experiences in women with preexisting T2DM from Thailand. This dissertation is a convergent parallel mixed-methods study, guided by the National Institute on Minority Health and Health Disparities (NIMHD) Framework. Data were collected two times. The first time was during pregnancy (T1). The second time was at 4-6 weeks postpartum (T2). The integration of qualitative and quantitative findings from T1 is presented in three chapters. Chapter 2 describes attitudes and confidence in diabetes management from twelve pregnant women with preexisting T2DM. Chapter 3 focuses on describing barriers and facilitators that influence diabetes self-management in pregnancy. Chapter 4 describes breastfeeding confidence and intention in pregnancy. In Chapter 5, the integration of qualitative and quantitative findings from T2 is presented. This chapter describes barriers and facilitators of breastfeeding in eight women 4-6 weeks postpartum. This dissertation holds significant importance due to its potential impact on improving the health of women and their offspring. The findings obtained from this research provide a profound and comprehensive understanding of the experiences of Thai women with preexisting T2DM during pregnancy and postpartum periods. This understanding serves as a foundation of knowledge that can guide future research endeavors to develop culturally sensitive multifaceted approaches aimed at addressing barriers, strengthening facilitators, and ultimately enhancing women's health.