A review of the evidence finds the impacts are far reaching
Around one in seven pregnant women are diagnosed with gestational diabetes (GDM). GDM is managed with healthy eating, physical activity, glucose monitoring and, sometimes, with medication(s). Pregnancy is already a time of great change, both physical and emotional. So, diagnosis of GDM can come as a shock, and cause added stress.
Some women report feeling ashamed of having GDM. They are concerned about how others might view them, and judge them. These are examples of ‘diabetes stigma’. There are two main types of stigma:
- Experienced stigma. This refers to being labeled, judged, or treated differently by others.
- Internalised stigma. This is when a person believes these negative labels and judgments about themselves. This is also known as self-stigma or shame.
Led by Emma Davidsen, researchers in Denmark have conducted a ‘scoping review’, to pull together what is already known about stigma in GDM. They found 44 relevant studies. Most studies used interviews or group discussions. The studies explored the key drivers, experiences and consequences of stigma.
What did the review find?
Drivers of Stigma
GDM stigma may be driven by several factors. First, there is a general lack of knowledge around GDM, its complex causes and risk factors. This may lead to myths and misconceptions about GDM. Other people may make women feel they are responsible for developing GDM. This is made worse by unrealistic social pressures of what it means to be a “good mother”. Stigma may be heightened for women who have other health conditions, overweight or obesity, or belong to an ethnic minority group.
Experienced stigma (how you are treated by others)
Women with GDM report being labelled as lazy or irresponsible. They report being blamed and shamed for their diagnosis or glucose levels. They report being treated differently by others. Women report receiving stigmatising comments and treatment from healthcare professionals, partners, relatives, and in the community.
Internalised Stigma (self-stigma)
Internalised stigma was the most common form of stigma reported by women with GDM. Women reported feelings of guilt and failure. They felt responsible for their diagnosis and the potential impacts on their baby’s health.
The impact of GDM stigma
Women reported negative impacts of stigma on their health and wellbeing. Due to experienced stigma or fear of being blamed, some women avoided health appointments and did not report their glucose levels to health professionals. Some women engaged in disordered eating. Others reported feelings of loneliness, social isolation, and stress. Impacts of stigma also included not wanting any more children and not prioritising their own health after pregnancy.
Like people with other types of diabetes, women with GDM experience stigma in many areas of life. Stigma has major negative impacts on health and wellbeing. So, tackling diabetes stigma must be prioritised.
To read more of our research about diabetes stigma, check out our previous blogs.
Reference: Davidsen E, Maindal HT, Rod MH, Olesen K, Byrne M, Damm P, Nielsen KK. The stigma associated with gestational diabetes mellitus: A scoping review. EClinicalMedicine, 2022; 11;52:101614. doi: 10.1016/j.eclinm.2022.101614.Print This Post