Barriers to postpartum follow-up of mothers with gestational diabetes mellitus and its implications: a mixed method study

Aims: To explore the barriers that reduce postpartum follow-up of mothers with gestational diabetes mellitus. Settings and design: This is a mixed method study with a qualitative study followed by a detailed narrative review conducted in Karnataka. The subjects were selected from Dr. T M A Pai Rotary Hospital, Karkala. Methods and material: A total of 6 in-depth interviews were conducted out of 9 patients who met the inclusion and exclusion criteria. The contact number of the patients was obtained and they were contacted over the phone. Interviews were conducted at a place and time of the women’s choice. Narrative review: Thematic analysis approach was used for analysis. The codes were formed from the transcripts and then categories were formed. A narrative review was also conducted to explore the existing evidence on the topic. In total, 62 articles were reviewed including various types of studies. Results: The key findings are categorized in general as barriers, then subthemes were formed. The most common barriers were lack of prior appointment for mothers, lack of adequate hospital facilities, baby and concerns, priority and lack of knowledge or health education. Conclusions: The overall study findings reveal that healthcare facilities must be strengthened to avoid long waiting time and overcrowding to improve the screening after delivery. Educating the women regarding the need for dietary restrictions and exercise and giving priority to their own health as well as reminder systems is necessary to ensure the postpartum follow-up.