Indigenous women's experiences of diabetes in pregnancy: A thematic synthesis

Background: Indigenous women's voices are largely silent in the literature because of a lack of opportunity to share their experiences and understandings of diabetes in pregnancy (DiP). Aim: To synthesise qualitative literature describing the experiences of Indigenous women with DiP. Methods: A librarian assisted, systematic search was conducted across CINAHL, EMBASE, Global Health, Medline, ProQuest, PubMed, Scopus and the Web of Science databases. International, peer reviewed studies published in English, between the years 1999 and 2019 that explored Indigenous women's experiences of DiP were sought. Thirteen papers were coded for recurring patterns and conceptual overlaps and synthesised into themes. Findings: Analysis revealed four themes: ‘Poverty and Vulnerability: Colonisation's Legacy’; ‘Contradictions and Confusion: Understandings of DiP’; ‘Shame and Blame: Experiences with Health Professionals’; and, ‘Community and Care: Cultural Constructions of Health’. Discussion: This review has revealed similar concerns and experiences of DiP among Indigenous women across communities in Canada, Alaska, the United States and Aotearoa New Zealand. To work with and effectively engage with Indigenous women, requires a shift from focusing on individual behaviours, to recognising and including cultural strengths, and addressing structural inequity in relation to healthcare. Conclusion: This review has resulted in a call to action for researchers to work collaboratively with Indigenous communities to co-design culturally safe, appropriate, and relevant policies, programs, models of care and educational materials with Indigenous women