This is the published version:
Rasmussen, Bodil, Hendrieckx, Christel, Clarke, Brydie, Botti, Mari, Dunning, Trisha, Jenkins, Alicia
and Speight, Jane 2013, Psychosocial issues of women with type 1 diabetes transitioning to
motherhood: a structured literature review, BMC pregnancy and childbirth, vol. 13, no. Article 218,
pp. 1‐10.
Available from Deakin Research Online:
http://hdl.handle.net/10536/DRO/DU:30059611
Reproduced with the kind permission of the copyright owner.
Copyright : 2013, BioMed Central
, Rasmussen et al. BMC Pregnancy and Childbirth 2013, 13:218
http://www.biomedcentral.com/1471-2393/13/218
RESEARCH ARTICLE Open Access
Psychosocial issues of women with type 1
diabetes transitioning to motherhood: a
structured literature review
Bodil Rasmussen1*, Christel Hendrieckx2,3, Brydie Clarke1, Mari Botti1,7, Trisha Dunning1,4, Alicia Jenkins5
and Jane Speight2,3,6
Abstract
Background: Life transitions often involve complex decisions, challenges and changes that affect diabetes
management. Transition to motherhood is a major life event accompanied by increased risk that the pregnancy will
lead to or accelerate existing diabetes-related complications, as well as risk of adverse pregnancy outcomes, all of
which inevitably increase anxiety. The frequency of hyperglycaemia and hypoglycaemia often increases during
pregnancy, which causes concern for the health and physical well-being of the mother and unborn child. This
review aimed to examine the experiences of women with T1DM focusing on the pregnancy and postnatal phases
of their transition to motherhood.
Methods: The structured literature review comprised a comprehensive search strategy identifying primary studies
published in English between 1990–2012. Standard literature databases were searched along with the contents of
diabetes-specific journals. Reference lists of included studies were checked. Search terms included: ‘diabetes’, ‘type
1’, ‘pregnancy’, ‘motherhood’, ‘transition’, ‘social support’, ‘quality of life’ and ‘psychological well-being’.
Result: Of 112 abstracts returned, 62 articles were reviewed in full-text, and 16 met the inclusion criteria. There was
a high level of diversity among these studies but three common key themes were identified. They related to
physical (maternal and fetal) well-being, psychological well-being and social environment. The results were
synthesized narratively.
Conclusion: Women with type 1 diabetes experience a variety of psychosocial issues in their transition to
motherhood: increased levels of anxiety, diabetes-related distress, guilt, a sense of disconnectedness from health
professionals, and a focus on medicalisation of pregnancy rather than the positive transition to motherhood. A
trusting relationship with health professionals, sharing experiences with other women with diabetes, active social
support, shared decision and responsibilities for diabetes management assisted the women to make a positive
transition. Health professionals can promote a positive transition to motherhood by proactively supporting women
with T1DM in informed decision-making, by facilitating communication within the healthcare team and
co-ordinating care for women with type 1 diabetes transitioning to motherhood.
Keywords: Type 1 diabetes mellitus, Woman, Literature review, Pregnancy, Life transition, Motherhood, Social
support, Well-being
* Correspondence: bodilr@deakin.edu.au
1
School of Nursing and Midwifery, Deakin University, 221 Burwood Highway,
Burwood, Vic 3125, Australia
Full list of author information is available at the end of the article
© 2013 Rasmussen et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the
Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.
