Perceptions of Respectful Midwifery Care among Mothers with Gestational Diabetes: A Qualitative Exploration of Maternity Care Experiences

Abstract

The high prevalence of gestational diabetes mellitus (GDM) highlights the importance of understanding the psychosocial experiences of pregnant women, particularly in relation to support the quality of maternity care. While previous studies have primarily focused on the clinical aspects of GDM, significant gaps remain in understanding mothers’ experiences and how family support and interactions with healthcare providers influence both adherence to self-management and maternal psychological well-being. This study aimed to explore the experiences of women with GDM in Bengkulu City, with a particular focus on the implementation of Respectful Maternity Care (RMC) principles. A qualitative phenomenological approach was employed, using in-depth interviews conducted both synchronously (in real time) and asynchronously (via messaging platforms) with six women with GDM, three midwives, and one head of a community health center. Participants were purposively recruited via social media and through local gatekeepers associated with community health centers. Thematic analysis, following Braun and Clarke, was applied, with verbatim transcription used to ensure data credibility. The findings revealed five main themes: emotional experiences related to diagnosis and maternity care, communication and therapeutic relationships with midwives, participation in decision-making, the need for empathic and continuous support, and challenges in managing lifestyle modifications. Stigma and psychological pressure emerged as barriers, whereas empathic communication, patient empowerment, and family/community support served as protective factors. These findings underscore that a holistic, mother-centered application of RMC can enhance maternal engagement, mitigate the effects of stigma, and improve adherence to self-management. The study’s implications are critical for developing integrative midwifery interventions that are sensitive to the local context and actively involve family and community support in GDM management.