Barriers to engaging with postpartum follow-up care in women after gestational diabetes: a qualitative evidence synthesis

Gestational diabetes (GDM) affects up to 10% of pregnancies and significantly increases the risk of developing type 2 diabetes later in life—by up to tenfold. Postpartum follow-up care is essential for preventing type 2 diabetes in these individuals. However, despite established clinical guidelines advocating for universal follow-up care, uptake is low among postpartum women with prior GDM. This review aims to synthesise qualitative evidence on the barriers and facilitators to engaging with postpartum follow-up care among women who experienced GDM in pregnancy. Findings will be mapped to behaviour change models - the Theoretical Domains Framework and the Capability Opportunity Motivation - Behaviour (COM-B) model. Understanding the barriers and facilitators to engaging with postpartum follow-up care will improve health service delivery for this high-risk population. Gestational diabetes (GDM) affects up to 10% of pregnancies and significantly increases the risk of developing type 2 diabetes later in life—by up to tenfold. Postpartum follow-up care is essential for preventing type 2 diabetes in these individuals. However, despite established clinical guidelines advocating for universal follow-up care, uptake is low among postpartum women with prior GDM. This review aims to synthesize qualitative evidence on the barriers and facilitators to engaging with postpartum follow-up care among women who experienced GDM in pregnancy. Understanding these barriers and facilitators will improve health service delivery for this high-risk population.