Introduction:

Diabetes is a global epidemic, with similar experiences of increased diagnosis and poor outcomes amongst Indigenous populations internationally. Māori are recognised as tangata whenua of Aotearoa (New Zealand). The prevalence of diabetes in pregnancy (DiP) is rising in Māori, resulting in poor intergenerational health outcomes. Ngā Hua o te Kōpū recognises colonial impacts on Māori inequities in DiP and amplifies the voices of wāhine Māori (Māori women) to produce recommendations to DiP services to improve outcomes.

Methods:

Utlising transformative kaupapa Māori research methods, five focus groups occurred across the Waikato region, to share wāhine Māori space, knowledge, and experience of DiP.

Results:

Thematic analysis identified three themes 1) Impact of diabetes: the importance of time for wāhine to process their diagnosis and activate self-management of diabetes; 2) Relationships: between wāhine and clinicians, and value whānau contributions; and 3) Aspirations for DiP: calling for options in the areas antenatal clinic, modes of communication mode and Māori-led sharing of information and education.

Discussion:

The World Health Organisation identifies colonisation as a primary social determinate of health for Indigenous populations globally, and encourages autonomy and authority over our own futures. The themes illustrated four kaupapa pou (pillars) that illustrate how services can meet the aspirations of wāhine Māori. Whanaungatanga (reciprocal relationships), tino rangatiratanga (self-determination), manaakitanga (centralising Māori with DiP voices), and the Crown’s obligation to uphold te Tiriti obligations.

Conclusion:

Ngā Hua o te Kōpū highlighted themes explaining wāhine experience of DiP care which extend to four pou outlining wāhine Māori-informed initiatives for DiP service changes. While it is not possible to undo the impacts of colonisation on Māori, this research project reflects and learns from the past to make progress for the future. A future where Māori navigate their own journey for DiP care (tino rangatiratanga) with support of the Crown (te Tiriti obligations), utilising reciprocal relationships (whanaungatanga) within a DiP service that delivers respectful, generous, care for others (manaakitanga).

Acknowledgements:

Waikato Medical Research Foundation

Wāhine research partners experiential expertise and knowledge