“I gave birth, and then I disappeared”—women's experience of primary care follow-up and lifestyle prevention after gestational diabetes

PURPOSE: Primary care follow-up of women with previous GDM is often lacking. Little is known about effective approaches to improve follow-up and promote a healthy lifestyle. METHOD: Semi-structured individual interviews were conducted with 17 purposively sampled women with previous GDM in southern Sweden. The interviews were audio-recorded, transcribed verbatim, and qualitative content analysis was performed. RESULTS: Three main categories were found: "a missed proactive opportunity caused by insufficient GDM follow-up", "need for a holistic approach to health and wellbeing", and "ambivalence toward tech-enhanced lifestyle management". Women with previous GDM felt abandoned by healthcare after labour, since follow-up in primary care was lacking. Follow-up was viewed as proactive and requested, preferably in the form of a holistic approach to health. Motherhood and future T2DM risk were the strongest motivators for healthy lifestyle behaviours. Overall, they were cautiously optimistic regarding digital solutions in facilitating follow-up and lifestyle improvement. The capability opportunity motivation-behavior (COM-B) framework was applied, highlighting key determinants of women's ability to make lifestyle changes. CONCLUSIONS: Promoting a healthy lifestyle among women with prior GDM requires efforts at multiple levels to reduce long-term diabetes risk. Structured primary care follow-up and person-centred lifestyle support can be potentially enhanced through digital health interventions.