Table 1.

Results from thematic analysis of women’s emotional and psychological experience of GDM by categories, codes and illustrative quotes

Categories/Sub-themes	Codes	Quotes
Experience of GDM diagnosis:
Initial emotional reactions to receiving a GDM diagnosis	Traumatised	It was very traumatising, and I cried for several days, because it was my first baby, and I waited so long for this baby. I was scared. (Focus Group 8, Participant 30)
	Anxious about the baby	For me it was scary, because I felt that I am going to lose my child. Or am I going to remain diabetic for the rest of my life, because I see people injecting themselves, I felt so bad, but the first thing was, is my child safe? My life changed completely (Focus Group 8, Participant 32)
	Confused about why and what to do	So, it really changed my life, I did not know it existed before I had it, that’s scary; if I could have known more about it, if I heard it somewhere. I really wish that I was informed, somehow. Even in our communities, it’s not spoken about, Gestational Diabetes. Maybe you could do something to prevent it from happening if you know information beforehand (Focus Group 1, Participant 4)
Experience of GDM pregnancy
Coming to terms with GDM diagnosis and adjusting to the constraints of living with GDM	Feeling trapped and controlled	When I got here, I didn’t know where to go, the security told you must sit in that room. You’ll go sit there, you get to see, you go wee, go take your weight; do that, and after that you see the doctor and from there you go home. It’s like you’re not sitting with someone and they’re explaining to you, this is what’s happening. You don’t know, and that is a problem for me, because if you don’t know where you stand. (Focus Group 4, Participant 14)
	Disruption to maternal and wife role	Now I think of the time when I was in hospital, the children were alone at home and my husband had to look for something for them to eat. Who was going to cook for them? (Focus Group 2, Participant 8)
	Being closely monitored	I was seven and a half months, and they said they would have to book me inside [hospital] for a few months till I give birth to monitor. I couldn’t go home. And when I went home, I would only stay two days and then I will come back again; I had to make sure that for that days I’m at home, I must eat well but I was just telling myself, no one can tell me, but my boyfriend was always monitoring me. He didn’t even go to work, he gave up his job, because it was for his baby, his first child. (Focus Group 3, Participant 12)
	Constantly worried, self-questioning and struggling to comply	I was just worried like, is there going to be enough space for the baby to grow? Do I need to keep the sugar down, what am I going to do? How do I do it? It felt like a constant battle. (Focus Group 6, Participant 20)
	Managing co-morbidity and protecting unborn baby	In the process of booking for ANC, when they did all the tests, they found that I was HIV positive. My main worry during the pregnancy was of transmitting HIV to the baby (Focus Group 6, Participant 21)
Experience of GDM delivery
Feelings of apprehension about childbirth and their maternal role	Irrational/paralysing fear of caesarean birth	My mother shared her experience with me of what she went though, and she had a Caesar because of the Diabetes, and I was scared I’m also going to have a Caesar, and she told me the things she went through, and I cried. I didn’t want to eat anything. I was so scared; it was very hard for me to accept. (Focus Group 8, Participant 26)
	Anxiety regarding maternal identity as a ‘good’ mother’	It was my first baby, I didn’t know I could fall pregnant, so it was, like, a huge thing for me to just get it right the first time. They also said they’re going to induce me. I said ‘I don’t actually want to be induced. I want the pain to come by itself (Focus Group 3, Participant 11)
	Separation from new-born following delivery	The nurses went with the baby the whole day. I just saw the baby, and they took the baby to check the baby, maybe she also has sugar. So, you are not with the baby, the baby is in another place, you know what you can feel [gestures]? I started to stress; now where is my baby? (Focus Group 2, Participant 8)
Post-partum period:
“In limbo” - feelings of abandonment once the intensive support from both the health system and family ends	Need for post-delivery counselling	You will need to know what you’re going to have to do to maintain a healthy lifestyle, so if there’s counselling and someone to talk you through it and guide you, even better, especially for those women that are not knowledgeable, that don’t know these things, it’s very good to be counselled afterwards. (Interview 1, Participant 5)
	Postpartum screening for diabetes	You see, I keep on having excuses because I’m not sick that time. I just need to check. I don’t care enough, I would say, so, because I am not sick, I don’t see a need, which is wrong, but that’s what I do. You will only get worried when you got sick, then you start making time for those things (Interview 3, Participant 10)