DRWF Women and Diabetes interviews: “We are missing out on opportunities to improve mental health” – midwife Laura Spence
The DRWF Woman and Diabetes series welcomes midwife Laura Spence, who was diagnosed with gestational diabetes during her third pregnancy, at which time she was also diagnosed with ADHD (attention deficit hyperactivity disorder).
At the heart of this project is a simple but powerful belief: every woman living with diabetes deserves to feel seen, heard, and supported.
Across the UK, women with type 1 and type 2 diabetes navigate a lifelong journey shaped not only by their condition, but also by the many milestones and challenges unique to womanhood – from adolescence and pregnancy, through menopause, to later life.
Alongside managing blood glucose levels, they balance careers, family, relationships, and their own health and wellbeing.
Yet too often, these experiences are underrepresented in public conversations about diabetes.
Many women tell us they have never heard a story that truly reflects their own – and that lack of visibility can leave them feeling isolated, misunderstood, or unseen.
The Women and Diabetes podcast series aims to change that.
Laura Spence is a midwife, who experienced gestational diabetes during her last pregnancy, in addition to a diagnosis of ADHD (attention deficit hyperactivity disorder). Laura wants to improve the experience of pregnancy, birth and early parenthood for neurodivergent people.
Laura said: “I trained in midwifery 15 years ago and stepped away from clinical practice just over two years ago to move into sexual health. I work across the women's health sector and sexual and reproductive health in a sexual health clinic. I am also a trained forensic examiner for the sexual assault referral centre.
“I was diagnosed with ADHD three years ago at the age of 37. I have three children, including a 16-year-old daughter, who has ADHD, autism and many chronic physical health conditions. My two sons are aged ten and eight. I was diagnosed with gestational diabetes in my third pregnancy, during which time I did not know I had ADHD. That pregnancy was particularly complicated because of the gestational diabetes, and I had quite marked postnatal depression and PTSD (post-traumatic stress disorder). All the pieces of my life seem to slot in together after that.”
DRWF: Can you tell us about your experience with gestational diabetes?
Laura: “With the first two children, I had two very healthy pregnancies. I was what is classified as green pathway, which means I was relatively low risk. I had a normal BMI (body mass index) and quite an uncomplicated family history. With the third pregnancy, started off similar to the first two. I was around 30 weeks pregnant when I went to see the midwife and she measured my bump. She felt that it was measuring on the larger side. I was referred for a growth scan.
“During that growth scan, they said that they estimated the baby's weight to be over the 98th percentile. I was then recommended to have the GTT (glucose tolerance test), which I fully expected that to come back as normal. I had lost a bit of weight between baby number two and this pregnancy and I remember one of my midwife colleagues saying I looked like a snake that swallowed a watermelon because I was so skinny. I just looked as if the bump was out of proportion with the rest of my body. So, when they came back and said, actually, this glucose tolerance test is positive, and it wasn't just mid-range. It was quite high. It put me right into the top management category that meant I had to see the diabetes team.
“I had to see the nutritionist and see the diabetes consultant. I absolutely was not expecting it, and I think my knowledge of gestational diabetes at that point, as a midwife, helped me to navigate that situation because I already knew what the risk factors were if I did not get this under control. I cannot imagine what that must feel like for someone else who doesn't already have that prior knowledge. How terrifying that must feel.
“There was a lot of conflicting opinions and advice that I was getting from different midwives. I then became quite unwell mentally after the birth. I remember not really leaving the house for about four weeks afterwards. I didn't want to go to the shops. I didn't really want to see anyone. I felt really low, which led me to seeing the GP.
“That led me to investigating my own level of neurodivergence. One therapy led to the other, to then me realising that I had ADHD.”
DRWF: How do neurodivergent patients cope and have good diabetes self-management?
Laura: “It is quite a complex thing to understand. While there is far more awareness around about those intersections, we ae not quite there yet. We are not putting out resources that are necessarily accessible or describing things for the right reading age or in the right formats, because we all learn in different ways, don't we? It depends on what that level of neurodivergence is, and what the support needs are. I do think that we're getting better at it, but I don't think that we're quite there yet.”
DRWF: Do healthcare professionals need more training and advice for understanding of what things mean?
Laura: “Absolutely. That is part of my social enterprise, NeuroNatal, that we are really focused on as providing education and support for healthcare professionals to help them understand what those neurodivergent needs might be. Helping them to know how to access those things, and how to navigate those conversations. I think a lot of the time there seems to be a little bit of fear around about it. They are frightened to ask in case they cause someone any offense, and maybe they just lack the confidence because they do not have the knowledge. That is really something we are trying to focus in on and provide them support and resources and some education around about it.”
DRWF: Tell us more about NeuroNatal?
Laura: “NeuroNatal was founded after my diagnosis. I reflected over my 15-year career as a midwife, and not once was neurodivergence ever considered in any aspect of maternity care.
“It is not asked about at the point of booking, and when you delve into what a sensory experience pregnancy can be and labour and the postnatal period, the risks are quite frightening. To give you a statistic, one in four women with ADHD will attempt suicide at some point in their life, and that is only the diagnosed ones.
“There is a huge generation of women who are still being missed, because of gender bias in research being heavily focused on white male children, giving us only one very narrow perspective of what ADHD looks like within the societal context. Because of that, it means that we might not be engaging these women in the right way. We are missing out on opportunities to improve their mental health.
“We are creating community and providing resources for free for neurodivergent parents, because I do not believe that parents, just because they have additional support needs, should have to pay for that.”
The DRWF Living with Diabetes women's health podcast series is supported by Abbott
Launched to coincide with World Diabetes Day (14th November), the DRWF Women and Diabetes series brings together inspirational women from diverse backgrounds who live with diabetes, to share their life stories in their own words.
We explore how they navigate the different stages of life while managing their condition, and the strategies they use to minimise its impact and live fully.
Sarah Tutton, DRWF Chief Executive, said: “At DRWF, everything we do is grounded in compassion, credibility, and collaboration. We actively listen to the voices of those we serve, ensuring that our initiatives are shaped by lived experience and respond to real-world needs. In doing so, we aim not only to inform and support, but also to inspire hope and positive change within the diabetes community.”
Watch all videos at the DRWF YouTube channel
Listen to the interviews in full as part of the DRWF Living with Diabetes podcast series here
Read more DRWF Podcasts: Launching the Women and Diabetes interviews series for World Diabetes Day
Read the DRWF diabetes information leaflet What is diabetes?
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