Reviewer ’s report  
 
Title: Perspectives on the psychological and emotional burden  of having gestational diabetes 
amongst low -income women in Cape Town, Sout h Africa  
 
Version: 0 Date: 18 May 2020  
 
Reviewer's report:  
 
Thank you for inviting m e to review this manuscript on "I felt like a prisoner" Perspectives on 
the psychological and emotional burden of having GDM amongst low -income women in Cape 
Town, South Africa" which was designed to explore the lived experience of GDM women in 
South Afric a.  
 
 
My general impression on this manuscript is that it had a clear research question and well 
defined questions that allow evaluation of study purpose. For the result, I found this study has 
been satisfactory answered and confirm through commensurate revi ew of available literature 
based on 35 GDM women which is sufficient.  
 
 
 
I have several comments for the authors:  
 
1. Title of manuscript: I personally think that "I felt like a prisoner" is very eye -catching 
but it does not represent the overall emotional b urden and perspective of GDM 
women as we noticed that there were mixed of different emotions chip in throughout 
the pregnancy as from point of diagnosis until postpartum follow up for neonates. I 
recommend the author could modify the title with a more gene ralized terms.  
 
2. Introduction: emotional distress happened among GDM women regardless of 
nationalities and ethnicities, yet the condition may varied based on quality of health 
care system. Based on the literature cited in introduction of this manuscript,  it was 
dominated with finding from Western countries, where the GDM women received 
better care and they were generally well -informed by the trained healthcare providers 
prior to any procedure given to GDM women as compared to South African GDM 
women. In m y opinion, author should also cite literature from countries in the east 
like South -east Asian or South Asian where the standard of care in O.G department 
may be at similar standard to that of in South Africa.  
 
 
3. Methods: Lack of information on qualitativ e research method (Eg: Ethnography, 
Phenomenological, grounded theory and etc) in the study design section.  
 
4. Methods: 35 respondents were included. Yet, author didn't mention how they 
ascertained when to stop recruiting respondents and how to justify da ta saturation, a 
boundaries defined for research should not go.  
 
 
5. Methods: This manuscript should add on information how they ensure this research 
was appropriately supervised, assurance of training, expertise and experience, which 
is important for its a ccountability.  
 
 
6. Methods: How the respondent's confidentiality and anonymity were guaranteed in 
this study, author should also provide ethical clearance approval number and whether 
they seek consent from respondent prior to the interview.  
 
 
7. Methods: re spondents share some distressing experience for being a GDM women, 
how interviewer indicate awareness and deal with this, does any strategies would be 
adopted to support and counselling to research subjects.  
 
 
8. Discussion: what are the implications of thi s study finding to healthcare provider and 
health care policy makers?  
 
 
9. Discussion: What is your suggestion for future research  
 
 
10. Reference: Lack of literature from countries in East.   
 
 
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the au thors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
 
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, f ees, funding, or salary from an 
organisation that may  in any way gain or lose financial ly from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation t hat may in any way gain or lose 
financially from the publication of this manuscript, either n ow or in the future?  
 
3. Do you hold or are you currently applying for any patents  relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating t o the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing int erests' 
below. If your reply is yes to any, please give details below.  
 
I have no competing interest.  
 
Reviewer Publication Consent. I agree for my report to be made available under an Open 
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