Gestational Diabetes
This week we are looking at Gestational Diabetes (GD). In the UK approximately 16 pregnant women out of 100 will develop GD. These women did not have diabetes before pregnancy, and for most women it goes away after birth. Some women may be diagnosed with GD in their first trimester - it is much more likely that those women did have Diabetes before they conceived, and in this case it won’t go away after birth, If you are diagnosed with GD you are more likely to develop Type 2 Diabetes later in life.
Your body undergoes lots of changes in pregnancy - and one of these changes is that the hormones produced make it harder for your body to use Insulin properly. Some pregnant people become Insulin resistant - making it hard for the body to use glucose (sugar) properly to make energy. This means the sugar stays in the blood stream - leading to a rise in blood sugar. This leads to Gestational Diabetes.
As part of your first midwife appointment, known as a ‘booking’ appointment, your midwife will discuss any risk factors for GD that you may have - these include a BMI above 30kg/m2, a previous baby weighing 4.5kg or more, previous gestational diabetes, a first degree relative with Diabetes, or if you have a South Asian, Black or African Carribean, or Middle Eastern background - as these ethnicities have a high prevalence of Diabetes.
If you have one of these risk factors you will be offered an oral glucose tolerance test from 24 - 28 weeks of pregnancy. If you had gestational diabetes in a previous pregnancy you will be offered the test earlier in pregnancy. You will be asked to fast overnight, and only drink water when you wake up. The test involves an initial blood test to measure the amount of glucose in your blood when you have been fasting, you then get to drink a delicious glucose gel which has 75g of glucose. 2 hours later another blood test is taken, allowing your team to see how your body processes the sugar. The results of these blood tests are used to diagnose GD.
It can be a real shock to be diagnosed with Gestational Diabetes, as most people have no symptoms at all - or any symptoms that you do experience are very similar to those of pregnancy, for example needing to pee more often, especially at night, feeling more thirsty than normal, being very tired.
If you are diagnosed with GD, you will be taught how to monitor your blood sugar levels. Many people with Gestational Diabetes can keep their blood sugar under control by making changes to their diet and physical activity levels. Your healthcare team will support you to do this, although it can feel really challenging and intimidating at first. However you may need medications to help keep your blood sugars within healthy limits.
Most women with Gestational Diabetes have otherwise normal pregnancies and healthy babies. Your team should explain the possible complications that can be linked to having GD, for example you are more likely to have an induction of labour or a caesarean section, have a baby over 4kg, or have extra amniotic fluid around your baby. Your baby may also have low blood sugars after birth, there is also a small increase in the rates of stillbirth for those with Gestational Diabetes. Hearing about increased risks for you and your baby is likely to cause some anxiety, but it is important to remember that a risk is only a chance of something happening, not a definite. Try to keep the risks in perspective, all pregnancies carry risks - that is just a way of discussing the chances of different outcomes. Although you cannot remove the risks associated with Gestational Diabetes completely, you can reduce them. Attend all of your appointments, and use your BRAIN to make good informed choices for yourself.
If you feel that anxiety and worry, about a diagnosis or anything else, is impacting your daily life please speak to your midwife or GP who will be able to signpost you to support. Many hospitals have dedicated Perinatal Mental Health Teams who can help with a whole host of mental health issues.
Hypnobirthing is for everybody and every birth. The skills that hypnobirthing will teach you will help you to navigate Gestational Diabetes, or anything else that comes your way in pregnancy and birth. Take a look at some of the stories from people in The Positive Birth community who have had Gestational Diabetes, and gone on to have amazing, empowering births!