Hey Mama! The second trimester is such a sweet spot in your pregnancy. Hopefully morning sickness is in the past, your energy has returned and your bump is big enough to look like you’re pregnant, but not so big that you are uncomfortable. But there is one thing that has the potential to throw a wrench in your prenatal plans: Gestational Diabetes.
First, what exactly is Gestational diabetes?
Gestational diabetes is a form of diabetes that comes on for the first time during pregnancy. Similar to Type 2 diabetes, gestational diabetes impacts the way your body stores too much glucose in your blood instead of using it for energy.
If a Mama’s blood sugar is too high, it can cause health problems for both her and baby! This is one of a few scenarios where a baby can actually grow to be “too big”. According to ACOG, gestational diabetes can lead to labor complications like shoulder dystocia, cesarean birth or heavy bleeding after birth. In addition to baby being big, Mama is also at an increased risk for high blood pressure aka preeclampsia.
So how do you know if gestational diabetes is an issue for you?
Some of the risk factors that you may have gestational diabetes:
- Being overweight
- Being physically inactive
- Previously having gestational diabetes in a past pregnancy
- Having high blood sugar
- A history of heart disease
- Having PCOS
But hang on! It’s important to note that just because you have one of these risk factors, it doesn’t mean you’ll have gestational diabetes.
And it’s also important to understand that you can still have gestational diabetes even if you don’t fit the risk factors!
This is why testing (which is done around 24-28 weeks) for gestational diabetes may be an important part of your prenatal care!
Here’s a rundown of how testing goes.
Step 1) You will show up to the lab and have your blood drawn to get a baseline for your blood sugar. Tip: Try to schedule this in the morning and be sure not to eat a carb heavy or sugary meal before! You also should be intentional to try to keep your stress levels down, as stress can impact your glucose levels.
Step 2) Drink a glucose drink. The most common drink used is the somewhat infamous “Glucola”–a super sugary, syrupy drink that contains 50 grams of glucose in order to spike your body’s blood sugar. You will have 15 minutes to drink up and then you’ll be required to sit for an hour.
Some Mamas are uncomfortable drinking the Glucola drink and opt for alternative ways of testing. You can ask your provider about using something like Apple Juice or “The Fresh Test” in place of Glucola, or other methods of testing like the jelly bean test or home monitoring.
Step 3) After you’ve sat for an hour, you will have your blood drawn a second time to measure how your body is interacting with a heavy glucose load.
While I’m crossing my fingers that you get the green light, sometimes the results are not what you hope.
What happens if you’ “fail” the glucose challenge?
First, please try not to panic, Mama! It is NOT a reflection of you or the home you’ve made for that little baby in your belly. It just means that we’ll want to get some clearer answers with another round of testing before proceeding.
Your provider will likely have you schedule a 3-hour (sometimes just 2-hour) glucose challenge. This time, you’ll take the initial blood draw followed by a Glucola drink that has even more glucose in it. Then, you’ll have your blood drawn every hour for the next three hours.
If your readings come back in the normal range, Great! All clear and no need to think about it much more.
However, if your readings after the extended glucose challenge indicate gestational diabetes, you will have to put together a plan for keeping your blood sugar under control for the remainder of your pregnancy.
Managing Gestational Diabetes
The good news is that for many Mamas, gestational diabetes can be managed with lifestyle changes and monitoring blood sugar!
Your provider’s office will likely set you up with information regarding nutrition and how to eat balanced meals that won’t send your blood sugar into a tailspin. Making sure to eat 3 small meals and small snacks is the best way to ensure there are no big spikes throughout the day! And also, getting enough protein will help keep things in balance as well.
In addition to diet changes, making sure to exercise each day will help keep your gestational diabetes in check. Even something as simple as a brisk walk that gets your heart rate up will do the trick!
You’ll also be asked to measure your blood sugar throughout the day using an at home glucose meter. Hopefully your office will help you order one to pick up, but if not they are sold at pretty much every drug store or online.
Testing your blood sugar at home is done by pricking your finger and squeezing a tiny dot of blood on the test strip and having it measure how much glucose is present. I know, yikes! But it’s not as bad as it sounds!
You’ll be asked to keep a log of your readings to bring with you to your appointments, so your provider can monitor you and make sure everything looks healthy for you and baby.
What if lifestyle changes aren’t cutting it?
When it comes to managing gestational diabetes, some Mamas need a little extra help with medication to keep their glucose levels in check if lifestyle changes aren’t having enough of an impact.
According to ACOG, the most common medication given is insulin. Insulin does not cross the placental barrier and is therefore safe to take while pregnant. If your provider believes you need insulin to manage gestational diabetes then they will teach you how to give yourself daily shots (or another type of oral medication if needed).
How does gestational diabetes impact your labor plans?
I understand, Mama. Being told you may have gestational diabetes can have you starting to stress about what the rest of your pregnancy holds.
Can I still eat the foods I’m craving?
How am I supposed to prick my finger every day?
What about my birth plan?
It’s an emotional rollercoaster for sure!
But the good news is that gestational diabetes, when managed, should not impact your chances of having the birth you want.
Your provider will be keeping an eye on baby’s size as you continue on in your pregnancy, and as long as everything seems to be normal and your blood sugar stays under control, the risk of baby becoming too large to deliver is low!
What happens if Baby gets too big?
In some cases, your doctor may be concerned with baby’s size. If this is the case, they might start discussing the possibility of an induction.
In the event that your baby is impacted by your blood sugar and grows to be large, it’s possible that your doctor may recommend a cesarean birth in order to keep you and baby safe from the risk of hemorrhaging or significant tears.
Scheduling a c-section may not be what you had planned, but it doesn’t mean you have to go in blind. Read this post about scheduling your cesarean birth for tips!
If you end up needing to schedule a c-section, I would be so honored to help guide you through the process of preparing for birth and postpartum by having you in my new Cesarean Birth Course. You can have a beautiful, calm belly birth and I will show you how!
Pregnancy can be stressful enough on its own, and adding in any unforeseen hiccups along the way has the potential for you to feel completely overwhelmed.
But not to worry, Mama! No matter what life throws your direction, one thing is for sure: You are doing an amazing job carrying your little one and it’s only a matter of time before you’re holding them close and forgetting about all of the stress leading up to that moment.
Psst! I would love to help guide you through the process of labor and delivery, no matter if you’re having an induction or a spontaneous birth! If you’re not already enrolled in my Calm Labor, Confident Birth course, I would love to “see you” in class and help you have an empowered birth experience. My students have direct access to both myself and other labor nurses as their virtual labor nurse doulas!