Gestational Diabetes Resources

If you are reading this, chances are you have tested positive as having Gestational Diabetes or you are researching what this is all about, perhaps you are considering the screening.

There is a huge amount of confusion with GD and how it impacts pregnancy and birth.

I speak to many women who are looking to find more information but feeling overwhelmed with where to begin. Therefore, I have collected together these links and resources in hope that you find them useful as you navigate what Gestational Diabetes may mean for you.

The following information is not to be used as medical advice. Gentle Mama does not offer medical advice. Instead I share these resources with you for you to consider and I trust that women will make the choices that feel right for them.

If you have GD and would like some support and to discuss your options please do get in touch with me and book a phone or in person consult.

First let’s look at what Gestational Diabetes is:

“Also called “gestational carbohydrate intolerance”, “abnormal carbohydrate metabolism” or type 3 diabetes, gestational diabetes is a transient condition that occurs and is diagnosed only during pregnancy. The word “diabetes” was used (instead of “glucose intolerance”) so that insurance companies would cover costs. GD is quite different than “true” diabetes (which comes with its own set of risks in pregnancy).

Read more here https://www.indiebirth.org/gestational-diabetes/

“Gestational diabetes is a typical example of a term with a strong nocebo effect. It has the power to transform a happy pregnant woman into an anxious or depressed one … One of the side effects of the term ‘gestational diabetes’ is to transform the interpretation of the results of a test into a disease. The status of disease implies that complications have been identified. It is commonplace to claim that macrosomia (a big baby) is the main complication. This should be considered an association. It is obvious that the energy requirements of a big baby are not the same as the requirements of a small one: the mother, who must make a bigger effort than others, is labelled as having ‘gestational diabetes’ … The nocebo effect of the term ‘gestational diabetes’ is becoming a serious issue. The use of enlarged criteria to interpret the tests is one of the reasons why the number of women diagnosed with gestational diabetes is increasing” (Odent 2013: 100-102).

Podcasts

If you are new to the world of podcasts, it’s completely free and you can listen to it by clicking on the links provided or you can find it in itunes and most podcasts apps.I find this form of media works really well when you are feeling completely overwhelmed and feel like you are going round in circles. It’s also particularly useful for busy mamas who may need to multi-task while listening or if you find you’re so tired, you can’t keep your eyes open when you finally get a chance to read! I can relate to both!

This episode by Maryn on the Indie birth ‘Taking back birth’ podcast, offers a fresh perspective on the issue; it’s well worth a listen.

https://www.indiebirth.org/the-truth-about-gestational-diabetes-no-doctor-would-ever-tell-you/

Lily Nichols, RDN, talks about what gestational diabetes is, how reliable testing is, how to prevent GD, why the conventional diet information is unhelpful and shares evidence based nutrition ideas to manage GD in the healthiest way. https://www.birthful.com/podcastgd/

Informational blogs and articles.

Dr Rachel Reed, a senior midwifery lecturer, academic and writer shares this thorough blog post on Gestational Diabetes. She offer a balance of research and logic alongside a deep understanding of birthing physiology https://midwifethinking.com/2018/03/20/gestational-diabetes-beyond-the-label/

Since Shoulder Dystocia and induction are two main concerns that are raised for women with the GD label, I would also invite you to check out her excellent blogs on this subject https://midwifethinking.com/2015/05/13/shoulder-dystocia-the-real-story/ 

www.midwifethinking.com/2016/07/13/induction-of-labour-balancing-risks/amp/

These additional links may also provide helpful information.

https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

“There is no evidence to support the claim that Gestational Diabetes is associated with stillbirth or newborn death” (Rebecca Decker -Evidence Based Birth)

Video

As an additional resource Lily Nichol’s offers this free video resource http://realfoodforgd.com/free-stuff/

Books

The fantastic charity AIMS (Association for Improvements in the Maternity Services) have published a book written by Deborah Hughes (BA (Hons), RM, MA, PGDEd).

It is available in both print and on kindle.

Real Food for Gestational Diabetes by Lily Nichols (available in print and on kindle on amazon) is a really wonderful resource for nutritional information written specifically for those with Gestational Diabetes. I would highly recommend getting a copy of this.

The majority of women I hear from are feeling pressure to induce before 40 weeks or certainly by 40 weeks. Interestingly, this is what the current NICE guidelines say:

Advise women with gestational diabetes to give birth no later than 40+6 weeks, and offer elective birth (by induction of labour, or by caesarean section if indicated) to women who have not given birth by this time. [new 2015]

1.4.5Consider elective birth before 40+6 weeks for women with gestational diabetes if there are maternal or fetal complications. [new 2015]

1.4.6Diabetes should not in itself be considered a contraindication to attempting vaginal birth after a previous caesarean section. [2008]

(NICE guidelines)

It can be a good idea to have a read through the NICE guidelines so you can further understand what it is that may be recommended to you by the health professional you are seeing. 

https://www.nice.org.uk/guidance/ng3/chapter/1-Recommendations#intrapartum-care-2

Just to be clear though, it is your body and your baby and you and you alone have the autonomy and authority over how you birth your baby. Everything is an offering and you can decide whether to accept or decline what is being offered. 

I would also suggest re-reading the midwife thinking article on induction I posted above. There are many more resources for induction so please get in touch and I will share these with you.  There is also a great facebook group called ‘Induction of labour’ that is facilitated by a wonderful independent midwife 

Evidence 

https://www.nice.org.uk/guidance/ng3/evidence

https://www.cochrane.org/CD012327/PREG_treatments-improve-pregnancy-outcomes-women-who-develop-diabetes-during-pregnancy-overview-cochrane

There is insufficient evidence to clearly identify if there are differences in health outcomes for women with gestational diabetes and their babies when elective birth is undertaken compared to waiting for labour to start spontaneously or until 41 weeks’ gestation if all is well.”

Cochrane report

https://www.cochrane.org/CD012910/PREG_planned-birth-or-near-term-pregnant-women-gestational-diabetes-and-their-infants

Can I still have a home birth?

Since birth is a normal biological involuntary function it remains a woman’s human right to birth at home. Unfortunately women are still asking permission to do something with their own bodies and we are still hearing that dreaded word “allowed” in maternity services.

If you know me then you will know how passionate I feel about birth rights and women’s choices. I can’t emphasise enough that no-one should be telling women they are not allowed to have a home birth, that they are not allowed to have a spontaneous vaginal birth, or whatever else they may be told they can not be allowed to do .

YOU are the one that does the allowing!

You have the legal right to choose where you birth and the NMC states that a midwife must support the birthing person’s choices even if the midwife doesn’t agree with them.

You can read more about your rights on the wonderful charity Birth Rights website

http://www.birthrights.org.uk/library/factsheets/Choice-of-Place-of-Birth.pdf

Birth Stories

Reading and listening to positive stories from other women is so valuable.

If you have a story you would like to share please do contact me.

Thank you to the women and families who have allowed me to shared their stories and to the fellow birthworkers who have also collected and shared these stories all with permission.

(more stories to follow)

http://www.homebirth.org.uk/gd.html
https://thebirthhour.com/gestational-diabetes-cesarean-and-hbac