As a mother of three children, each pregnancy, birth and parenting experience was unique. At approximately 24 weeks pregnant with my youngest child, I completed the routine Pregnancy Oral Glucose Tolerance Test (POGTT) to discover I had Gestational Diabetes Mellitus (GDM). According to Diabetes Australia (2020), 12-14% of pregnant women will develop GDM.
When I was initially told by my doctor that my fasting POGTT meant that my pregnant body was unable to balance my glucose levels, my first thought was…oh no, I’ve eaten too much cake! Although my dietary intake was sometimes a little naughty (I craved chocolate), I soon learned my risk factors for developing GDM wasn’t necessarily diet related. Yes, my chocolate craving did contribute to my high sugar levels, but my risk factors were also increased due to being greater than 35 years old, from an African heritage and having a BMI greater than 30. I felt conscious of how much weight I had gained during my pregnancy and now my body was telling me I needed to focus on maintaining a healthy diet to ensure my pregnancy and birth remained risk free.
I was referred to a dietician and an amazing group of diabetic clinicians who educated me on how to maintain a healthy blood glucose level (BGL) during my pregnancy. I wasn’t a midwife back then, so my knowledge was limited but the education provided me with an empowering sense of self determination to ensure my baby and I were healthy. I was given an extensive amount of dietary advice and a kit to ensure I was self-monitoring my BGL regularly. The kit included a booklet where I was required to record my daily BGL, which was taken prior to each meal and at bedtime. I was given a device known as a glucometer to measure my capillary blood levels. Basically, the device pricks the tip of the finger to draw a droplet of blood, which then goes on a strip, that is inserted into the device that gave me my BGL reading. I remember being a little nervous to do this four times a day but after the demonstration and having to do it for the reminder of my pregnancy, it became a routine necessity that was pain free.
Most women can stabilise their GDM with dietary changes, unfortunately my pregnant body was unable to stabilise my BGL. I was advised after a few weeks of close monitoring and further doctor reviews, that I needed to have regular insulin injections to maintain a normal BGL. This was a little terrifying but once again, the diabetic team at the hospital calmed my nerves. They explained it in a way that reassured me, disclosing it was something beyond my control and my pregnant body just needed a little assistance. With that in mind, I received another kit. This time, it included an insulin pen, which administered the insulin medication that I titrated according to my BGL. I was approximately 30 weeks gestation when I started insulin and my GDM routine had become a big part of my pregnancy. The daily insulin injection in my belly, the routine finger pricks to measure my BGL and the close monitoring of my diet was a necessary journey for me and my beautiful baby boy.
As the pregnancy progressed, I had a few extra ultrasounds to measure the growth of my baby as women with GDM are at risk of having bigger babies. The maternity team monitored me closely because a larger baby increased the risk of having birth complications and possible admission into the nursery for my little one. At 38 weeks gestation, my baby had grown to a larger size and the obstetric team recommended an induction of labour. This pregnancy journey was unique for me and my baby, who was born healthy and as expected, on the heavier side. He was monitored in the nursery as his BGL’s were unstable as a result of me having GDM in pregnancy. Breastfeeding provided optimal support for stabilising his BGL. Interestingly, the moment I gave birth to my baby boy, I no longer had GDM as my BGL’s stabilised. I am continually in awe of what a woman’s body can endure and how we naturally adapt to our own experience. In saying that, the support I had over the weeks of pregnancy and beyond, were unconditional and incredibly empowering.
As a result of having GDM in pregnancy, I am now at risk of developing Type 2 diabetes later in life. This is something I continually think of as I pass the bakery each day and as I resist that chocolate craving.
Be Prepared. Be Confident. Be Empowered. By Midwives.
BirthHQ Midwife, Nurse & mum of three
diabetesaustralia.com.au. 2021, Gestational Diabetes – Diabetes Australia. [online] Available at: https://www.diabetesaustralia.com.au/about-diabetes/gestational-diabetes/> [Accessed 15 January 2021].