Every pregnancy has its own set of ups, downs, special moments, and emotional setbacks. My pregnancy with Dessa was no exception! Thankfully, the joyful moments from my pregnancy greatly outshine the frustrating events, but there were some moments that were challenging for me to overcome, especially when it came to my health. I occasionally shared small glimpses of my experience with gestational diabetes on the blog and Instagram account, and I have recently become aware of the fact that it's a fairly common diagnosis for many expectant mothers. And yet, somehow, it can feel incredibly alienating to be diagnosed because many women don't realize they know other people who have gone through the same thing.
It's my hope to share a little bit about my own experience with gestational diabetes to offer a little reassurance to anyone else diagnosed with the condition that you are not alone and also let you know what other unexpected repercussions may await you down the road. I always found the shock of new information to be the biggest obstacle to overcome. Hopefully this post will soften the blow a bit and help you feel more equipped to handle what lies ahead.
From the One-Hour Glucose Test …
I turned 35 when I was 2 months along, which automatically qualified the pregnancy as being “high risk”. Those words sounded scary, but everything went smoothly for the first few months. My weight and blood pressure were always under control and the baby grew and developed exactly as she should. At my 28 week OB appointment, I had the infamous glucose screening. (I call it infamous because I've always heard other expectant mommies talk about how nasty and terrible the test was.)
Turns out, the test really itself isn't that bad. You just have to drink 10 ounces of a sweet drink that tastes like flat pop in a few minutes time, then wait an hour to have your blood sugar tested. It's not the best tasting drink ever, but it's far from being the worst.
As I said, the test itself is no big deal. It's the phone call that I received the next day that turned my glucose screening into a big deal – my doctor informed me that my blood sugar was too high and I had to undergo a three hour glucose test. I listened carefully to the doctors instructions about how to proceed, thanked him for the call, hung up the phone and promptly burst into tears. I had a whole storm of pregnancy hormones racing through my body and I was devastated by the mere possibility that I would be diagnosed with gestational diabetes.
… to The Three Hour Glucose Test
About a week later, I had my three hour glucose screening. My doctor failed to mention on the phone that the three-hour test actually takes about four hours, that I had to fast for twelve hours before the screening, and that I had to show up at the lab at 6am for the test. I was already upset about needing a second screening and the fact that it was such an inconvenience just made me more upset.
Rob was a good sport and dragged himself out of bed to keep me company the morning of the test. They drew blood to test my fasting blood sugar levels before I drank the sugary drink, then processed the blood work – which meant I had to sit around and wait for nearly an hour while I awaited the initial test results. Once my bloodwork was in, I had five minutes to down another 10 ounces of sugary drink. This time I was warned that most women who chug the juice throw it back up, so I was advised to drink slowly, but also make sure I downed it within 5 minutes. Talk about contradictions.
I consumed the exact same orange flavored sugary drink for my three hour screening as I did for the one hour test at the doctor's office. But something about putting all of that sugar into a belly that had been fasting for 12 hours after a night of really terrible sleep made my stomach churn. I was absolutely miserable for the first hour of the test and it was a huge effort to keep the juice down. Once I drank the juice, I had to check in to the lab after each hour for an additional blood draw. The women in the lab didn't care how I spent my time in between needle pokes (as long as I didn't spend that time eating or puking), so Rob and I headed back to the car while we waited. I just wanted to curl up into a ball and sleep. So I attempted to do just that. It didn't go all that well, but it was more comfortable than sitting in the lab's waiting room.
Somehow, I made it through the three hour test and kept the “juice” down the entire time. I was feeling pretty good until my doctor called me the following afternoon and broke the news that I did, in fact, have gestational diabetes. He told me I would need to get a glucose meter so I could check my blood sugar four times a day and I would need to attend a diabetic class at the hospital. Just like before, I politely thanked him for the phone call, hung up the phone, and promptly started to bawl.
Learning to Cope with Gestational Diabetes
I swear I cried buckets of tears every single day leading up to my diabetes class. The diagnosis didn't make any sense. I was healthy! And I really, really didn't want to poke myself in the finger four times a day to check my blood sugar. My grandparents were diabetic and I recall letting my grandmother (whom Dessa is named after) check my blood sugar once when I was a child. She reassured me that it didn't hurt very much, but the prick did hurt quite a bit (at least it did from my perspective as a child). I kept envisioning that childhood experience and was completely dreading every diabetic moment that remained of my pregnancy.
Ever the rule follower, I promptly followed the doctor's advice and did what I was supposed to do. I obtained a glucose meter and all of the necessary testing supplies, then scheduled an appointment for the diabetes class. I didn't really know what to expect of the class, but I imagined that it was going to be filled with all types of people who had recently been diagnosed with diabetes and that I was going to be the only young pregnant women in a sea of people 30+ years older than myself with multiple health issues.
Becoming Educated about My Condition
You can imagine my relief when I walked into a small conference room with five other pregnant women and a hospital nutritionist. In that instant, I felt a wave of reassurance that my problem was not unique and that it would be ok.
The class itself lasted just a few hours. The instructor led us through some basic information about gestational diabetes, why it's important to maintain our blood sugar levels, and how to manage it by monitoring our diet.
After she covered all of the basic information, the instructor made the process truly manageable. She told us exactly which types of food we had to keep an eye on (diary, fruit, beans, anything made from grains, and of course all sweets.) Anything not in those categories (meats, nuts, fats and veggies) was fair game and we didn't have to worry about those items.
My spirits perked up a bit when she explained that even though cheese is a dairy product, it's considered a protein and not a carbohydrate. I was overjoyed to hear that I could keep eating plenty of pasteurized cheese without giving it a second thought. It made a nice temporary distraction from the finger prick cloud that had been hanging over my head for the past week.
It was also a relief to hear that I had to eat sugar and carbohydrates every day. The issue wasn't that those foods were bad – it was that my body couldn't break them down fast enough, but they were still a necessary component of my diet. I just needed to closely monitor and manage those foods in my diet so that my body could break them down at a healthy rate.
At the class I learned that a serving of carbohydrates is 15 grams and that I would need to eat 1 to 3 servings of carbs every time I ate. The exact amount depended on the time of day and if I was eating a meal or a snack. The instructor taught us how to read labels and look up the carbohydrate content of foods without labels (like pieces of fruit.) The best part was that I needed to eat something every four hours during the day – which meant lots of snacks for me! She broke things down and made it all super-simple, which was something I desperately needed in my overwhelmed state.
Testing My Blood Sugar
Just when I could wrap my head around the necessary changes to my diet and felt like I could manage this whole gestational diabetes thing, the instructor asked all of us who had a glucose meter to take them out. She explained how the meter and the lancets (pokey things) work. She also explained the goals for our blood sugar readings: 90 mg/dL or when we first wake up and 120 mg/dL or less two hours after each meal (I wouldn't have to test my blood sugar after a snack). I felt my heart race a little bit every time she mentioned the device and I was so dang nervous to give my finger a poke. Finally, when there was no avoiding it any longer, she asked all of the women at the class to try using their device to test their blood sugar.
I put my lancet in the device, pulled back the spring, held my breath and pushed the button. To my surprise, I barely felt anything. Like, barely. And just like that, I had a tiny drop of blood. I massaged my finger to draw out a little more blood and brought the glucose meter with the loaded test strip to the tiny wound.
From that moment on, I was officially managing my gestational diabetes. Monitoring the time between meals and testing my blood sugar quickly slipped into my daily routine. I kept a log of my blood sugar readings after each test, which I always brought to my OB appointments so he could keep an eye on my blood sugar levels as well.
Living with Gestational Diabetes
Sometimes you just need a little something to take the edge off a particularly difficult situation. It took a little time to wrap my head around the idea that gestational diabetes was not the worst thing ever and it was going to be ok.
I started with a small, cosmetic improvement to help me view my testing materials in a better way. I stopped at an accessory shop and purchased a cute little travel makeup bag. It was the perfect size to hold my glucose meter, log book, lancets, a pen, and my test strips. Somehow carrying all of those supplies in a cute little bag felt a little less awful than when I carried them around in the ugly travel pouch that came with my glucose meter.
Once I had something cute to carry my supplies in, it was time to get on board with the nutritional aspect of proper self-care. Monitoring my carbohydrate content was manageable, but it wasn't always easy. I was always able to read labels and create sensible meals within my dietary parameters at home, but dining out and other social events was always a challenge. It's hard to look wistfully at the desert spread at a party and only have a few bites of your favorite sweet treat. And restaurants are notorious for creating really unhealthy, carb-loaded menus. When it came to restaurants, a salad was one of the only things I could eat a large enough portion of to feel full and still stay within my carbohydrate limits. But I could only indulge in salad. No croutons or other carbohydrate laden treats that often accompany restaurant salads. No dessert. No lemonade or soda to drink – just a glass of water or unsweetened ice tea on the side. If it was a special occasion or if I really needed a carb-free mocktail, I would order a club soda with lots of lime; which was a far cry from the pre-pregnancy cocktails I loved so much, but at least it was something and it wasn't going to adversely affect my blood sugar.
Then there were my food-related schemes.
I became a pro at finding ways to have my all-time favorite sugar and carb loaded treats. I will always and forever view a icy cold glass of Coke as a sweet treat that offers a much needed pick me up. As you know, sodas are loaded with sugar and don't really offer any nutritional value. In fact, one of the guidelines that the class instructor laid out for us was to avoid sugary drinks of all types because a little bit of a sweet beverage quickly fills the full sugar allotment for a meal. One of my favorite meals to prepare for myself was to whip up some scrambled eggs with lots broccoli and onion and a little American cheese (basically a carb-free bowl of protein and veggies) and have a mini can of Coke with my eggs. I discovered 7.5 oz cans at the grocery store and was overjoyed to see that they only contained 25 g. of sugar, which was actually a low amount of sugar for a meal (I was supposed to consume 30-45 grams of carbs at lunch and dinner).
The instructor also reassured us that it was ok if we occasionally overindulged a little. The best way to undo excess sugar in our system was to move around and burn it off. There's a small soft serve ice cream place within walking distance to our house. Sometimes Rob and I would walk to buy a guilt-free ice cream treat. It's worth noting that the treat was guilt-free for two important reasons:
- We walked to get the ice cream, which was over a mile if you take the round trip into account.
- I got the tiniest, simplest treat on the menu: a mini cup of vanilla soft serve ice cream. No sprinkles, candy or other toppings. Just plain ol' vanilla ice cream. And when I say mini, I mean mini. The treat was maybe three ounces in size, but I savored every sweet tiny bite and it was 100% worth it!
I did my very best to manage my gestational diabetes, but I didn't eat perfect carbohydrate portions 100% of the time. If I was at a party for a special occasion, I always indulged in moderation, but I certainly allowed myself to eat more carbohydrates than I would on a regular day. I'd let myself enjoy a small portion of pasta, plus half of Rob's dessert and maybe a few bites of someone's roll with butter. Sometimes you need to let yourself off the hook just a little bit. I never allowed myself to go crazy and pig out on all of those treats, but a few extra bites of some delicious foods seemed fair to me. I tried to walk off some of the sugar after the event to help my blood sugar levels. And I always noted any special circumstances in my log so I could recall the reasons for my elevated sugar. (And yes, my sugar was always elevated after eating for a special occasion.)
How Gestational Diabetes Affected our Baby
My single biggest motivator during the entire ordeal was my fear of having a big baby. At one point, I even asked the doctor during one of my monthly check ups if I was likely to have a 10 pound baby if I was able to keep my sugar levels under control. That wasn't anything he could guarantee for my delivery, but he did reassure me that I was on the right track.
Beyond that, I didn't really give much consideration to how my gestational diabetes would affect the baby. I was informed that mothers with gestational diabetes often give birth to babies with low blood sugar (because the baby's system tries to overcompensate in the womb for mom's elevated blood sugar levels), but this sounded like a temporary thing and I wasn't given any details about what that means for the baby.
Looking back, it's the one piece of information that I wish I had been better informed about because Dessa did have low blood sugar when she was born and it was a significant obstacle for us to overcome at the hospital.
Dessa arrived with a bang more than 48 hours after I was admitted to the hospital weighting a glorious 7 pounds, 10 ounces. After waiting and working for so long, I was completely exhausted and overwhelmed with my brand new role as parent. The nurses pricked Dessa's foot right after she was born to check her blood sugar and (sure enough) it was low. No big deal, I figured that would happen. I didn't really worry about it. In the blurry haze of my newfound role as mother, I was given a little help learning to breastfeed, was told to let the nurse know before I started breastfeeding so they could check her sugar levels, then was left alone with Rob to rest and care for Dessa.
Each time Dessa fussed and showed signs of hunger, I grabbed her and started breastfeeding. Rob and I always remembered after she was on my breast that we were supposed to call the nurse to check her sugar. The nurses were very kind and always managed as best they could to get a blood sugar reading even though the timing wasn't quite right. Our baby's blood sugar was consistently low or right on the borderline for where it should be. The hospital protocol required three readings in a row that were above the baseline and Dessa just couldn't hit that mark more than once without her sugar levels dropping out before the next feeding. A parade of nurses and pediatricians came to see me as well as a lactation consultant, but it was all a blur. I was tired, in pain, and Dessa was never really in the mood to eat.
At some point, someone (I think it was a nurse) brought a small bottle of formula and a small oral syringe. They encouraged me to feed Dessa a little formula with the syringe to try and elevate her blood sugar. It was an effort to get that baby to eat. She just wasn't interested. We felt pretty great after giving her 1 mL of formula… that is, until the nurse asked how we were doing and we she said the goal was to put 5 mL in Dessa's belly. Rob and I both got wide eyes, laughed awkwardly and said we would try our best. Despite our best efforts, that little princess didn't eat nearly as much as the nurse had hoped. We took it all in stride and figured Dessa would eat and things would even out when she was ready. After all, this was her very first day of life on the outside.
Then, about 20 hours after Dessa was born, a pediatrician came to the room for a serious talk. They were concerned that Dessa's blood sugar just wouldn't maintain a healthy level. We were informed that the hospital had to intervene by taking Dessa to the nursery overnight so they could get her blood sugar on track. They could either administer an IV or feed her formula, but at this point they had to do something.
In hindsight, I shouldn't have been surprised at the news that the staff needed to intervene. After all, they did send a constant stream of people into our room to check on Dessa and try to get her blood sugar up. But in my postpartum haze I was caught completely off guard by the news and immediately started to cry. I was upset that they were going to take my baby away for the night and disappointed that she was going to be given so much formula. I could handle a few mL to supplement my colostrum, but this time it wasn't a few mL – it was a bottle.
There's such a cultural push to breastfeed these days and the words “breast is best” kept resounding in my head. I had a plan to breastfeed exclusively for four weeks, then slowly introduce the bottle (with milk that I had pumped, of course) and begin to transition Dessa so she could go back and forth from breast to bottle when I returned to work. I had done all of the research and it was a good plan! I even specifically registered for Avent bottles because they have a wide base, which is recommended to make the switch to bottle easier. Feeding my baby formula was never a part of that plan and neither was introducing the bottle so soon.
I had a very difficult time coping with the realization that things were not going to work out exactly as I had planned. I was exhausted, in pain, and filled with hormones. I'll just let you imagine what kind of a wreck I was at this point. Reluctantly, Rob and I followed the nurse who wheeled Dessa down the hall to the special care nursery. Once we arrived, a very kind nurse who works with the newborns sat us down, let me cry my eyes out, talked us off the ledge, reassured us that we could spend as much time with Dessa in the nursery as we wanted and that things would be ok.
Rob and I both teared up when we parted with Dessa and went back to our room. As you might expect, things did work out in the end. The two of us got some much-needed sleep (even with my 1 am trip down the hall to visit Dessa that night). Around 4am, another very kind nurse delivered a happy, well-fed baby to my bedside. Most importantly, Dessa finally passed the hospital protocol and three blood sugar readings that were all above the baseline. Our baby was out of the woods and finally on track!
Gestational Diabetes After Baby
After three months of a strict diet to manage my gestational diabetes, it felt so strange to suddenly be free of carbohydrate concerns. From the moment I entered the hospital, my gestational diabetes only became a thing mentioned in passing. New nurses would come into the room and ask if I had any pregnancy complications. I would reply that I had gestational diabetes, and then they were onto the next item in my computerized chart. It was so strange. This was a condition I had lived with and regulated so carefully for weeks and once I was in the hospital, gestational diabetes was reduced to an item on a checklist. I was admitted to the hospital on a Monday night and was hooked up to an IV, which delivered any necessary nourishment without any need to worry about my gestational diabetes.
After a very long day awaiting for any sign of labor after receiving cytotec and pitocin and a constrant stream of IV fluids, I was overjoyed to get a green light to eat real food on Tuesday night. I asked if I should check my blood sugar or limit my carbohydrate intake and was told that neither of those things were necessary. Feeling quite shocked, I pushed a little further and asked if it was ok for me to eat fast food. Again, the nurse explained that I could eat whatever I was in the mood for. I knew exactly what I was in the mood for: a Burger King Whopper with fries and a Coke. That night, Rob and I feasted without giving my blood sugar any more thought than a passing glance. It was the most fast food I had eaten in three months and it was glorious.
And that's how things continued for the entire duration of my time in the hospital. I never once limited anything that I ate and my blood sugar wasn't monitored at all. It all seemed so foreign after everything I had been doing for the past three months. When the doctor stopped by for one last check before Dessa and I were discharged, I asked about the diabetes: if I should be concerned and how to proceed once I returned home. He explained that I would need to return to the lab after four weeks for one final glucose test (this one would be a two hour test) but I could eat anything I wanted in the meantime. He also explained that there was a very small chance that my diabetes would remain with me forever, but the chances of that were very slim since I was not exhibiting pre-diabetic characteristics at the start of my pregnancy.
The Post-Baby Follow Up Glucose Test
I completed the doctor's orders and dragged myself out of bed early one Saturday morning for another 6am glucose test. This one was very similar to the three hour test. I had to fast for 12 hours in preparation for the test and they began by taking my fasting blood sugar. Nearly an hour later when that round of bloodwork was in, I sat in the chair and downed the orange sugary beverage. I had to check one hour after finishing the drink for a follow-up blood test, then again after the second hour. After that I was free to go. Thankfully, the test was much easier on my stomach and I didn't experience any of the nausea that I had during my three-hour glucose test. Within the week I received word that my blood sugar levels were normal and healthy.
And just like that, I was free from the cloud of gestational diabetes.
Silver Linings of Life with Gestational Diabetes
When I was first diagnosed with gestational diabetes, it was a significant mental obstacle to overcome and the condition wasn't always easy to manage. I certainly shed my fair share of tears along the way, but my experience was not terrible every step of the way.
The most significant positive impact of managing my gestational diabetes was that I was eating well. Really well. Sugary, carb-laden, deep fried foods and beverages would have immediately exceeded my mealtime limitations, so my diet was filled with lots of vegetables, meats and other healthy proteins. The diet was good for me and (more importantly) good for my baby. All of those nutritious foods helped Dessa grow healthy and strong in the womb.
As a result of all my healthy food choices, I saw great results on the scale. I wasn't gaining much weight late in my pregnancy because I wasn't eating the kind of foods that would cause me to pack on the pounds. And after Dessa was born, the scale returned to my pre-pregnancy weight within weeks. It isn't something I discuss much because it really was the result of managing my condition and I would never, ever want any other woman to compare her own post-pregnancy body to mine. But the truth is I was on a fairly strict diet for three solid months, which had a lasting, positive effect.
You Are Not Alone
One of the most significant realizations that emerged from my experience with gestational diabetes was understanding just how common the condition can be. It's not a topic that just casually comes up, but I have noticed time and again that when I mentioned my condition in a conversation or on social media, other women chimed in about their own experiences. If you have been diagnosed with gestational diabetes and are struggling with your new normal of blood sugar testing and carbohydrate counting, please know that you are not alone. Gestational diabetes is much more common than you think. I was right there struggling, too, and I want to reassure you that everything will be ok in the end. You've got this, mama!
If you have any questions about my experience or you want to share a little bit about your own journey with gestational diabetes, feel free to leave a comment below. Let's raise each other up and help support any other women who are currently frustrated and overwhelmed with their own circumstances. This pregnancy stuff is hard and sometimes we just need to lean on each other a little – even if it's through a virtual hug on the internet.