UPDATED: November 2020

I  just had an email from a client with a concern I get quite a lot, so I thought I would share this and my response:

“Hi Pip,

The main concern I have right now is that I was diagnosed with gestational diabetes (borderline) and even though I have very healthy diet and lifestyle and blood glucose levels are all within target range every time I measure, my Obstetrician has advised he will not let me go past my due date, and I really was hoping not to be induced.  So actually the thought that I might have to be induced is my main concern right now, which I have to overcome~J “

Hi J,

As you do the course you will realise you have to use your BRAIN technique and trust your body and instincts.

Obstetricians can get caught up with looking for a problem when actually everything is just fine.

Gestational diabetes is a perfect example of this.

Plus there is a big difference between “routine care” and “evidence-based” care.

Always ask to be shown the evidence and remember it is your birth, not theirs.

Also, know that all Australian obstetricians are meant to follow this guideline:

 “Women who have been fully informed regarding a recommended course of action, and the potential consequences of not pursuing such management, should have their decisions respected if they decline such a course of action.”  http://www.ranzcog.edu.au/doc/standards-of-maternity-care-in-australia-and-new-zealand.html

Knowledge is power and very comforting, so here are lots of articles you might like to read about gestational diabetes and induction.

Buckley, S. J. (2008). ‘Gestational Diabetes Testing’. In Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices. Retrieved  from http://www.fullcirclemidwifery.com/2009/02/gestational-diabetes-information/

Goer, H. (1996). Gestational Diabetes: The Emperor Has No Clothes. The Birth Gazette, 12(2). Retrieved  from http://www.gentlebirth.org/archives/gdhgoer.html

Odent, M. (2004). Gestational Diabetes: A Diagnosis Still Looking For a Disease? Primal Health Research: A New Era in Health Research, 12(1). Retrieved from http://www.bellybeginnings.com/Handouts/GestationalDiabetes-Odent.pdf

http://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

http://www.sarawickham.com/quotes-and-shares/quote-of-the-month-for-may-gestational-diabetes/

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

http://www.sarawickham.com/articles-2/ten-things-i-wish-every-woman-knew-about-induction-of-labour-the-article/

Can we really say there is a clear reason to induce just for borderline gestational diabetes and a suspected big baby?

Kind regards Pip

The BRAIN technique stands for Benefits, Risks, Alternatives, Intuition, and Nothing.

(Often it can be a good question to ask “what’s actually going to happen if I choose to do nothing?”)

Here is a newer article that outlines the problems of being labeled with Gestational Diabetes (GD).

Gestational Diabetes: beyond the label

The bottom line is that if you are diagnosed with GD but manage to maintain your blood sugars then you are at no greater risk of complications than any other pregnant woman.

This is because what affects a baby is their mother’s high blood sugar levels crossing the placenta and getting into their body. But if the mother doesn’t have high blood sugar levels then her baby will be fine.

Apart from all the risks of induction to a healthy baby and woman, I also feel the need to point out another “Risk” of being diagnosed with GD.

A couple of years ago I finally got around to getting some Life Insurance.  I was surprised to be asked if I had ever been diagnosed with GD as part of the process. I haven’t but I asked why they were asking. I was told that it would increase my premium if I had.

Since then I have always worried that women who are misdiagnosed with GD, especially when they are “borderline”, will have to pay higher premiums because it will forever be in their medical records.

If you read the above article by Dr. Rachel Reed you will realise how flawed the testing can be and you might want to consider using the BRAIN technique before you consent to be tested for GD in the first place.

A Cochrane Review concluded: “There is not enough evidence to guide us on effects of screening for GDM based on different risk profiles or settings on outcomes for women and their babies… “

So definitely worth checking this risk out with Insurance Companies.