One of the biggest concerns that people (including health care providers) have when GD comes into the picture of the potential of having a “big baby”. While it is possible that a bigger baby could mean a tricky birth due to shoulder dystocia or a possible cesarean section, it is certainly not a foregone conclusion! Yes, when babies are getting more glucose during gestation they do tend to get a bit chunkier, especially in the upper body, but there is no reason to panic. People give birth to “big” babies (what does “big” even mean?) all the time! If you have high BGLs or have been labelled as having GD, make sure you take some time to read up a bit on this issue because your care provider will almost certainly have concerns and you will want to be an informed participant in an important conversation!
For more information on Gestational Diabetes, “big babies” and inductions check out this great post over at Evidence Based Birth Does Gestational Diabetes Always Mean a Big Baby and Induction?
So, if I am labelled as having Gestational Diabetes, what does that mean for my pregnancy and birth?
For most people, managing Blood Glucose Levels and having a healthy and happy pregnancy is totally achievable with a little extra self-care and good communication with your health care team throughout your pregnancy. Having Gestational Diabetes does not mean you are sick or that you cannot physically have the birth you have envisioned for yourself.
Advocating for evidence based care (as opposed to routine care) will be very important if you are hoping to have a vaginal birth or to avoid an induction because, unfortunately, many care providers feel the risk of a “big baby” outweighs the risks of induction or cesarean birth, even though the evidence does not necessarily support that conclusion.
The reality is that once you have been labelled as having Gestational Diabetes, even if your BGLs are within normal limits after the initial “diagnosis”, you will be faced with limitations on when and where your care providers are comfortable with you giving birth. Giving birth at home is often ruled out as an option (though not always - so if this is a goal make sure to you advocate for yourself) and inductions or planned cesareans become part of the conversations you will be having with your team as they work to reduce documented and perceived risks to you or your baby.
Keep the conversation going with your healthcare providers about what their concerns are and above all, ask for evidence based information to help you decide how you would like to move forward with your birth.