Pregnancy health

Minor health issues
Stretch marks | Weight gain | Morning sickness | Tiredness | Constipation | Swollen ankles and fingers

Serious health issues
Hyperemesis | High blood pressure and pre-eclampsia | Cholestasis | Symphysis pubis dysfunction | Vaginal bleeding

Gestational diabetes

By the time you get to about 24 weeks (ie six whole months of being pregnant) you could be forgiven for thinking that the riskiest stretch of pregnancy might be behind you (barring the unknown quantity of labour).

But for some pregnant women (between about 2% and 14%) a new health issue can loom on the horizon after this point in the form of gestational diabetes.

This is when you have too much sugar in your blood because your body can't produce enough insulin (which converts blood sugar into energy) to meet the extra demands of pregnancy - ie incubating a growing baby and hormones produced by the placenta that resist insulin.

Risk factors for gestational diabetes are:

• Being overweight
• Already having had a large baby (4.5kg or more)
• Previously having had gestational diabetes
• Family history of diabetes (a parent, sibling or child with diabetes)
• Family origin with a high prevalence of diabetes (South Asian, Middle Eastern or black Caribbean descent)

Gestational diabetes often doesn't have any symptoms, but you might find you have:

• Excessive thirst
• Are weeing a lot
• Tiredness
• Blurred vision

If sugar is detected in your urine during a routine antenatal check, you'll probably be sent for an oral glucose tolerance test (OGTT).

"First you have to have a glucose test by fasting for several hours then they test your blood and urine for raised sugar levels. Based on these results you may be able to control diabetes by what you eat, ie no sugars, fewer carbs etc or, like me, have insulin injections several times a day and record everything you eat! Very boring!! But the good news is in nearly all cases it dissapears after baby arrives, as it did with me." Milkybarsrus

How does gestational diabetes affect your baby?

Gestational diabetes can lead to your unborn baby piling on the the pounds, particularly around the shoulders, chest and abdomen (known as macrosomia or 'of large body').

This can make giving birth vaginally difficult as your baby having large shoulders doesn't help what's already a tight squeeze.

Very large babies are more likely to be induced and to need delivering by caesarean, but not all women with gestational diabetes have large babies.

Your baby may also be born with low blood sugar (hypoglycaemia) but this doesn't mean they have diabetes.

"I had GD diagnosed late in second pregnancy (36 weeks) and ended up giving birth to a baby just shy of 11lbs - at home thank goodness, and all was well. I was told by the diabetic specialist that it's not really understood why some women with GD have giant babies and others don't. DS was definitely not just a normal 'big' baby - he very much looked like a child who'd had too much sugar in the womb: massive cheeks, huge chest and stomach, double chin, man boobs. He wasn't especially long and his head circumference was average. He's now a very slight little boy of four." Fabsmum

How does gestational diabetes affect you?

It's daunting to be told you have gestational diabetes, but there are plenty of Mumsnetters who've been through it before you - have a look at this support thread for example.

"They recommend low GI foods, look for low GI symbol on packets, and have carbohydrates with each meal eg wholegrain/multigrain bread not white, eating five small meals. It's all a matter of trial and error, and once you understand what does and doesn't work for you you will be better able to control your blood sugars. I recommend investing in a couple of good diabetic cookbooks though as they can give you some diversity in what can otherwise be a really boring diet given what you CAN'T eat being pregnant AND diabetic." Mum26plus

The good news is that it usually disappears once you've given birth and it can be controlled by diet and exercise, although if it can't you'll need to inject insulin.

The bad news is that once you've had gestational diabetes there's an increased risk you'll develop it in subsequent pregnancies and that you'll develop type 2 diabetes later in life.

One mum's experience of having gestational diabetes:

"I managed to control it by diet. I had to see a diabetes consultant and be taught how to check my glucose levels, be given advice on diet etc, and had to check my glucose levels six times a day (ran out of fingers that weren't sore very quickly!) and saw the midwives and a diabetes nurse every two weeks. I had to keep a food diary so that the diabetes nurse could check it out.

"You may need insulin if your diabetes can't be controlled by diet alone, but usually the diabetes goes away after you deliver and the insulin can be stopped.

"When my dd was delivered she was monitored to ensure that the GD hadn't affected her. This involved them sticking needles into her heel every 2 hours and I hated that, but do be aware that you can refuse to let them do this. My midwives were very supportive and basically told the paediatrician to bog off as my dd was obviously healthy. The paediatrician also demanded that my dd was force-fed formula every two hours as well ... I didn't need the midwives to tell him to bog off on that one, I did that myself in no uncertain terms.

"I had a lot of extra scans, partly because of the GD, partly because the GD caused extra fluid which they were concerned about, and partly because I'm ancient. From 24 weeks I was scanned every two weeks, and I also had to have scans to measure the rate of the blood flow in the placenta. They told me that she could be a big baby because of the GD and I was told she was going to be well over 10lb, but she was born at 37 weeks at 8lb 8oz." WigWamBam

Minor health issues
Stretch marks | Weight gain | Morning sickness | Tiredness | Constipation | Swollen ankles and fingers

Serious health issues
Hyperemesis | High blood pressure and pre-eclampsia | Cholestasis | Symphysis pubis dysfunction | Vaginal bleeding