Jenna's story - a positive birth despite gestational diabetes


In order to tell my positive birth story you need to understand where my head was at when I first found out I was pregnant. I’d always known I wanted children, but saw the birth as a necessary evil to get to the end result. “Just take the drugs Jenna, you have a low pain threshold,” family members told me.

What started my journey, was browsing the local library and stumbling across the book, ‘Ina May's Guide to Childbirth’ by Ina May Gaskin (‘America’s leading midwife’ it said on the cover). It’s not often we can say a book changed our life, and maybe it didn’t change my life but it changed the birth I was destined to have. Before reading it, I thought I’d take every medical pain relief possible. maybe even an elective caesarean. After reading it I realised birth could be calm, empowering, even enjoyable; and that all those medical interventions could actually have the exact opposite effect of what I’d wanted - more likelihood of forceps, emergency caesareans, a longer labour. I was convinced.

My husband and I threw ourselves into a hypnobirthing course. We hired a doula. I started listening to positive birth stories in the bath using the podcast The Birth Hour. I surrounded myself with positivity and grew my self-confidence.

I had a good pregnancy, no morning sickness, and lots of energy once the second trimester came along.

Then at 28 weeks I was diagnosed with gestational diabetes (GD) after a glucose tolerance test. I was shocked when the result came back positive. After the initial disappointment eased I again threw myself into research but this time for gestational diabetes. I was told I would not be allowed to go beyond 40+6 weeks and if I ended up needing metformin or insulin to control my sugar levels then an induction would be even earlier and would have to be on the labour ward. So my new mission was ensuring I remained diet-controlled and could use the birth pool in the midwife led birth centre. 

When you have gestational diabetes, the main concern is that your baby grows too big and ends up getting stuck. You typically get a couple of extra scans to monitor the baby’s growth. At my 36 week scan my baby was measuring on the 97thpercentile (to put this in context I am 5’3” tall and weighed 50kg before getting pregnant, so very petite).

The consultant looked over my scan results and then proceeded to say “right we better get you booked in”. “For what?” I asked. She looked confused and then went on to say she was recommending I get induced by 39-40 weeks due to the size of my baby. When I asked why she explained that inducing the baby a week earlier would reduce the risk of the baby getting stuck (i.e. shoulder dystocia). When I challenged what reduction in risk I could expect, she replied 10%. Now what she wasn’t able to tell me was what the absolute risk was. 10% off a risk of 70% is a much bigger deal than 10% off a risk of 0.7%. Like so many women I felt awkward going against medical advice. What did I know? She was the doctor. So I compromised and agreed to get booked in for an induction on my due date. I could cancel it anytime I was told.

I went home and tried to relax. I tried not to think about it. But all I could think about was that date looming in the distance. I started googling “how to go into labour naturally”. Pineapples, sex, castor oil, raspberry leaf tea, dates, curries? Suddenly I’d gone from enjoying my maternity leave to feeling nervous. Then I remembered a story I’d listened to on the podcast ‘The Birth Hour’ about a woman who was overdue and trying every method under the sun to bring on labour. Then she went for a walk under a full moon crying with frustration that she was still pregnant. She looked up the full moon and said to her baby “ok, I’m letting go. I understand that this birth will happen whenever you’re good and ready.” That story had left a big impression with me. I knew the best shot I had of going into labour naturally was being relaxed. How was I going to achieve that with that induction date looming over me? So I spoke to close friends, doulas and my husband about the idea of cancelling my induction. Just return to the state of every other pregnant lady; waiting with no deadlines. 

The minute I called the hospital and cancelled my induction my tension fizzled away. I went back to enjoying my maternity leave. I nourished my body and mind with baths, hypnobirthing, walks in the summer sunshine, positive affirmations. On my due date my husband went out for a nice meal, talked about work, family and other non-baby related things.

The next day we went for a walk after dinner (a habit I got into to bring down my sugar levels post-dinner) and by the end of the walk my Braxton hicks were feeling ‘different’. I’d always planned to labour at home for as long as possible and ‘ignore’ early labour. I’d bought ingredients for a chocolate loaf cake I’d planned to bake in the early stages.

What I hadn’t considered was what I’d do if I went into labour at night! My husband went to bed. We were both convinced this was going to take ages being a first baby. I dimmed the lights, switched on my diffuser, put my yoga mat down. I did my best by myself and then when I felt I couldn’t cope alone anymore, I woke my husband. We laboured together in bed for a while. He drifted off to sleep, I laboured alone, trying to stay calm. It got to 2am and I shook him awake hissing, I needed the TENS machine. Good tip, if you plan to use a TENS machine, practice first so your first time isn’t in the throws of labour. We knew I was getting to the stage where I couldn’t cope with the tools at home and when my bloody show had more bright red blood than I was expecting, we got in the car to the hospital.

My doula met us at the hospital. I remember the relief and safety I felt the moment I saw her step out of the elevator into labour reception. She gave me a massive hug as I had a contraction. We went into triage where I was examined. I was 2cm dilated! Whilst I was surprised I wasn’t disheartened. I knew that just because it had taken me 7 hours to get to 2cm it didn’t mean it was going another 35 hours to get to 10! The next steps were to get me into a room (I said I didn’t want to go home) and focus on relaxing and dilating. My doula and I swayed and walked the room. The reason I’d wanted to labour at home for as long as possible was because I thought it was the place I would relax the most. That might well be true, but the other factor I’d forgotten about was safety. With my doula and in the confines of the hospital I suddenly felt safer than I had in my dark bedroom by myself.  

I’d requested in my birth plan not to have cervical checks and if I had them to not know the numbers. I’d also requested to use the birth pool. The midwife said I would need to be at least 6cm dilated in order to use the pool. When she checked me I’d gone from 2cm to over 6cm in less than 1 hour! I literally jumped into the birth pool. It was bliss. I laboured there using the gas & air as well but the best thing after the pool was a cold wet flannel that my husband kept cold (we kept a 2 litre bottle of water in the freezer from week 36 that we brought to the hospital) on the edge of the pool. I rested my forehead on it between contractions. 

 The midwife wanted me to give birth on dry land out of the pool due to the size of the baby (something about them being better able to assist and monitor me). I tried a number of positions; all fours, leaning with my hands on the bed, squatting, birth stool, but eventually I was getting tired and it was suggested I get on the bed. After more pushing I started to tire again so my legs were put into stirrups. That gave me some relief, but then eventually I was getting tired again.

What eventually worked was counter pressure on my feet by the midwife and me putting my hand ‘down there’ to feel my baby’s head. I’d been convinced I’d not want to see or feel the baby’s head, but it was the most empowering thing to actually feel tangible progress as I pushed. In the final stages the midwife was on the other side of the room and I felt a surge coming. I called out “Serena where are you?!” My husband saw she was across the room and wasn’t going to get across the room in time and leapt out of his chair and put his hands on my feet. He saw our daughter’s head being born. That’s something he never thought he would do! Finally I roared our daughter into the world, she was put on my chest and I looked at her in amazement that I had given to birth this amazing creature. With no drugs!

She was actually 8lbs 8oz, so not quite the 9lbs the scan predicted. What I later learned from reading my labour notes (anyone can request them under GDPR laws) was that I went from 2cm to fully dilated in 2 hours 15 mins! Just shows what the power of ignoring numbers and measurements and letting your body have the birth it’s meant to have can achieve. People say women with quick labours are lucky which is true, but also I truly believe we can make make our own luck through preparation, positivity and great support. 

 

Resources

Gestationaldiabetes.co.uk

A great website run by a mum who had GD. Useful recipes, the chocolate cheesecake I served at a dinner party to unknowing guests it had no sugar in it! There is also a facebook group which helps you feel like you’re not going it alone.

Real Food for Gestational Diabetes by Lily Nichols

Much like the guidance on the gestational diabetes website, this book recommends a high protein, high fat diet to help control sugar levels. I haven’t come across any mothers who were able to follow the NHS diet guidance and remain diet controlled. A bowl of bran flakes or two Weetabix is packed with carbohydrates and therefore sugar! The grainless granola from this book was also great as most women find post breakfast blood sugar readings the toughest meal to control. 

NICE guidelines

They might be dry, but they’re worth reading up on as the guidance changes often and it gives proper evidence and research links to why doctors may recommend certain courses of action. 

Experiment with foods. Keep a food diary alongside your blood sugar readings. Often things like fruit which are high in sugar can be tolerated when paired with protein or fat. Berries with nuts, fruit with yoghurt, apple with cheese. 

Go for walks after your meal as much as possible. Even 10 minutes can make a big difference. I found I could even eat fish and chips, go for a 20 minute walk and have good blood sugar readings. Some people ask if it’s cheating, but it’s not as the exercise breaks down the sugar in your blood. 

Whilst GD can be a pain, the upside is you will probably be the healthiest you’ve ever been when it comes time to give birth. Every finger prick and extra appointment is completely worth it.