Late in my second trimester of being pregnant with my second baby, I found out I had gestational diabetes. At first, I was completely shocked. I had what I considered to be a pretty healthy lifestyle and didn’t believe the diagnosis, even though my body gaining a quick sixty pounds with small dietary changes in the first two trimesters should have been an indicator.
I was quick to hope that my first test results were wrong but after a week of keeping track of my foods and blood sugar numbers, my fasting numbers were proving that it was likely that the test results had been right. Eventually, the three-hour blood glucose test confirmed: I indeed had gestational diabetes.
At first, I felt defeated. I had an unplanned c-section with my firstborn and had chosen this time to work with an independent midwife so I could have an out-of-hospital VBAC (vaginal birth after cesarean). After my first experience in the hospital, I wanted to avoid being there again unless there was a medical reason. This was a very personal choice for me and something I felt strongly about. If I was unable to control my gestational diabetes with diet alone, I would need to be put on insulin. If I was put on insulin, I would have a medical reason to need to birth at the hospital. Furthermore, I would likely be induced earlier than my due date. As my first baby didn’t come until 41 1/2 weeks, I wanted to avoid unnecessary induction before 42 weeks unless medically needed.
Another surprising feeling was that of guilt. I couldn’t stop thinking that I had done something wrong to create this internal unsafe environment for my baby. I felt a bit ashamed that my dietary choices had led to this diagnosis. After having a few friends reach out to me who also experienced gestational diabetes and reading a few articles/posts on gestational diabetes, I realized that feelings of guilt and shame were quite common among expectant mothers with a gestational diabetes diagnosis.
After a visit to a perinatal specialist who firmly scolded me for choosing an out of hospital VBAC birth, (without even asking about my reasons), I decided that the guilt I was feeling was a choice to carry or not. Deep down I knew that this wasn’t something wrong I did or anything wrong with me, and I decided to try my best to make a lifestyle and diet change that would give me the best chance at keeping my fasting numbers within the safe range.
I also worked on acceptance and letting go of the outcome: My baby and body would ultimately be in control of the birth story, and I was okay with whatever outcome there was. My goal was to try my best for the outcome that made me feel the safest and that would make my desired outcome most likely.
There isn’t a lot of obvious support for mamas looking for an out of hospital VBAC, especially those with a gestational diabetes diagnosis. I knew I needed to create an intimate support system around myself that was compiled of people that would respect my choice to try and stay off insulin and to fix my diagnosis nutritionally. Luckily, my husband, my providers, and close friends and family were in my corner and willing to help where I needed more emotional support.
My attempt to stay off insulin
After removing bread and refined sugars from my diet, I still was finding it hard to manage my fasting numbers. My provider said it was time to remove other sources of carbohydrates so I removed all fruit from my diet. My fasting numbers were STILL high. After a bit more searching, I came across research that was showing the Keto diet could reverse type 2 diabetes. This was an ah-ha moment! I thought, well, if it can reverse Type 2 diabetes, then it has to reverse gestational diabetes, too!
In a last-ditch effort to stay off of insulin, I tried the Keto Diet. I dove headfirst into it and removed almost all carbohydrates including most vegetables, and restricted the few vegetables I had to under 50 carbs a day (we’re talking a few cups of spinach, broccoli and/or mushrooms). It was a restrictive and socially awkward diet, but once I got through the initial withdrawal of carbohydrates I started to get in a flow with my meals and my fasting numbers started to be within the healthy range (i.e. under 95).
I used the Carb Manager AP to keep track of my food intake and found that the foods I could rely on the most were eggs, avocados, olives, spinach, mushrooms and broccoli, as well as a few nuts. I also ate a lot of fatty meats: steak was a staple in my diet. In the final month, I purchased some cauliflower pizza crusts and KETO friendly foods that I would use VERY sparingly to give myself a treat here and there. I also made being active more of a priority where I would walk for 30-60 minutes on a treadmill 4-6 days a week. I also tried to go to yoga two times a month.
After stabilizing my blood sugars on the Keto Diet, my weight stabilized and I didn’t gain another pound. After the initial withdrawal from sugar, I felt so much better emotionally and physically. I even started to sleep much deeper! At 41 weeks I went for my appointment and the baby was doing great and measuring perfectly. I had made it to the final weeks without needing insulin and still was healthy and a great candidate for a home birth.
I left my 41-week appointment and ran errands with my husband during the day. At night, around 9 pm, small contractions started and at 10 pm when my husband went to bed, I couldn’t sleep from the contractions picking up. I didn’t think much about it, texted my doula that I thought labor had started and I was going to just see if it continued. By 1:30 am things shifted drastically and fast, and I realized I was alone and hadn’t caught the shift early enough. I woke my husband up in a panic and yelled at him to call the midwife and doula. He woke in a daze thinking I was in early labor and tried to calm me down, (there was no calming, I was feeling the urge to push!). I tried to convince him again that the baby was coming soon and in my hysteria, I picked up the phone myself at 1:50 to tell my doula to tell her that the baby was coming. By 2:15 am I was laying in the tub, with my baby on my chest. My husband helped catch our baby boy as he came out in a matter of a few pushes while my midwife and doula were on their way. Shortly after, our birth team arrived and did all of the required checks and tests. Everyone was healthy and well. By 5:30 am, we were in bed, just the three of us, sleeping together as a family and waiting to start the next day together.
In the end, I realized that the most important thing I was searching for was respect and support in my informed birth choices. My provider was honest with me about what going on insulin would mean, (it would take away a choice I desired and likely would mean an early induction), and gave me the support to choose a different approach when I expressed that a hospital birth wasn’t aligned with what felt best for our family. Even if our birth story had ended with me needing to be on insulin, a delivery in the hospital, or even needing a repeat c-section, it still would not change the fact that I was deserving to be informed, listened to, and fully respected along the way as I made choices for my body. No matter the outcome, every birth experience should feel aligned to being treated with humaneness and dignity along the way.
This is something we all deserve in birth. My hope is that this type of care becomes the norm for every provider. If women are searching for another option, they deserve to be listened to, informed with evidence based information, respected, and to feel safe and supported in any option they choose or that may be required for safety.