GESTATIONAL DIABETES

WHAT IS THIS?

Gestational diabetes is a condition caused by a rise in blood sugar levels which can possibly develop in pregnant women around the 24th week of gestation. “It is a common medical problem – Hypertension being the first while gestational diabetes comes second,” says Dr. Tarakeswari, our specialist in gestational diabetes.

HOW IS IT CAUSED?

Hormones from the placenta, which connect the baby and the mother, help in the baby’s development. These hormones also block the action of the mother’s insulin in her body. Insulin aids the process of converting glucose in the blood to energy. During pregnancy, the mother’s body uses at least three times the regular amount of insulin. When the body is not able to produce the optimum levels of insulin it requires during pregnancy, it leads to Gestational Diabetes.

PREVENTION

There is no guaranteed method to prevent the onset of gestational diabetes. However, adopting healthier choices earlier in life and during pregnancy are helpful in keeping it under control. If you have had gestational diabetes previously, then following a healthy lifestyle reduces the risk of having it in future pregnancies or developing Type 2 diabetes consequently. Here are some of the healthy choices women can make:

Eat Healthy Foods:

  • Choose to eat foods with high fibre content and low in fat and calories.
  • Add ample fresh fruits and vegetables to your diet.
  • Strive to balance your protein and carbohydrate content while making sure you gain enough nutrients from your daily food intake.
  • Watch your portion sizes.

Exercise:

  • Be sure to add a cardio workout for at least 30 minutes to your day. It could be brisk walking, light jogging, cycling or swimming.
  • Stay moderately active every day.

Losing Excessive Pounds:

  • It is not recommended to lose weight during pregnancy. Hence shedding excess weight before conceiving helps you have a healthier pregnancy.

MYTHS

There are an umpteen number of myths about gestational diabetes which have been addressed time and again. These myths paint a false picture in people’s minds creating a stigma around this disease. Two of the most common and important myths are addressed below.

IP2-FB - Myth vs Fact

However, diabetic pregnancies require extra care and excellent blood sugar control, before and during the pregnancy. If you have diabetes and are trying to conceive, it is vital to talk with your doctor.

Myth 2: Gestational diabetes does not need to be taken seriously.

Although gestational diabetes usually disappears after childbirth, it needs to be monitored. Ignoring it not only leads to complications in pregnancy, it is also a health hazard to the mother and baby. Our specialist Dr. Tarakeswari says, “There are two complications which may arise if the blood sugar levels are not controlled. Firstly, the baby is born overweight, leading to difficulty in delivering the shoulder, causing shoulder damage. The second one could be an increase in the need for a C-section to deliver the baby.”

If precautionary measures are not taken in time, there are high chances that the mother and the baby will develop Type 2 diabetes later in life. This makes it vital for the mother to keep her blood sugar levels in check.

HIGH AND LOW RISK FACTORS:

These factors determine the likelihood of developing gestational diabetes.

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OUR SPECIALIST

Dr. Tarakeswari is the Head of Obstetric Medicine Unit at Fernandez Hospital. Her professional interests include Medical Disorders Complicating Pregnancy, Recurrent Pregnancy Loss and High Risk Pregnancy. Dr. Tarakeswari, our specialist in the care of Gestational Diabetic mothers, has been associated with Fernandez Hospital for 20 years. Since joining in March 1995, she has supported, counseled and guided mothers with gestational diabetes through their pregnancies.

Dr. Tarakeswari
Dr. Tarakeswari

YOUR QUESTIONS ANSWERED

Q: Tell us how Fernandez Hospital acts a referral center for Gestational Diabetes? 

Dr. Tarakeswari: As we have a nutritionist, an endocrinologist and an expert fetal medicine team under the same roof, a lot of pregnant women diagnosed with Gestational Diabetes come in for a second opinion. We make sure we know complete details about the patient’s previous pregnancy history; it could be either diabetes or any other condition. Firstly, the nutritionist and the endocrinologist review the patient together. The nutritionist suggests the mother a diet plan and the endocrinologist checks her current diet and starts her on insulin. Once this process begins, the fetal medicine team keeps a constant check on the health of the baby. As everything is done under one roof, it becomes easy for the patient to keep herself and her baby healthy.

Group Photo

A picture of the team

Happy mother Ms. Sandhya gupta shares her experience with Fernandez hospital:What really stuck us about FH from the very beginning – over and above their medical expertise – is their thoroughness and personal care. Despite packed schedule, Doctors would specifically ask us multiple times if we had any questions. And we had a lot of them! Doctor would listen to one and all and reply with full patience. Follow ups for tests/appointments were another hallmark. 3 months into pregnancy, and it was discovered I’m gestational diabetic and we went into panic mode, again! We had read/heard about stories of complications due to diabetes: high risk pregnancy, baby weight, C-section. FH staff also went into overdrive. We were given special appointments, all scenarios were explained, and assured that with proper advice and care it can be managed. Regular appointments with Dr. Santosh (Endocrinologist), dietician consultations, regular-and-frequent sugar level test records, and all these being discussed with Dr. Tara – led to keeping sugar level in control over the months. Towards the last weeks, doctor paid special attention to glucose levels and baby weights and advised induced labour a little before full-term. Sure enough, we have a healthy baby boy with 3 kg weight at birth from NORMAL DELIVERY! This requires another special mention – while we had a notion that doctors every-where jump to C-section at first chance, at FH, Hyderguda, it was just the opposite! Most beautiful reward we got for sure. Thanks FH (doctors/nursing staff/others) for the beautiful gift and amazing experience. We’ll cherish the experience and be in your gratitude forever!”

 

 

Q: Does gestational diabetes go away after delivery?

Dr. Tarakeswari: We do a follow up after 6 weeks of delivery. If the blood sugar levels are high, we advise the patient to continue the diet. There are cases where the blood sugar level returns to normal while in some cases, they might develop Type 2 diabetes after delivery. If one develops diabetes during pregnancy, there are high chances of it transforming into Type 2 diabetes in the future.

Q: How much does gestational diabetes counseling help the pregnant women?

Dr. Tarakeswari: Counseling helps a lot during pregnancy. There are women who come to us before planning their pregnancy. We tell them to check their blood sugar before they conceive because they might have a family history of diabetes.

Counseling gives you information on the body health conditions. Information is provided to pregnant women before signing them for blood sugar levels check. They need to be kept calm as panicking can only cause distress. Before ordering the test, we tell them why it is important. Usually we do the test at 24 to 28 weeks as that is the time when gestational diabetes is detected. But for those with a family history of diabetes, it is done around the 16th week.

Q: Are there specific doubts that pregnant women have during pregnancy?

Dr. Tarakeswari: They do have questions like —

What happens to my baby if I have gestational diabetes?

Will the baby have diabetes?

Will I have a normal delivery?

We assure them that nothing will happen to their baby and if they are well in control of their diet, and exercise on a regular basis, they can have a normal delivery. But if the sugar level is high, we make sure to tell the patient to admit themselves a week before their due date.

 

Q: Is it compulsory to take the test at 26 weeks or does it depend on certain factors?

Dr. Tarakeswari: We take a combination of both into consideration. If somebody is treated for infertility and her BMI is 30, we test them before 16 weeks itself. If she has a BMI of 24 and she conceives with no family history of diabetes, then we test her at 24 weeks.

Happy Parents Ms. Richa and Mr. Anilesh share their experience with Fernandez hospital:

”When my wife conceived after two early miscarriages, it came as a beautiful surprise which was later shattered by the detection of Rubela/Herpes & MMR virus through torch test. To top up, the mother was also detected with Gestational Diabetes. Hope showed up with someone suggesting Fernandez Hospital as the best place for all such otherwise difficult cases. And the journey started with first visit at Hyderguda Branch. The consulting Doctor’s serious intervention along with much care and concern brought us to the last leg of our journey. Not even a single detail went unnoticed and at all steps taken by them stood by us and here we are, with a cute little girl delivered normally. Yes! Surprising but true, that even mothers with gestational diabetes can deliver normally and we are a true witness to this.

We take pride and pleasure together to thank the whole team at Fernandez Hospital, Dr. Tarakeswari and other senior doctors who stood with us all through. We also thank the Nutrifit team led by Dr. P. Janaki for their dietary planning and assistance. Not to forget the ever smiling team at the OP helpdesk to always accommodate us even in the 11th hour. But on top of all, we are humbled by patient intervention and concerning attitude of the labour room team who persisted despite all odds to help us deliver a health born baby. We fall short of words to describe our sincere gratitude towards all of them (as one team) for everything. It sure has been a life changing and heartwarming experience that God gave us through bringing us to Fernandez Hospital.”

Pathway to a Healthy Birth

This is a special feature on “Pathway to a Healthy Birth” – an infographic done by childbirthconnection.org to help women learn the safest and smoothest route for labor, birth and the crucial days that follow, including tips to stay on the pathway and things to avoid.

CC.NPWF.HPoC.Infographic.Women.2015

Childbirth Education

Childbirth is as old as the beginning of the human race. It is a natural process and yet “soon-to-be” parents tend to be anxious about coping with this new and uncertain phase in their lives. Childbirth education will help them know what to expect during pregnancy. It teaches them techniques to relieve the pain — making it easier for the mother during labour while keeping her partner informed of her developments.

Childbirth classes are not only informative, they also relieve the couple’s anxiety by providing a forum for exchanging experiences while listening to other expectant couples. They learn how to cope with the entire birthing process, making it a memorable personal experience rather than just a tense day in the Labour Room.

A childbirth instructor like Martine becomes your “third wing”.

A good instructor knows the importance of natural birthing without invasive medical procedures. She will, therefore, guide and teach you methods to make your birthing experience less uncomfortable.

Martine Cambron is a childbirth instructor from France married to an Indian. She has 20 years experience and has been associated with Fernandez Hospital since the last 15 years. Her childbirth expertise has enabled herself to give birth to nine children, all of them normal deliveries.

“Motherhood is a beautiful experience and my effort is to make this journey a special one for all mothers-to-be. Nine natural births! To be motherly is the key,” says Martine.

Mothers find the classes helpful.

A mother trained by Martine says, “When I had my first baby in the U.S. in February 2008, I had a Birth Doula who supported me throughout my labour and delivery. When I was expecting my second baby here in Hyderabad, I had no clue if there were any classes or doulas here. When I spoke to Dr. Evita Fernandez about ALL NATURAL DELIVERY, she immediately told me that I could talk to Martine about it.”

Says another happy mother: “Martine is a very nice and kindhearted human being.  Being a mother of nine, she can easily understand what a pregnant woman goes through during labour and delivery.  I had taken classes from her, though I myself got trained as a CHILD BIRTH EDUCATOR. After a long gap, it was nice to have detailed classes on diet and nutrition, understanding your pregnant body, what to anticipate, breathing techniques, labour positions, etc., including postpartum care.

The Lamaze Technique

While birthing is a painful process, these classes give pointers on how to reduce the pain. Breathing, the most important activity for the human body to function is given utmost priority to help the mother relax while in labour. The Lamaze technique, developed by French obstetrician Dr. Fernand Lamaze in the 1940’s is employed to help mothers respond positively to pain. The Lamaze philosophy stipulates that “birth is normal, natural, and healthy” and that “women have a right to give birth free from routine medical interventions.” Connecting with the baby becomes an important aspect for expectant parents. Mothers and their spouses are educated on focused breathing techniques, movement and positioning, massage, and relaxation throughout labour. The system is intended to contribute to the process of labour without the use of drugs.
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Benefits of Breathing Exercises:

Breathing is a comfort technique helping mothers ease the pain during childbirth. The benefits of learning different ways to breathe while experiencing contractions will help you enjoy the entire process of childbirth, even though it might be overwhelming.

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Inhaling gives you strength, while exhaling helps you push out the pain. Inhaling through your nose and exhaling through your mouth at a constant pace during contractions can benefit you in the following ways.

  • It helps you make the contractions work better by sending in a surge of oxygen to the uterus.
  • It aids the baby’s descent by relaxing the abdominal and genital muscles.
  • It provides another channel for you to focus on to counteract the discomfort which persists during labour. 

Q & A with Martine:

Q: What is your goal being a childbirth educator?
M: My goal is to prepare women for natural birthing and to facilitate mothers-to-be to cope with the changes in their body.

“It is a course of 6 classes with me,” says Martine.

Q: How important are these classes?
M: One big difference between people who attend classes and those who do not, is that there is no shouting during labour from those who attend. They have a calm and relaxed labour.

Mom Priyanka says : “During my labour, I did not take an epidural.  I used these breathing techniques and and had a normal delivery without any kind of medical intervention. Mrs. Martine was there with me during my labour. As I had not taken epidural, I was able to tend to my baby’s needs and feed her within the first hour of birth which is very important for her immune system development.

I would like to wholeheartedly thank Mrs. Martine for her wonderful support and compassion and hope she will change lot of women who are afraid of labour pains, to go for natural delivery.”

Movement in Pregnancy:

While at work:

Make it a point to take some time off from sitting at your desk at work and stretch your body. It helps in facilitating the hormones and blood flow through your body for you to remain much more at ease.

While Sleeping:

As the pregnancy advances, sleeping can become quite an ordeal. While sleeping, you can rest your head on a pillow comfortably cushioning the nape of your neck while you tuck a second thin pillow or a towel under your stomach. Resting your leg on a pillow or placing one between your legs can help you feel much more relaxed.

Couples Participation:

“In all our classes, it is important to have the husband with the wife,” says Martine.

Pregnancy is a joyous yet overwhelming experience for both partners. The journey is to be walked by both the parents. It is not just the mother’s responsibility to birth a healthy baby. Constant support and encouragement is highly important to get through a healthy pregnancy. Therefore, it is vital for both the parents to actively participate in child education classes. It not only nurtures a healthy bond within the family, it also takes away quite a bit of stress from the mother.

“The emotional empathy that my partner provided me during labour is what he learned from attending the classes. It helped him remain in control. The videos shown during the classes educated him much about the birthing process. I strongly recommend Lamaze for both the partners. It’s a blessing,” says Mom Apoorva.

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The partner can provide support to the mother by learning about:

  • The birthing process.
  • The breathing techniques – reminding the mother how to progress through contractions through breathing while she is in labour.
  • Nutrition required for the mother and baby.
  • What to pack while rushing to the hospital.
  • How to take care of the mother and the baby.

Parents Speak:

Parents Avinash & Nidhi:

I really have no words to explain my gratefulness. Thank you for everything. I realized everything can be controlled by the breaths we take, and being calm all the time. The breathing exercises helped boost my willpower and assured me that I can keep things in control. The pain is natural but my approach was so positive, it made me wonder if it was really me to undergo labor for so long. Thank you for being there to make the situation bright and happy.

Mom Apoorva:

I would definitely recommend Lamaze classes especially for first time mommies. I feel Lamaze provides confidence and assurance that one can have a normal, healthy and natural birth. I gained almost 25 kgs during my pregnancy and was diagnosed with gestational diabetes and hypothyroidism. I had lost all hopes of a normal delivery. To worsen it, I was swollen all over. My hands, calves and feet were swollen about twice their size. But the breathing techniques helped me focus during labour. They not only kept me well oxygenated but encouraged me to acquire a new strength and think positively about my labour.

Benefits of Prenatal Yoga

For every pregnant woman, the journey from conception to childbirth should be a wonderful experience. Fernandez Hospital is actively developing methods to make this path problem-free and smooth for mothers-to-be. A woman’s body during pregnancy is as fragile as a newborn baby, and we therefore understand the importance of fostering the well-being of the home in which a new life grows.

Yoga has been glorified through the ages for its varied benefits. With changing times, prenatal yoga has been gaining popularity to aid expectant mothers through an easy childbirth. If practiced right, under the guidance of experienced yoga instructors, prenatal yoga is a boon to pregnant women during and after childbirth.1
more “Benefits of Prenatal Yoga”