Gestational diabetes care

When you have gestational diabetes, it’s important to know what care you’re entitled to at every stage – during pregnancy, labour, birth and after your baby is born.

What happens after I’m diagnosed with gestational diabetes? 

You should be referred to a joint diabetes and antenatal clinical within one week of diagnosis. You should be referred to a dietitian too. 

In the meantime, try to keep up your activity level and eat healthily. Your healthcare team will then give you more information at your first appointment. 

During pregnancy, you should expect more appointments, tests and scans than other pregnant women. Getting the right support and treatment will help you enjoy a health pregnancy and give birth to a healthy baby.  

You should also expect to be in touch with your diabetes and antenatal team every one to two weeks throughout your pregnancy. 

“Like most women with gestational diabetes, my biggest worry during my pregnancy was whether my baby would be OK. I had lots of scans and extra checks which all turned out to be fine and this really helped to reassure me.” 

Read Reena's story.

Although most women's blood glucose levels usually return to normal after the birth, you are more at risk of developing type 2 diabetes. 

So after your baby is born, you should have access to NHS follow-on care. If you’ve had gestational diabetes, use our free tool to check you’re getting the checks and care you need to help you reduce your risk of type 2 diabetes.  

How do you take care of gestational diabetes? 

Your checklist 

Your joint diabetes and antenatal team are responsible for making sure you get the care and information you need. They should: 

• Give you information on gestational diabetes and explain treatments for gestational diabetes. 
• Give you a blood glucose meter, teach you how to use it and decide on your blood sugar targets with you. 
• Make sure you have a Maternity Exemption Certificate or Card, which will make sure you get free prescriptions. 
• Explain who the different members of your healthcare team are and what they will do to help you. 
• Refer you to see a dietitian to talk about your diet and physical activity. 
• Tell you about the Healthy Start scheme (this is called the Best Start Foods in Scotland), which gives you money on a card to help you buy healthy food, milk and vitamins and if you’re eligible, help you to apply.   
• Tell you who to call if you need extra support including out-of-hours support.
• Explain how to treat hypos (low blood sugar) and hypers (high blood sugars).

Go to our shop to download our free Care to expect for gestational diabetes leaflet from our shop.

Get the most out of your appointments 

One of the most important things you can do to help make sure you have a healthy pregnancy is to make regular appointments with your healthcare team – and go to them. 

You should be offered ongoing opportunities to receive information, education and support. You should also have the opportunity to talk with your midwife or doctor if you have any concerns. 

If you prepare before you go, it’ll make all the difference: 

Before an appointment 

• Decide what you need to know and make a note of a few questions, and write down points you want to talk about. 
• Take things you think will be useful, like your blood sugar results – use My Blood Sugar Targets (PDF, 104KB) – or a list of your medications. 
• Ask if you’ll need any tests before going to the next appointment. 
• Ask if you need to bring anything with you, like a urine sample. 

During an appointment 

• Listen and ask questions. Don’t be shy to ask if you don’t understand anything. 
• Take notes to help you remember what’s been said. 
• Ask for your test results and what they mean. 
• Take someone with you to help with questions and remembering what’s said. 
• Make a plan with your healthcare professional about what should happen next. 

After the appointment 

• Put your next appointment in your phone calendar or diary and make a note of anything you need to do beforehand 

Do you get more ultrasounds if you have gestational diabetes? 

Yes, you’ll usually be offered the following scans to check the size and overall health of your baby: 

• an ultrasound scan at around week 18 to 20 of your pregnancy to check your baby for abnormalities 
• ultrasound scans at week 28, 32 and 36 – to monitor your baby's growth and the amount of amniotic fluid, plus regular checks from week 38 onwards. 

Every woman is different, so the timing of your scans might depend on your individual circumstances. 

During your pregnancy, if you notice that your baby’s movements have slowed, stopped or are different to normal, you should contact your midwife or maternity unit immediately. 

There are staff on the hospital maternity unit 24 hours a day, seven days a week who can check your baby is OK.   

Will my doctor support me? 

Yes, although your healthcare team or midwife will be your main source of care, you should have the opportunity to talk to your doctor if you have any concerns.  

Do I need to have more blood tests?  

As well as regularly testing your blood sugars at home, as part of antenatal care like all pregnant women you will be offered several blood tests (as well as scans) to make your pregnancy safer or check that your baby is healthy. 

Your healthcare team will advice on what tests you need. See NHS information on antenatal checks and tests. 

What happens during labour and birth? 

You’ll be advised to give birth in a hospital. That’s because it’s easier to deal with any problems that may happen. 

The birth of your baby is likely to be earlier compared to a woman who does not have diabetes, especially if there are complications such as high blood pressure or a big baby. This will be discussed with you after your 32- and 36-week scans.   

Many women worry that they will have to have a caesarean section if they have gestational diabetes, but that’s not the case. It’s likely that you will be able to have a vaginal birth if that’s what you choose. 

During labour and birth, your blood sugar levels will be monitored carefully. If they are falling outside your target levels, it is likely you will be given a drip.

How will my baby be cared for? 

After birth, you and your baby will be carefully looked after. Here's a few things you can expect to happen: 

Your baby should stay with you unless the team has any concerns. If there are concerns, they may move your baby to a special unit – called a neonatal unit. 

Your baby will need to be fed soon after birth – within 30 minutes – and then every two to three hours after that. 

Your baby’s blood sugar level will be checked regularly to help stop it from going too low. 

You and your baby will have to stay in hospital for at least 24 hours before you can go home. This is because your healthcare team will need to make sure that your baby’s sugar levels are ok and that they are feeding well. See our information on breastfeeding further down.

What happens to my blood sugar levels after I’ve given birth?  

In some cases, pregnancy uncovers existing diabetes, so after giving birth some women will need to carry on with their treatment. 

But most women’s blood sugar levels go back to normal after labour. So, if you’re taking diabetes medication, including insulin, it will be stopped straight after birth.  

However, you now have a high risk of type 2 diabetes.  If you’ve had gestational diabetes, use our free tool to check you’re getting the follow on NHS care and checks to help you reduce your risk of type 2 diabetes.  

Emotional support after pregnancy  

Some women can feel down, anxious or tearful after giving birth. Your health visitor and GP should talk with you about how you’re feeling after the birth.  

If your feelings last longer than two weeks or start later, you could have postnatal depression. Symptoms may include feeling sad or low for long periods of time, tiredness, not sleeping well and feeling like can’t take care of your baby.  

If you think you might be depressed, talk to your doctor, midwife or health visitor straight away. They will be able to arrange care and support for you. With the appropriate support most people make a full recovery 

See more information on getting emotional support after pregnancy on the NHS website.  

Our helpline is also here for you on 0345 123 2399. 

Future pregnancies

You and your maternity team should discuss contraception prior to you giving birth. Find out more on our main after the birth page for people with all types of diabetes.  

During future pregnancies, tell your healthcare team that you have a history of gestational diabetes. You should be offered a blood glucose monitor to carry out early self-monitoring at home or an Oral Glucose Tolerance Test (OGTT).  

Breastfeeding

It’s best for you and your baby’s health where possible to breastfeed. But this may not always be the right choice for you.  

What may be helpful to know, is that you can collect (express) and freeze the first breast milk your body makes from 36 weeks on into your pregnancy. This is known as colostrum harvesting and your healthcare team may talk to you about this. 

Collecting and storing this early milk before your baby is born may take the pressure off you if you’re concerned about breastfeeding, particularly if it’s your first pregnancy.    

When your child is born, they won’t have diabetes, but they are at risk of low blood sugar levels as their body gets used to managing their own blood sugar levels and insulin.  

How does breast milk help?

Colostrum has extra nutrients which boosts your baby’s immune system and helps their digestive system to develop. Find out more about colostrum expressing.  

If you breastfeed your child (this includes colostrum expressing) this can also help reduce your risk of type 2 diabetes, although we don’t fully understand why yet.   

Sian: “On the morning of my c-section I took in my little frozen lunchbox of colostrum in syringes.   

“My baby's sugars were fluctuating. But she was able to take all the milk that I had expressed for her. It definitely helped counter the guilt of having gestational diabetes and it was something I could control.”