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Gestational diabetes: care to expect before and after birth

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.

You should expect more appointments, tests and scans than other pregnant women. These will help make sure your pregnancy is going as smoothly as possible. 

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.”
Reena, read her story

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 how it’s treated.
  • 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 who to call if you need extra support.
  • Explain how to treat hypos (low blood sugar) and hypers (high blood sugars).

Get the most out of your appointments

One of the most important things you can do to 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 and education. You should also have the opportunity to talk with your midwife or doctor if you have any concerns.

If you prepare a bit 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 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.

What happens during labour and birth?

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

You should also be advised to have your labour induced, or a caesarean section if this is the best option for you, before 41 weeks of pregnancy – if you have not had your baby by this time. You may be advised to have your baby earlier than this if there are complications, such as high blood pressure or a big baby.

During labour and birth, your blood sugar levels will be monitored carefully. If your levels aren’t between 4-7mmol/l, you may be given a drip.

What happens straight after the birth?

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.

I've had my baby. What now?

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.

But, in some cases, pregnancy uncovers existing diabetes, so some women will need to carry on with their treatment.

After having gestational diabetes, you’re at an increased risk of developing it in future pregnancies, so you should be offered testing for diabetes when planning future pregnancies. You’re also more likely to develop Type 2 diabetes in later life.

“Six weeks after giving birth, I had a follow-up blood test, which showed my blood sugars were back to normal, although I’ll have to be tested every year for diabetes. I know I’m at a higher risk of developing Type 2 diabetes now, which is a worry, but also an incentive to keep healthy. I get lots of exercise running around after Jack and Thomas.”
Vicky, mum of two

To reduce your risk:

  • Make sure your blood sugar levels are checked regularly, including a test between 6 and 13 weeks after you’ve given birth and then an annual test to check your blood sugar levels are normal. 
  • Look out for the signs and symptoms of diabetes and arrange to see your GP or nurse if you’re worried. 
  • 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). If the results from your first OGTT are normal, you should be offered a follow up test later in your pregnancy.
  • Take steps to manage your weight, make healthier food choices and keep up your physical activity. This will help to reduce your risk future risk of developing gestational diabetes again or Type 2 diabetes in the future.

“Looking back at my pregnancy, I feel more informed about gestational diabetes and my future risk of Type 2 diabetes. If I were to have a second child, I’d go into the experience much more prepared.”
Reena, read her story

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 have postnatal depression, talk to your doctor, midwife or care team straight away. They will be able to arrange care and support for you. The earlier it’s diagnosed and treated, the quicker you’ll recover.

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