As a doula, you will be asked many questions. You cannot give medical advice, diagnose, or treat anything. However, you can provide general information to help educate your clients. Knowing common pregnancy conditions, such as gestational diabetes, is an important part of providing full pregnancy support.
Part of your prenatal education and support is to help clients work towards their healthiest pregnancy and birth. Each person’s ‘best’ is unique. However, we know those who have continuous support and receive prenatal education often have better outcomes.
What Causes Gestational Diabetes?
Researchers are not absolutely certain why some women develop gestational diabetes (GD) while others do not. But there are risk factors associated with the condition.
We know that the pregnancy hormones released by the placenta play a role, because many are insulin blocking hormones. During pregnancy, many women experience a slight elevation in blood sugar following meals, which is normal and does not cause harm.
However, in women who are already at risk for elevated blood sugar, the addition of those hormones released during pregnancy can significantly increase blood sugar levels, leading to GD.
After we eat, our bodies convert food into glucose which enters our bloodstream. The pancreas responds to the glucose, and releases insulin, which moves the glucose from our bloodstream to our body cells where it is used as energy.
Diabetes is a condition where the pancreas is unable to make enough insulin to process the glucose in the bloodstream. Uncontrolled blood sugar can lead to many serious complications. In pregnancy, GD with uncontrolled blood sugar can lead to complications for the birther and the baby. Fortunately, GD can often be well controlled.
Why Do Some Women Get GD And Others Do Not?
There are risk factors associated with GD. Pre-pregnancy diet and lifestyle might play a role for some. However, genetics and hormones seem to play a big role for many.
If you have clients reaching out to you while they’re trying to conceive, you can discuss how overall well-balanced diets and exercise might reduce their risk of developing GD in a future pregnancy.
Of course, genetics and some health conditions cannot be changed. Being aware, however, can help clients prepare for the possibility of developing and managing. They can also talk to their midwife or doctor to find out if earlier testing would be beneficial.
Some risk factors for gestational diabetes are:
- A history of PCOS (Polycystic ovary syndrome)
- A family history of GD, or Type 2 diabetes
- A high pre-pregnancy BMI (Body Mass Index) – especially with a larger midsection
- A personal history of GD
- Being 40 years or older
- Utilizing assisted reproductive technology such as IUI, IVF
- A history of insulin resistance
- Leading a sedentary lifestyle
- A diet high in processed carbohydrates
- If you were a low birthweight baby
Many of these risk factors (PCOS, BMI, assisted reproduction, etc) can affect hormones, and so it makes sense that they can also increase the risk of gestational diabetes. We cannot change risk factors based on family history, age, and so on, but we can change diet and lifestyle.
As a doula, having general preconception and prenatal nutrition information can be a great way to support clients. If you’d like to provide your clients with evidenced based information, we highly recommend completing the Perinatal Nutrition Educator course.
What Do I Need to Know as a Doula?
As a non-medical support, having basic knowledge about what gestational diabetes is, risk factors, and potential complications is what you need to know.
You can help your clients reduce their risk or manage their condition with basic information. Again, they will need to follow their healthcare providers specific recommendations. However, you can share this general information with them.
They can reduce their risk or manage GD with the following:
- Become more active, especially following meals. Even a walk after dinner can help maintain healthy blood sugars.
- Eat a healthy whole foods diet, low in processed sugars and refined grains.
- Pair carbohydrates with proteins, to reduce overall intake of carbohydrates and help stabilize blood sugar.
- Meet with a dietician, who will help them develop a healthy meal plan.
- Encourage lots of water drinking and skipping sugary drinks. Even 100% fruit juice has a lot of sugar with little to no nutritional benefit.
When gestational diabetes leads to uncontrolled sugars it can increase the risk of pregnancy and birth complications. While it is a common condition, complications can present serious risk. A large for gestation baby, increased risk of c-section, increased risk of induction, baby admitted to the NICU for blood sugar issues, etc. are all risks.
Helping educate clients about GD is a great way to support them and increase the likelihood of a positive pregnancy and birth experience. As mentioned above, the Perinatal Nutrition Educator course is a great way to learn more about supporting your clients.
Author: Aliza Juliette Bancoff
Aliza Juliette Bancoff is a well-known doula and doula trainer who has been providing doula services to families for over a decade. She is the founder of Main Line Doulas, a doula group providing doula support in the great Philadelphia area for the last decade, the International Doula Institute, which provides online doula training and lactation training and certification programs and the International Breastfeeding Institute which provides lactation training and certification. She is the co-founder of United Birth, a company devoted to increasing access to doulas across the country to make the perinatal time safer both physically and emotionally. “Every birthing person deserves access to quality doula support. And we are working to make that a reality across the country. The work we are doing to get doulas to every birthing person will decrease the black infant and maternal mortality rate significantly by 2030.” Says Bancoff. Aliza is known for her compassionate and empowering approach to doula work, and she has been featured in numerous media outlets, including United Nations Maternal Health Report, Parent Magazine, CafeMom, theBump and many more. Aliza's journey into doula work began when she gave birth to her first child and felt a strong calling...