Does anyone else think the traditional oral glucose tolerance test to screen for gestational diabetes, is enough to put anyone in to a diabetic coma? For regular healthy women who are conscious about what they eat, this test is highly inappropriate.
Let me explain why…
Firstly, let’s go over some basic physiology to understand how a healthy body deals with the breakdown of sugar (glucose). As glucose is ingested, blood glucose levels rise almost immediately. The pancreas responds by secreting insulin. Insulin helps the liver store excess glucose as glycogen until it is needed. As blood glucose levels begin to fall a few hours later, the stored glycogen is converted back to glucose to provide energy until more food can be eaten.
What many people don’t realize is that during pregnancy the placenta produces the hormones Lactogen, Estrogen and Progesterone, all of which counteract the function of insulin. The placenta also makes potent enzymes that destroy Insulin. Why would that be, I hear you ask. The body suppresses insulin purposely to allow more glucose to remain available in the mother’s bloodstream for longer periods of time. This is known as ‘glucose sparing’. Glucose sparing increases as pregnancy advances, peaking during the third trimester when the fetus gains most weight and needs more nourishment to grow. In other words, at 28 weeks (the time gestational diabetes screening is performed) the body actively creates higher levels of blood glucose (the very thing the test screens for) so that it is available for the baby to use to support its growth in the last trimester. In the medical field this is seen as a malfunction, a glucose ‘intolerance’, however this is normal pregnancy physiology.
For those of you who are not familiar, I will briefly explain the procedure of the oral glucose tolerance test (OGTT).
- A woman fasts for (at least) 8 hours before the test
- Her fasting glucose level is taken via a blood sample to gain a baseline result
- She is given a sugary drink containing 100g of glucose (often with artificial colors and additives too) within 5 minutes
- Blood is taken at 1, 2 and 3 hour intervals after the drink is consumed
The problem with this test in women who don’t ordinarily ingest such high levels of glucose, is that their body is not used to handling the overload. The pancreas cannot produce sufficient quantities of insulin fast enough to meet the demand. Therefore levels become temporarily elevated until the pancreas has chance to catch up. This decreased carbohydrate tolerance is known as starvation diabetes. When the pancreas catches up with the glucose overload, insulin surges, and glucose levels plummet. This is called the rebound effect. This shock reaction is not true diabetes. A woman with a diet with a low intake of refined carbohydrates is at high risk of starvation diabetes.
Giving a woman a concentrated refined sugar load before testing is not recommended. She can have a physiological reaction to the glucose overload which can mimic diabetes. When the pancreas is presented with such high levels of glucose, not enough insulin can be produced fast enough to compensate. A temporary peudo-diabetes results, making results abnormally high. When the pancreas catches up insulin surges and blood glucose levels crash. This rebound effect actually mimics hypoglycemia. The period of time for this to occur varies, but often the 1-3 hour OGTT is not long enough to allow levels to come down to a normal baseline.
This test is bad enough to put the mother through, but think what effects this has on her unborn baby. Think carefully before willingly undergoing this seeming ‘harmless’ procedure.
Ask your health care provider for alternative screening methods.
I came across this on Facebook, and it struck me as a fascinating topic, and one in which I’d say affects the majority of women in some way after the birth of their children.
Why is it that we have come to accept our pregnant bodies as a thing of beautiful which is celebrated and praised, yet we are so ashamed as a society of our post birth body.
Why is this subject never talked about?
Margaret Lazarus‘ film BirthMarkings explores our post-birth bodies, and how our self-image changes after giving birth. BirthMarkings reframes the concept of beauty and motherhood, raises important questions about body image, and reveals the incongruity of western standards of beauty with the natural process of pregnancy and childbirth.
How do you feel about your body since giving birth?
Related Topic – ‘Beautiful Whatever’
Sarah Buckley, MD, Author of ‘Gentle Birth, Gentle Mothering’
Kerstin Uvnäs Moberg, MD & Professor in Physiology, Author of, ‘The Oxytocin Factor’
Pretty convincing reasons why natural birth is not just important for the Mother, but for society as a whole.
Quotes taken from the ‘One World Birth’ trailer. Click here to check out their website
- A ‘Good Patient’: Defined (smiffybaby.com)
- Birth Practices Which Interfere With Breastfeeding (smiffybaby.com)
- Join the Revolution (smiffybaby.com)
Nursing is Normal is a photographic project that shows mothers nursing in public places. All photos are taken by husband and wife duo, Zachary and Michelle Stephens in and around Brattleboro, VT. All moms and babes are volunteers. Our goal is to promote nursing as it should be, normal.
Thank you for sharing!
- Nursing is Normal (smiffybaby.com)
In the lead up to World Breastfeeding Week (Aug 1st-7th), the Australian Breastfeeding Association are launching a campaign to promote public breastfeeding, by teaching teens in schools that it is OK to breastfeed in public. It is pushing for boys and girls to be taught the benefits of breastfeeding in a bid to boost feeding rates.
“Despite every national and international health authority recommending exclusive breastfeeding for the first six months of a baby’s life, the latest research suggests that the mums and dads of the future don’t fully grasp the importance of breastfeeding.” (Ms Ingram)
Breast is best: Year 11 students Samantha Paras, Annabell Ram, Bianca D’Aloia with Rowan Brookes from the Australian Breastfeeding Association, and her daughter Niamh, and TV presenter Andi Lew with her son Beaudy. Picture: Erinna Giblin, Source: Herald Sun
‘Actress Elizabeth Hurley had one. So did supermodel Claudia Schiffer. Ex-Spice Girl Victoria Beckham and singer Toni Braxton had two each. TV mom Patricia Heaton had four. They’re so popular among the upper class in Brazil that the only way you won’t get one in Rio de Janeiro, as the joke goes, is if your doctor gets stuck in traffic.’
(Time magazine, 2004)
After reading about the newest arrival to the Beckham household last week, it made me consider the health implications of scheduling births prior to 39 weeks.
The negative connotation, ‘too posh to push’, according to the Urban Dictionary, refers to the growing number of prospective mothers who opt to have an elective cesarean section rather than a natural vaginal birth. Whether or not the label fits, many thousands of women across the globe are scheduling their births for reasons other than those medically indicated. In certain circumstances it may be necessary to schedule an elective cesarean due to complications of the pregnancy, but for the most part, these women are scheduling their births for the sake of convenience, to fit in with their busy lifestyles.
Numbers are sky-rocketing, with cesarean rates far surpassing the World Health Organization (WHO) recommendation that cesarean deliveries should make up less than 15% of all births, and less than 9.5% of births in the modern Westernized world. In the US, cesareans rates are at an all time high, with one in 3 women (32%) giving birth by cesarean. According to Dr. Samantha Collier, vice president of medical affairs at HealthGrades, a company that rates the quality of health care in the US, about 22% of those C-sections-or 63,000 births per year-are purely by patient choice, a 20% increase since 1999.
I find it sad to believe that vanity and the pressures of modern day life are standing in the way of normal physiological birth, and the health of many thousands of newborns. Only 25 percent of women know a full-term pregnancy should last at least 39 weeks, according to research published in the December 2009 issue of Obstetrics and Gynecology. Many people believe that all a baby is doing in the last few weeks of pregnancy is gaining weight, making for a more difficult and painful labor and birth. However this is not the case. Although babies do lay down the majority of their body fat in these last few weeks, they also undergo many other important developmental changes. The brain, lungs and eyes are all in the final stages of development in the final weeks of pregnancy, and imaging studies indicate that the brains of infants born after 39 weeks are notably larger than younger gestation babies. A baby’s brain at 35 weeks weighs only two thirds what it will weigh at 39 to 40 weeks. A recent study carried out by the March of Dimes, the National Institute of Health (NIH) and the Food and Drug Administration (FDA) highlighted that even though the occurrence is low, the risk of newborn death was 50% lower in babies born at 39 weeks or later.
Babies who are born prematurely will have more health problems not just at birth, but later in life too. Babies born early are at risk of breathing difficulties, hearing and vision problems, low birth weight, intestinal problems, difficulties maintaining their temperature leading to problems feeding, learning and development disabilities and even bleeding or fluid in the brain. These will not occur in all newborns that arrive early, but the risks remain.
Why scheduling an early birth can be a problem
(Taken from March of Dimes)
- Your due date may not be exactly right. Sometimes it’s hard to know just when you got pregnant. Even with an ultrasound, your due date can be off by as much as 2 weeks. If you schedule to induce labor or a cesarean birth and your date is off by a week or two, your baby may be born too early.
- Inducing labor may not work. If your labor is induced, the medicine your doctor or Certified Nurse-Midwife (CNM) gives you may not start your labor. When this happens, you may need to have a c-section.
- A C-section can cause problems for your baby. As discussed above, babies born by C-section may have more breathing and other medical problems than babies born by vaginal birth.
- C-sections can cause problems in future pregnancies. Once you have a C-section, you may be more likely in future pregnancies to have a C-section. The more C-sections you have, the more problems you and your baby may have, including problems with the placenta.
- A C-section is major abdominal surgery for mom. It takes longer for you to recover from a C-section than from a vaginal birth. You can expect to spend 2-4 days in hospital after a C-section. Then you’ll need around 6 weeks (sometimes longer) after you go home to fully recover. You also could have complications from the surgery, including infections and bleeding. So it’s important to stay in touch with your health care provider even after you go home.
Babies need time to fully develop in order for them to be strong enough to survive ‘on the outside’.
Unless there are medical concerns, the safest and healthiest place for developing infants is in the womb.
- Birth Practices Which Interfere With Breastfeeding (smiffybaby.com)
- Doulas: The Essential Ingredient (smiffybaby.com)
Finally, a TED Talk about birth!
Ginny Phang, a Singapore-based Doula and childbirth educator, discusses why a Doula can be so valuable to a woman in labor.
Ginny believes in enriching a woman’s childbirth experience, supporting couples through their choices and helping them to achieve the best possible birth experience. In her TED talk she tells the audience what drove her to becoming a Doula, the processes of labor, and interestingly how our ideas of birth can shape our own experiences of labor.
Here are her top 4 ways to prepare for a positive birth experience:
1. Eliminate fear. “Get all of the skeletons out of the closet.”
2. Learn coping strategies. Learn how to really relax
3. Prepare a birth plan. A plan A, plan B, plan C…
4. Get support. “The right kind of support… find a doctor and hospital to support the mother and what she wants.” Having a doula with you helps– it makes you realize, “if this mother can do this, I can do this, too.”
A doula helps, “give the power back to women and trust their bodies.”
An amusing blog post from the Analytical Armadillo about the complicated rules of breast coverage.
Thanks for sharing.
- Avoid heavily processed foods-often contain huge amounts of fat, salt and sugar
- Eat organic, locally produced foods-these contain the highest amounts of nutrients and least pesticides
- Enjoy foods in their natural state-for example, eat fresh fruit, rather than frozen or canned
- Eat a rainbow of foods-a variety of colors, types, and textures, to get a full spectrum of vitamins and minerals
- Eat little and often-this helps to balance your blood sugar, and may prevent nausea
- Drink at least 2-3Ls of water a day-your body needs water to function, plus dehydration can lead to premature labor
- Try to exercise a little every day-brisk walking is an excellent form of exercise, yoga, swimming & cycling are also great
- Do not diet or detox during your pregnancy
- Find healthy alternatives to your cravings*-this is usually your body’s way of telling you something is missing from your diet.
*Eg, If you do find yourself drawn to the giant golden arches of McDonald’s desperate for a big juicy burger, your body is probably in need of some iron, why not try cooking a steak at home-a healthier alternative to a big greasy burger with plastic cheese.
Be aware though, if you are craving sugar, try not to give in. Craving sugar is usually a sign you are in need of protein (strange as this may sound). This is usually your body telling you to eat more frequently and that your blood sugar is low. Protein helps to sustain and stabilize blood sugar levels to prevent this from happening. Don’t go more that 2-3 hours without eating something. Try carrying bite size snacks in your purse so that you never are without!
Eating Habits Programmed During Infancy-Healthy Child Healthy World
During pregnancy it is not uncommon to find yourself as a human magnet. You will find that without realizing it, you have entered in to a new ‘members only’ club. Women of all ages will smile at you in the street, random people will stare at your belly in awe, doors will be held open for you, and total strangers will feel the need to put their hands on your bump. People love to tell you all sorts of things when you are pregnant. They will relish in telling you the joys, the horrors, the hells, the triumphs of their pregnancy and birth experiences. People will tell you ‘you should never do this’, and ‘definitely do that’, whether you ask for their opinion or not! You will hear things from your mother, your mother in law, your aunty, your cousin, your best friend, your boss’s wife, the elderly lady down the street, people on the bus, mom’s in the park, and it is likely that they are all saying completely different things. All this advice can become overwhelming and confusing, and is often not based on anything more than old wives tales. So I wanted to set a couple of common pregnancy myths straight.
The common pregnancy myth about ‘eating for two’, is just that-a myth. Although you want to nourish yourself during your pregnancy, you do not want to over eat. In reality, we only require an additional 100 calories in the first trimester, and 300 extra calories during the second and third, which when you think about it really isn’t a lot. During pregnancy your body becomes more efficient at absorbing nutrients from the foods you eat. Eating twice as much does not double your chances of having a healthy baby. Have you ever wondered why pregnant women are so prone to constipation? Unfortunately, constipation affects approximately half of all women at some point during their pregnancy. Although it may be annoying, it does have its purpose. The passage of food through the gut is slowed down due to the effects of pregnancy hormones progesterone and relaxin. The hormones relax the muscles of the intestines, which takes the body longer to move food along. The longer the food sits within the intestines, the more time the body has to absorb its nutrients needed to grow a healthy baby. Unfortunately, this can lead to constipation. The best ways to avoid constipation is by increasing your fiber intake, drinking plenty of water (around 2-3Ls a day) and by doing regular exercise.
Make healthy choices during your pregnancy. Your baby’s health is directly related to what you eat before, during and after pregnancy. Nutrition is key to a healthy pregnancy and birth and is the biggest and most valuable tool you have for avoiding discomforts and complications, such as nausea and vomiting, heartburn, leg cramps, high blood pressure and swelling. Overall, healthy moms have healthy babies.
Think quality over quantity. Nutrition is one of the only things you have complete control over. So make every bite count. Eat nutrient rich, organic whole foods whenever possible. Avoid processed and refined foods, artificial sweeteners and preservatives. This is important throughout, but especially during the first trimester, as many women will experience ‘morning sickness’, (which by the way is another myth, morning sickness can occur at ANY time of the day!) where it may be difficult stomach a lot of food. If you are throwing up, you want to be sure that the food you are getting is the best it can be, and full of all the vitamins and minerals you need for your baby.
It is normal to gain between 25-35lbs during pregnancy, but remember that weight gain is individual. If you start off with a BMI (body mass index) slightly lower than average, you may find your put on a little extra weight-don’t be alarmed! We put on weight for a reason, and it is normal. Do not try to diet or loose weight whilst pregnant. It is dangerous and can lead to a number of complications. Also, don’t expect the weight to just fall off once you’ve given birth. Although breastfeeding does help to loose some of the weight put on during pregnancy, our body does still need additional calories and weight whilst nursing. Be kind to yourself. Remember that the pregnancy weight took 9 months to put on, and it is perfectly acceptable for it to take 9 months, if not longer, for you to return to your normal weight again. Unfortunately, our bodies don’t just ping back in to shape the moment we give birth. Don’t be put off by stories of celebrities or even friends, returning to their pre-pregnancy skinny jeans 3 days after stepping foot outside of the hospital doors! This is not a reality, and we should not adopt these unrealistic expectations. It is not healthy for anyone!
Myth number 2 ‘fats will make you fat’ is another common misconception, not just in pregnancy but in general too. Avoiding fats will not stop you from gaining weight. Gaining weight is inevitable during pregnancy. In fact eating the right kinds of fats will actually help you burn fat, control your moods, and fight fatigue.
For years nutritionists and doctors have preached from the low-fat bible, claiming that cutting fats will aid weight loss, prevent heart disease and manage cholesterol. But eliminating fats entirely from our diets is not the answer. In our culture we are obsessed with fat-free, dairy-free and low-fat alternatives, we forget that certain amounts of fat are essential for our bodies to function effectively. Fats are crucial for the nervous system and the development of the baby’s brain. It is not about the total amount of fat in our diet, it is about the type of fat that we eat. We have to remember that not all fats are equal.
A walk through the aisles of Albertsons or Ralphs provides us with many supposedly ‘guilt free’ alternatives: Fat free ice cream, low fat candies, cookie and cakes. When you come to browse the shelves for milk, for example, it is pretty hard to come across a carton of whole, or full fat milk. The array of low-fat and fat-free alternatives are all around us, but they do not take the importance of essential milk fatty acids and fat-soluble vitamins (A & D) in to consideration. Today most people think they are doing a good thing by drinking low-fat milk, but most of these commercial milk products are completely deficient of these vital nutrients. These products are marketed to our nation’s insecurities surrounding body image and weight gain. The low-fat label is a marketing tool, and a good one at that. One that’s had us fooled for many decades. If you think about it another way, 2% milk still has a very low fat content-2%-that’s 98% fat free!
The truth is, pregnancy is not the time to be doing fat-free anything. Don’t get me wrong, I’m not advocating bingeing on nothing but cheesey fries with lashings of ranch dressing, Twinkies and chocolate sundaes, but the key is seeking out the ‘good’ fats. Ones which really are healthy for us. It is about cutting out the bad fats and replacing them with healthier choices to promote optimum health.
Remember what your mother always told you, ‘You are what you eat’.
‘Pre-pregnancy diet affects health of future offspring’-Science Daily, July 4th 2011
Eating Habits Programmed During Infancy-Healthy Child Healthy World