Gestational diabetes and giving birth
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If labour starts before 37 weeks
What happens after my baby is born?
Gestational diabetes and your health
What does all this mean for you?
Planning the birth
Gestational diabetes can make some problems more likely as your pregnancy progresses, and can affect when and how you give birth. Your healthcare team should explain your options for giving birth, before you make your birth plan.
High blood sugar (glucose) levels in pregnancy can cause your baby to grow larger than normal (called macrosomia). Your baby’s size will be monitored in pregnancy using ultrasound scans. If your baby is large, you may be advised to have an early induction (starting labour artificially) or planned caesarean section.
If you’ve had a caesarean section in the past, you might be keen to try for a vaginal birth. You may still be able to have one, even with gestational diabetes. Your doctor or midwife can help you decide what is best for you.
Your team will advise you to give birth in a hospital. This is because it has specially trained staff and equipment to look after you and your baby, during and after labour.
If you have any other health problems, such as being overweight, or some nerve problems, you may be advised to see an anaesthetist. They can talk to you about the methods of pain relief most suited to you during the birth.
Some people like the idea of a water birth. It might be possible to have a water birth with gestational diabetes. But this will depend on lots of things, so speak to your healthcare team about your options for giving birth, and ask about a water birth if that’s what you would prefer.
When to have your baby
If your pregnancy goes on for too long, it may increase the risk of problems for you and your baby.
If you live in England and Wales, you will be advised to have your baby before 41 weeks. If you don’t go into labour naturally by then, you will be offered an induction or advised to have a planned caesarean section.
You may be advised to have your baby before this if you have complications such as high blood sugar levels, high blood pressure, or a big or small baby.
In Scotland, most pregnant people with diabetes have labour induced within 40 weeks.
If your labour starts before 37 weeks
If you go into labour early, you may be given steroid medication to help your baby’s lungs develop. If you’re on insulin, your insulin dose will be increased and your blood sugar levels will be monitored even more closely. This is because steroids can raise your blood sugar.
Monitoring during labour
It’s important that your blood sugar levels stay in the target range during labour. This will help to prevent your baby’s blood sugar getting low in the first few hours after they’re born.
Take your testing kit with you to the hospital, so that you can monitor your own blood sugar at first. Once you are in active labour, the hospital team will monitor your blood sugar every hour to make sure it stays at a safe level. You might be given insulin and glucose through a drip to help with this.
During labour, your baby’s heart rate may be checked continuously using an electronic monitor.
If your baby is not moving through the birth canal, one of their shoulders may be stuck. This is called shoulder dystocia and it can happen if your baby is large. You may need an assisted birth. This is when the doctor uses special instruments to help deliver the baby.
What happens after my baby is born?
Your baby will stay with you unless they need extra care.
There is no reason why you can’t breastfeed your baby if you have gestational diabetes. It is safe and can help protect their future health. If you’ve had gestational diabetes, your baby may be at greater risk of obesity and diabetes in later life. But breastfeeding can reduce these risks, as well as lowering their risk of some infections, asthma and heart disease.
No matter how you choose to feed your baby, you should start feeding them as soon as you can after birth (within half an hour). You should then feed them at least every 2-3 hours after that. This will help your baby’s blood sugar stay at a safe level.
Find out more about feeding your baby after birth.
A few hours after the birth, your healthcare team will test your baby’s blood sugar level. They will do this by pricking their heel to get a drop of blood. Your baby may cry, but it should be over very quickly, so try not to let this upset you. The test is done to keep your baby safe.
If your healthcare team has any concerns, your baby may need extra care in a neonatal unit for a while. Your team may suggest this if your baby:
- is unwell
- needs closer monitoring or treatment
- needs help with feeding
- was born early.
“I was an emotional wreck afterwards for a whole week, crying all the time. I didn't like seeing my baby with tubes in him, and he had jaundice as well, so we weren't allowed to go home. But now, he's fabulous, constantly crawling around, he's a really busy baby!”
Aisha
Gestational diabetes and your health
You’ll probably be advised to stop taking any diabetes medication as soon as your baby is born. This is because gestational diabetes tends to go away after the birth.
You should have a blood test before you go home, to make sure your blood sugar levels have gone back to normal. You should also have a diabetes test about 6-13 weeks after your baby is born. This is because some people will still have diabetes after pregnancy.
Once you’ve had gestational diabetes, you are more likely to develop type 2 diabetes in the future. This means you should have a blood sugar test once a year, which you can arrange at your GP surgery.
Find out more about the long-term implications of gestational diabetes.
If you become pregnant again
If you’ve had gestational diabetes, you are more likely to get it again in your next pregnancy. If you’re planning to get pregnant again, it’s even more important to have a healthy lifestyle now. This will help to:
- reduce your risk of getting gestational diabetes in your next pregnancy
- improve your fertility
- reduce your risk of problems in pregnancy
- protect your baby’s future health.
Find out more about getting pregnant if you’ve had gestational diabetes before.
What does all this mean for you?
If your birth experience is different to what you had hoped for, this can be hard to come to terms with. Try to remember that labour and birth often does not go to plan, whether you have gestational diabetes or not. For many people, knowing more about induction and caesarean births helps them feel better prepared for what may happen.
“I'd seen a lot of my friends have children, so I had an idea that labour can change dramatically in minutes. I knew that the ideal wasn't always possible. I think that helped a bit.”
Michelle
If you do feel very emotional about any aspect of your pregnancy or birth – even if it’s a long time afterwards – it can help to talk about it. You can speak to friends or family, your midwife, health visitor or GP, or you could consider counselling.
You can also speak to our midwives on our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].
Royal College of Obstetricians & Gynaecologists, Diabetes UK (2021). Gestational diabetes - Information for you. https://www.rcog.org.uk/media/b10mqyfw/pi-gestational-diabetes.pdf
National Institute for Health and Care Excellence (2015). Diabetes in pregnancy: management from preconception to the postnatal period. NICE guideline 3 (updated 2020). https://www.nice.org.uk/guidance/ng3
Ye W, Luo C, et al. (2022). Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis. BMJ. :e067946. https://doi.org/10.1136/bmj-2021-067946
Scottish Intercollegiate Guidelines Network (SIGN) (2010). Management of diabetes: national clinical guideline 116 [updated 2017]. https://www.sign.ac.uk/assets/sign116.pdf
NHS website (2022). Gestational diabetes - Treatment. https://www.nhs.uk/conditions/gestational-diabetes/treatment/ [accessed January 2024]
National Institute for Health and Care Excellence (2022). Fetal monitoring in labour. NICE guideline 229. https://www.nice.org.uk/guidance/ng229
Horta BL, Loret de Mola C, et al. (2015). Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatrica. 104(S467):30–7. https://doi.org/10.1111/apa.13133
National Institute for Health and Care Excellence (2014). Maternal and child nutrition. NICE Public Health Guideline 11. https://www.nice.org.uk/guidance/ph11
Zheng M, D’Souza NJ, et al. (2024). Breastfeeding and the Longitudinal Changes of Body Mass Index in Childhood and Adulthood: A Systematic Review. Advances in Nutrition. 15(1):100152. https://doi.org/10.1016/j.advnut.2023.100152
National Institute for Health and Care Excellence (2021). Postnatal care: Breastfeeding information and support. NICE Guideline 194 (Evidence review S). https://www.nice.org.uk/guidance/ng194/evidence/s-breastfeeding-information-and-support-pdf-326764486010
Xue M, Dehaas E, et al. (2021). Breastfeeding and risk of childhood asthma: a systematic review and meta-analysis. ERJ Open Res. 7(4):00504–2021. https://doi.org/10.1183/23120541.00504-2021
Nakada S, Ho FK, et al. (2023). Association between being breastfed and cardiovascular disease: a population cohort study of 320 249 participants. Journal of Public Health. 45(3):569–76. https://doi.org/10.1093/pubmed/fdad016
Umer A, Hamilton C, et al. (2019). Association Between Breastfeeding and Childhood Cardiovascular Disease Risk Factors. Matern Child Health J. 23(2):228–39. https://doi.org/10.1007/s10995-018-2641-8
Read more about gestational diabetes
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Causes of gestational diabetes
We do not understand exactly why some women get gestational diabetes and others don't. But we do know that some factors increase the risk. -
Symptoms of gestational diabetes
Gestational diabetes does not usually cause any symptoms. Most women only find out that they have it when they are tested for the condition. -
Testing for gestational diabetes
Whether you are at risk of developing gestational diabetes or not, you’ll usually be offered an oral glucose tolerance test (OGTT). -
What are the risks of gestational diabetes?
Gestational diabetes can cause problems in pregnancy, but these risks can be reduced with careful management of diet, exercise, medicine & help from doctors. -
What is gestational diabetes?
Gestational diabetes is a type of diabetes that can develop during pregnancy. With management, most women will have healthy pregnancies and healthy babies. -
Gestational diabetes and your mental wellbeing
It’s natural to feel worried if you’ve been diagnosed with gestational diabetes. Here are some on how to ease any concerns. -
Gestational diabetes
Gestational diabetes is a specific type of diabetes that usually develops around the second or third trimester and normally goes away after you've given birth. -
Treatment for gestational diabetes
Gestational diabetes is treated by making changes to diet and exercise to manage glucose levels. If this doesn’t work, you may be given medication. -
Long term implications of gestational diabetes
If you have gestational diabetes, you can reduce your risk of future health issues by maintaining a healthy weight, exercising & eating a balanced diet. -
Feeding your baby and gestational diabetes
If you have gestational diabetes, it’s important to feed your baby as soon as possible and then regularly after you give birth. -
Understanding the glycaemic index
The glycaemic index is a measure of how quickly sugars are released into the bloodstream. Knowing what foods to avoid helps control gestational diabetes. -
Managing your weight with gestational diabetes
Women who are overweight are at higher risk of developing gestational diabetes, so it's important to know how to manage your weight and diet during pregnancy. -
Injecting insulin
If you’ve been prescribed insulin as a result of being diagnosed with gestational diabetes, you’ll need to give yourself this as an injection. -
Monitoring your own glucose levels
If you have gestational diabetes, measuring your own blood glucose levels will become a regular task, either by using the finger prick test or a CGM. -
Gestational diabetes and premature birth
Diabetes is a condition in which there is an inability to control blood sugar levels and it leads to high amounts of sugar in the blood. -
Staying active with gestational diabetes
If you have gestational diabetes, exercise is safe and can help you manage your condition by reducing your glucose levels. -
Gestational diabetes and your diet
Eating well is an important part of staying healthy throughout your pregnancy, especially if you are managing gestational diabetes. -
Taking medication and insulin for gestational diabetes
Some women can control their glucose levels through diet and exercise alone, but others will need to take tablets or injections to help control it.