Don’t Risk Yourself Out of a Homebirth: Prevent Gestational Diabetes

By Amy V. Haas, BCCE

It’s the third class in my childbirth education series – the time when I encourage my students to ask about prenatal testing – and I’ve started to dread some of the questions about glucose tolerance testing.

Most of the time, when someone asks about glucose tolerance testing, I discuss the history and refer them to Henci Goer’s book, The Thinking Woman’s Guide to a Better Birth. Typically, at least one person in the class decides they don’t want to be tested. That’s totally their right. But what happens when they spill sugar in their urine? It’s a sign that something is out of whack.

I’m not sure whether or not people really take me seriously when I caution them to check the amounts of sugar in their cereal or yogurt or to not use milk as their only protein source at a meal. I try to emphasize that they can avoid unstable blood sugar levels by using the Brewer Pregnancy Diet.

Unfortunately they must not be listening because, inevitably, someone is diagnosed with gestational diabetes. This becomes a serious problem when that person was planning a homebirth and they were just risked out of one. I wish women who are planning a homebirth would understand that they, of all people, are going to have to work to stay healthy and low risk or they just might lose that option.

I have talked about preeclampsia and prematurity in previous articles (“Preventing Complications with Nutrition,” Midwifery Today, Issue 67, Autumn 2003 and “Preventing Prematurity,” Midwifery Today, Issue 72, Winter 2004-2005) but have never really addressed the increasingly problematic issue of glucose intolerance or gestational diabetes as it is officially known.

The fact is that, yes, each of us has an area of weakness in our bodies. Some of us are prone to blood sugar problems, others to high blood pressure, etc. Glucose intolerance is not uncommon during pregnancy, when the body is stressed to support a pregnancy, build a new human and still maintain the woman’s bodily needs. It is a sign that a woman’s body needs a different balance and variety of whole, healthy foods and less straight sugar.

Now before you start screaming that there won’t be anything to eat, I have to tell you that a whole food, higher protein, high complex carbohydrate diet gives you many more choices than the standard diabetic diet. Been there, done that, not fun! And inevitably I notice that within two weeks of going on the standard diabetic diet a majority of the women go into labor. Not necessarily a good thing if you are not at term.

So how do you improve your diet to help avoid gestational diabetes? Start by avoiding empty calories. Soda, white flour and white sugar should be eliminated. Desserts restricted to the occasional category. Anything with a sugar content of more than six grams should be accompanied by a protein source. This includes milk because lactose (milk sugar) is notorious for spiking blood sugar levels. Yogurt is another culprit. I looked at a container of Bryers yogurt one day and discovered it had 45 grams of sugar! A serving of Ben and Jerry’s ice cream only has 25 grams of sugar. I’d rather save the sugar grams for the ice cream, after I’d eaten a good high protein meal. Be careful about your portions though.

If you are eating yogurt, try to limit the sugar content to fewer than 20 grams per serving. I started looking around and discovered that Greek yogurt is higher in protein. I also switched to unsweetened, non-fat yogurt and add my own measured amounts of maple syrup (usually only one teaspoon) with fresh fruit. That way I control what I am getting and don’t feel ill. For cereals, the protein content should be more than five grams per serving, with a matching fiber content, and sugar level of no more than 10 grams. If you can get the protein and fiber higher than that and the sugar lower, that’s even better. Adding a handful of almonds to your cereal can help bring the protein content up.

I am not as worried about how many carbohydrate grams a woman is eating per day as I am about what type they are. High complex carbohydrates are going to contain more fiber. You should actually be getting 1/3 of your protein from complex carbohydrates. Just be careful to read the labels, as high fructose corn syrup seems to be in everything ‑- especially bread ‑- and it is not something you want in your diet.

Using the glycemic index will be a help. But remember, potatoes are not evil. In fact, they are very nutritious, as long as they are not boiled (unless you are making soup or stew.) However, since they are higher on the glycemic index, you want to make sure you combine them with protein.

Getting back to the practical stuff, I’m sorry but Pop-Tarts, donuts and danish are desserts, not breakfast and things like Gummy Bears and Teddy Grams should not even be in your house. You can’t just up your protein and continue to eat junk carbs. Bagels with cream cheese ‑- unless they’re whole grain ‑- are not a great choice for breakfast. Sadly, cream cheese has very little protein and is high is saturated fats and lactose. Instead, pick a whole grain, high-fiber bread source and top it with a tasty protein, such as a slice of real cheese or peanut butter. Luckily, it is not too hard these days to determine the protein, fiber and sugar content of a food item. Just read the label, and don’t forget your fruits and vegetables.

Think about getting more color and variety in your whole, healthy food choices and you will have lots of good things to eat – not to mention a much healthier pregnancy and a much better chance of having that homebirth you want. Bon appetit!

[As seen in issue #93 of Midwifery Today]

Amy V. Haas, BCCE, is a certified childbirth educator, writer, consultant and lecturer in the field of pregnancy and birth. She was also one of the founders of and the community resource coordinator for the Rochester Area Birth Network, and mom to two great boys.

Midwifery Today & Amy V. Haas©2023