I went into my first pregnancy about 30 pounds overweight. I remember being so afraid the effects of pregnancy would tip the scales (literally) to obesity and utter misery. I made it through the first trimester only gaining a couple of pounds but I figured the worst was yet to come.
I have a condition called PCOS (Polycystic Ovarian Syndrome) which makes me insulin resistant. Ironically, it’s one of the reasons I’ve struggled with weight (that and the fact that I love sweets). The placenta takes over at around 12 weeks in pregnancy so PCOS patients get tested for Gestational Diabetes at the end of their first trimester because the placenta releases a hormone that makes the pregnant woman even more insulin resistant.
Testing for Gestational Diabetes involves the patient drinking a sugary drink (Glucola) and then having their blood drawn an hour later. This typically happens at around 27 weeks. Again, for PCOS patients the test is done much earlier in their pregnancy due to their already being insulin resistant. If you fail the initial test, a 3-hour confirmatory test is then completed. It involves a fasting blood draw, then drinking the Glucola drink and then a blood draw 1, 2 and 3 hours after you finish the drink (I know this process intimately because I participated in it just this morning).
I can remember the day of my first pregnancy that I received the dreaded call with my glucose screen results. I hung up the phone and cried. Then I called a girlfriend and she said the most amazing thing, “Jess, I think this is going to be a gift from the Lord.” I had no idea how right she was. I visited with a nutritionist and she put me on an eating plan. If I followed the plan and monitored my blood sugar (by pricking my finger 4 times a day), I could avoid insulin shots.
My plan was simple. Normally, people should have around 20 servings of carbs per day (a serving = 15 grams). For those of us with gestational diabetes (GD) we could have 13 servings. In addition to limiting my servings, it was important that I had them at certain times of the day (to spread things out) as well as cutting out fruit before noon as fruit sugars are harder to process in the morning.
So my eating plan looked like this:
Breakfast – 2 servings of carbs, protein, no fruit
Snack – 1 serving of carbs, protein
Lunch – 4 servings of carbs, protein, veggies (some veggies are carbs)
Snack – 1 serving of carbs (fruit)
Dinner – 4 servings of carbs, protein, veggies, maybe fruit
Snack – 1 serving of carbs
After 6 months on this regimented, yet doable plan I felt better than I had felt in years (even 9 months pregnant). One of the dangers of GD is how it effects the baby’s size so Dr. Rupe kept close watch on our little one throughout those months and she seemed to be growing just fine. Dr. Rupe also assured me that the decrease in calories would not have a negative effect on the baby if I focused on eating the right things and kept taking my prenatal vitamins.
In May 2008 right before I delivered Hope I weighed exactly what I weighed when we conceived her. I had not gained a pound. Hope was born a very healthy 6 pounds, 11 ounces. After the delivery (ok, a few days later when I braved the scale), I weighed 20 pounds less than when I got pregnant. This truly was a gift from the Lord for me.
I am sorry to say that I went back to my old ways shortly after I delivered (what with the stress of being a new mom and all) so I’ve gained most of that weight back. As I await the results of my screening this time, I am filled with mixed emotions. I would love the chance to lose the weight again. Not that I couldn’t have done it on my own in the past 2 years but some of us just need a little incentive for these things. But I also want nothing more than to make sure my baby is safely growing inside of me. I know the Lord is holding this baby together in his hands and I trust him no matter what comes my way. If I have GD (which I most likely will), then I will count it as the grace of God giving me a second chance to get healthier. If I do not have it, then I will thank the Lord for not allowing something that could possibly effect the baby and I will ask him for the grace to be purposeful and disciplined to get healthier.
If you find that you do have GD, I hope that you can look at it as an opportunity to finish your pregnancy well so that both you and your baby will be as healthy as possible after delivery. (Most women will not actually lose weight due to GD. That was most likely due to the fact that I was diagnosed so early on and stayed on the plan for 6 months.)
I would love to hear from you if you have had GD in the past or you have it now. How did you deal with the diagnosis? What worked for you?
(Update: March 19, 2012 I did not have GD with my second pregnancy. I even passed the initial screen! Which supports the fact that every pregnancy is unique.)