Pregnancy, the true stress test

Pregnancy can be a true stress test for any woman.

If all goes well, of course, it should be a beautiful 10 months of preparing to meet your healthy baby. Some women, however, will inevitably face challenges such as high blood pressure and gestational diabetes during this time.

Pregnancy is a perfect opportunity to learn how to be as healthy as possible, and how to better understand your body’s responses to this life-changing challenge.

If any of our patients at the Spectrum Health Medical Group are affected by high blood pressure or gestational diabetes, it is our goal to make sure mom and baby stay safe and healthy throughout the pregnancy, during the delivery, and after the birth.

We want to see a healthy mom and baby leave the hospital to start the wonderful days of bonding and growing. We also want to help mom age in good health, so she’s ready for all life has to offer and she can avoid chronic medical conditions.

Growing concern

When a patient I’ll call Laura came to see me for her 32-week checkup, she was all smiles when I walked into the exam room. Her baby had given her a big kick just before getting the hiccups.

It was Laura’s first pregnancy. She certainly felt overjoyed, but also slightly uncomfortable because of the swelling, back aches and fatigue she had been experiencing.

Her blood sugar level began to concern her, too. She checked it twice a day, worried she’d have to start diabetes medication if she couldn’t keep her blood sugars down with diet alone.

A growth ultrasound earlier that week indicated her baby had been growing very rapidly. This bit of news only exacerbated her concerns about the delivery.

To make matters worse, Laura’s family history had its own set of problems. Her mom had diabetes during her pregnancy with Laura, and she had to have a C-section because Laura was too large for a vaginal delivery.

Understandably, Laura grew more concerned about the remainder of her pregnancy.

Weight gain became yet another source of stress.

Like her mom, Laura battled weight gain nearly her entire life. She felt she could never maintain a healthy weight, even though it seemed she dieted constantly.

In high school she played soccer and stood out as an athlete, but that would prove to be the only period when she didn’t have to worry about her weight. Her troubles began in college, when stress and late nights of studying took a toll. She gained 40 pounds in those four years.

After college she would try hard during the week to stick to a strict diet, but she always binged on the weekends and would gain it all back.

It became a vicious cycle that went on for years.

Laura became discouraged, but she finally found peace with her weight and she did her best to stop beating herself up about the situation.

She knew her cholesterol was slightly high, but she never thought about her blood sugar until she became pregnant.

At 28 weeks pregnant, a one-hour glucose test put her level at 160. This meant her body could not respond to the 50-gram sugar load and her blood sugar would still be too high an hour later.

Laura then had to do the three-hour test, which showed all abnormal values.

She needed to go on a strict diet of only low-sugar foods and fewer carbohydrates. Unfortunately, despite following this diet consistently, her levels began to rise.

She knew she might have to take medication to keep her levels in check.

Sugar-busting

Laura’s situation is not unique. In fact, it’s something many women experience during pregnancy.

If you have gestational diabetes, your baby is constantly exposed to high blood sugar, which usually leads to disproportionate weight gain in the belly and liver.

If your baby grows too big in the waist, there’s a possibility you cannot have a vaginal delivery, which would necessitate a C-section. In addition, your baby’s insulin level will be high at birth, resulting in low blood sugar right after birth. This sometimes results in a short stay in the neonatal nursery, for intravenous sugar to be slowly weaned off.

And it’s not just a short-term problem, either.

There’s a lifelong concern for a baby who is developing in a high-sugar environment. It changes the behavior of genes, insomuch as the baby is more likely to struggle with weight issues and develop an increased risk for diabetes.

This had been Laura’s story—and she did not want to thrust the same thing onto her unborn child. She also wanted to learn as much as possible to avoid having these same issues with her next pregnancy.

At Spectrum Health’s Maternal-Fetal Medicine office, high-risk pregnancy specialists who managed Laura’s blood sugar levels ultimately recommended she start taking diabetes medication to keep things under control.

She had some reservations about taking the medication, but we talked about the increased risk of problems she and her baby would face if she didn’t take them.

Perhaps the best chance for Laura to avoid a C-section, medication would help ensure a healthy vaginal delivery. It would also help avoid blood sugar issues after the birth.

Although the medicine would help keep Laura’s blood sugars even, she knew she would have to continue checking her levels every day—and she’d have to keep up good eating habits.

I also encouraged her to learn everything she could about the glycemic index, which classifies food based on its sugar content, and we talked about the benefits of breastfeeding, which could help her newborn stay healthy and help her lose weight.

Finally, I recommended Laura read one of my favorite books: “Sugarbusters.”

This informative book about sugars in food would give her the knowledge she needed to help her not only in this challenging time, but in the many years to come. Laura was excited to get the book and share her new knowledge with her mom.

Worthwhile cause

Before we talked, Laura never realized how important her family history had been to her overall health, and she also didn’t know diabetes could be passed down so easily.

Laura educated herself. She began to see that a deeper knowledge of her own family history could help her learn more about her body chemistry, and help her treat possible “pre-conditions.”

If she had known in her 20s that her blood sugars were already borderline high, for example, doctors could have pointed her to a six-month stint of a medicine called Metformin, which would reduce her sugar cravings and insulin resistance.

She also might have been more motivated to eat a Mediterranean diet and exercise more regularly. She wouldn’t have become discouraged, either, because her efforts would have worked.

Pregnancy became a stress test for Laura, but in the end she felt better learning about the many things she can do to improve her own health and her baby’s health—both during and after the pregnancy.

Before Laura left my office, we listened to her baby’s heartbeat.

She knew her efforts would be more than worthwhile.