Lowcarb or carb loading childbirth, gestational diabetes edition
July 9, 2013 12:20 PM
Managing gestational diabetes fairly well by eating paleo/low carb and injecting insulin (tiny dose, rarely) when anticipating higher glucose levels. Now I read pregnant women should load carbs shortly before and during the childbirth itself. I'd like to avoid both a carb crash and hypoglycemia during delivery. I also worry about the baby being hypoglycemic if I have high glucose levels during delivery and I'm getting conflicting info (yes, danger v. no, too short a time to impact baby). So, what to eat leading up to and during delivery?
What does your doctor/midwife say? Anecdotally, I had gestational diabetes (controlled by diet) and couldn't eat for 30 hours before my son's delivery (long, slow labor, and I wasn't allowed to eat once I was admitted to the hospital), though they did give me a couple of small cups of apple juice to sip slowly during that period. It wasn't fun, but I had enough energy for a couple of hours of pushing and had a successful vaginal delivery. My son's blood sugar levels were fine following delivery. I think you'll be fine without the carb loading (and as you said, it could impact the baby, so why risk it?), but your health care provider may give you some limited carbs if labor is prolonged.
posted by hovizette at 12:50 PM on July 9, 2013
posted by hovizette at 12:50 PM on July 9, 2013
hovizette: doctors give the conflicting advice (the system here is such that I meet different doctors almost each time), the midwife (under whose care I am consistently) doesn't have experience with GD.
Just to clarify my intentions: I'm not going to do carb loading, but even relatively "normal" (for healthy people) carb levels increase my blood glucose beyond the good range, so I wonder how to get a good balance and avoid running low on energy due to either carb crash or not enough glucose - and minimize impact on the little one.
posted by meijusa at 1:22 PM on July 9, 2013
Just to clarify my intentions: I'm not going to do carb loading, but even relatively "normal" (for healthy people) carb levels increase my blood glucose beyond the good range, so I wonder how to get a good balance and avoid running low on energy due to either carb crash or not enough glucose - and minimize impact on the little one.
posted by meijusa at 1:22 PM on July 9, 2013
I had GD as well. I think that carb loading is a theory, whereas managing GD is known to be important. Don't carb load if it's going to mess with you.
I admitted to L&D at 11am and due to other factors (pre-ecclampsia and the possibility I might need a c-section) wasn't allowed to eat much more than sugar free slushies and popsicles until delivery, which was at 12:15 the next day. Had that not happened I would have been on the same GD diet as usual. My son's glucose levels were fine. So, in my opinion, managing your GD during labor is the most important thing, diet-wise.
posted by DrGirlfriend at 1:23 PM on July 9, 2013
I admitted to L&D at 11am and due to other factors (pre-ecclampsia and the possibility I might need a c-section) wasn't allowed to eat much more than sugar free slushies and popsicles until delivery, which was at 12:15 the next day. Had that not happened I would have been on the same GD diet as usual. My son's glucose levels were fine. So, in my opinion, managing your GD during labor is the most important thing, diet-wise.
posted by DrGirlfriend at 1:23 PM on July 9, 2013
The carb loading thing is just so you have energy for labor, and carbs can be relatively easily digestible and palatable. But the important thing is to eat something that won't make you puke - doesn't have to be carbs! Just pick out some low glycemic index foods that you think would sit well on your stomach - nuts? Watermelon? Chicken breast? Maybe some whole grain toast with butter? Stuff like that.
posted by yarly at 4:53 PM on July 9, 2013
posted by yarly at 4:53 PM on July 9, 2013
My experience during childbirth as a mother with gestational diabetes: I ate as much as I could of the grilled cheese sandwich I was given, which ended up being only a few bites. From experience, I knew that much would not bring my glucose too high. I had eaten normally before that. I got through everything just fine (no hypoglycemic crash). I did feel pretty bombed afterward, but it was hours of drug-free labor and I lost a lot of blood.
You might want to have some easily digested toast on hand for nibbling. Unless you're super sensitive, it won't be enough to spike you too high, and it will help to keep your energy up.
posted by moira at 5:10 PM on July 9, 2013
You might want to have some easily digested toast on hand for nibbling. Unless you're super sensitive, it won't be enough to spike you too high, and it will help to keep your energy up.
posted by moira at 5:10 PM on July 9, 2013
Also, if you're looking to eat something that gives you longer-lasting energy, you might try foods higher in fiber (assuming you can stomach them).
posted by moira at 5:16 PM on July 9, 2013
posted by moira at 5:16 PM on July 9, 2013
I've just come off having GD, my daughter is six days old. I had a c section so this information isn't directly relevant to you but I was told by my endocrinologist to take my insulin the night before, fast from midnight and not eat or take insulin before the morning surgery. They would monitor my levels during the operation.
If I went into labour spontaneously, I was told they would monitor my levels throughout (before they took me into a c section anyway, my OB GYN was pretty insistent I have one regardless). Either way, the advice all the way through was low GI, definitely no carb loading unless I had a sugar crash.
Your endocrinologist and OB GYN should be working together. I would insist that they consult each other and come up with a plan of attack. Either way, I wouldn't take advice off the Internet, this is a pretty big deal. What will more than likely happen though, is that they will monitor your blood sugar throughout labour and feed you or not accordingly. You won't be left to make this call yourself.
My daughter had low blood sugar for the first day and a half after birth. Because my milk wasn't in yet, she was given formula to bring it up and it settled really quickly. The hospital staff are all over this (at least in Australia!) and monitoring both of us during and after birth was a major priority.
Get your doctors to talk to each other and agree on a game plan. Failing that, I wouldn't veer from your current low GI diet unless explicitly instructed. Best of luck, I'm sure everything will be fine.
posted by Jubey at 6:05 PM on July 9, 2013
If I went into labour spontaneously, I was told they would monitor my levels throughout (before they took me into a c section anyway, my OB GYN was pretty insistent I have one regardless). Either way, the advice all the way through was low GI, definitely no carb loading unless I had a sugar crash.
Your endocrinologist and OB GYN should be working together. I would insist that they consult each other and come up with a plan of attack. Either way, I wouldn't take advice off the Internet, this is a pretty big deal. What will more than likely happen though, is that they will monitor your blood sugar throughout labour and feed you or not accordingly. You won't be left to make this call yourself.
My daughter had low blood sugar for the first day and a half after birth. Because my milk wasn't in yet, she was given formula to bring it up and it settled really quickly. The hospital staff are all over this (at least in Australia!) and monitoring both of us during and after birth was a major priority.
Get your doctors to talk to each other and agree on a game plan. Failing that, I wouldn't veer from your current low GI diet unless explicitly instructed. Best of luck, I'm sure everything will be fine.
posted by Jubey at 6:05 PM on July 9, 2013
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posted by chickenmagazine at 12:34 PM on July 9, 2013