Gestational Diabetes Explained

Gestational Diabetes Explained: What It Means for Your Birth

Hearing the words, "You have gestational diabetes," can feel like someone just dumped a bucket of ice water on your carefully imagined birth plan.

Your mind might immediately jump to:

Did I do something wrong?

• Will my baby be okay?

• Does this mean I'm definitely getting induced?

• Can I still eat ice cream? (Asking for... a friend.)

First, take a deep breath.

Gestational diabetes (GDM) is one of the most common pregnancy complications, and the vast majority of people with gestational diabetes go on to have healthy pregnancies and healthy babies.

A diagnosis doesn't mean your birth suddenly has to follow one specific path. It simply gives you and your care team more information so you can make thoughtful decisions together.

And as we talk through testing, treatment, and birth options, this is a perfect time to pull out your B.R.A.I.N. tool:

• Benefits

• Risks

• Alternatives

• What does your Intuition tell you?

• What happens if we do Nothing (or wait)?

Those five questions can help you navigate almost every decision you'll encounter.

What Is Gestational Diabetes?

Gestational diabetes is high blood sugar that develops during pregnancy in someone who didn't have diabetes beforehand.

During pregnancy, your placenta is incredibly busy producing hormones that help your baby grow.

Unfortunately, those same hormones can make your body a little... stubborn.

They interfere with insulin, making it harder for your body to move sugar out of your bloodstream and into your cells.

Normally, your pancreas simply works overtime and makes more insulin.

Sometimes it can't quite keep up.

When that happens, blood sugar levels rise and gestational diabetes develops.

Here's the part I wish every pregnant person heard:

This is largely caused by placental hormones—not because you ate too many cookies.

Could nutrition play a role? Yes.

But plenty of people who eat balanced diets, exercise regularly, and live very healthy lifestyles still develop gestational diabetes.

Your placenta doesn't always ask permission.

Who Is More Likely to Develop Gestational Diabetes?

Certain things increase the chances:

• Previous gestational diabetes

• PCOS

• Family history of Type 2 diabetes

• Previous larger baby

• Carrying twins or higher-order multiples

• Being over age 35

• Certain ethnic backgrounds

• Higher BMI before pregnancy

But plenty of people have none of these risk factors.

Pregnancy loves to keep us humble sometimes.

How Is Gestational Diabetes Tested?

Most providers screen between 24 and 28 weeks.

There isn't just one way to do it, and it's worth asking what options your clinic offers.

Option 1: The Traditional Glucose Drink

This is the bright orange (or lemon-lime... or fruit punch...) drink you've probably heard about.

You'll drink a measured amount of glucose and have your blood drawn afterward to see how your body processes the sugar.

Depending on your provider, this may be:

The Two-Step Test

The most common approach in the United States.

First:

• Drink 50 grams of glucose

• No fasting

• Blood draw after one hour

If that screening is elevated, you'll return for a fasting three-hour diagnostic test.

The One-Step Test

Some practices instead perform one fasting 75-gram glucose tolerance test with blood draws over two hours.

Neither approach is "better" for everyone—different organizations recommend different strategies.

If you're curious why your provider uses one method instead of another...

Ask!

(B.R.A.I.N. works beautifully here.)

Option 2: The Fresh Test®

You've probably seen this all over social media.

The Fresh Test® is an alternative glucose drink made with:

• Dextrose

• Natural flavors

• Fewer ingredients

• No artificial dyes or preservatives

Many parents simply find it tastes better and sits better on their stomach.

One important clarification:

It isn't designed to "beat" the test.

It contains the same carefully measured amount of glucose needed for accurate screening.

Not every office accepts it, so call ahead before showing up proudly carrying your own packet.

Option 3: Food-Based Alternatives

Some providers may offer food-based alternatives such as:

• Jelly beans

• Other carefully measured glucose-containing foods

These options sound appealing, but they're not standardized.

Foods digest differently because they contain varying amounts of fat, protein, and fiber, making the results harder to compare consistently.

If you're interested in avoiding the traditional drink, ask your provider:

• Is this an option in your practice?

• How accurate is it?

• What are the pros and cons?

That's another perfect opportunity to use your B.R.A.I.N. questions.

Can I Skip the Test?

Some practices allow home blood sugar monitoring for one to two weeks instead of the glucose drink.

Others don't.

Neither approach is right for everyone.

If you're considering declining the screening test, don't feel like your only choices are "yes" or "no."

Instead, have a conversation.

Ask:

• What information are we trying to learn?

• What are my alternatives?

• What happens if I choose a different approach?

That's informed decision-making.

What Happens If You Test Positive?

First...

Don't panic.

And maybe don't spend the next four hours doom-scrolling Facebook groups.

Many people diagnosed with gestational diabetes never need medication.

Treatment often starts with:

• Small nutrition adjustments

• Pairing carbohydrates with protein

• Gentle movement after meals

• Monitoring blood sugar at home

If medication or insulin becomes part of the plan, that isn't a failure.

It's simply another tool.

Just like wearing glasses doesn't mean your eyes failed.

Does Gestational Diabetes Mean I'll Be Induced?

This is probably the question I hear most often.

The honest answer?

Maybe—but not necessarily.

The decision depends on several factors, including:

• Your blood sugar control

• Whether medication is needed

• Baby's growth

• Your overall health

• Your provider's recommendations

If blood sugars stay well controlled with nutrition alone, many people may have the option to wait for spontaneous labor, depending on their provider and their individual pregnancy.

If medication is needed, many providers recommend delivery around 39 weeks.

Rather than focusing on what "always happens," ask your provider:

• Why are you recommending this timing?

• What benefits are you hoping to achieve?

• What are the risks of waiting?

• Are there other reasonable options?

Yep...

That's B.R.A.I.N. again.

How Can Gestational Diabetes Affect Baby?

When blood sugar stays elevated over time, babies receive extra glucose too.

That can increase the chance of:

• A larger baby

• Shoulder dystocia

• Low blood sugar after birth

• Additional newborn monitoring

The encouraging news?

Good blood sugar management dramatically lowers many of these risks.

This is exactly why screening and treatment matter—not because something is "wrong," but because we have an opportunity to improve outcomes.

Will I Need Extra Monitoring?

Possibly.

Your provider may recommend:

• Growth ultrasounds

• Non-stress tests (NSTs)

• Biophysical profiles (BPPs)

• More prenatal visits

If additional testing is recommended, don't hesitate to ask:

"What information will this give us?"

Understanding the purpose behind a recommendation often makes decisions feel much less overwhelming.

What About Labor?

Having gestational diabetes doesn't automatically change everything about your birth.

You may still be able to:

• Walk during labor

• Change positions

• Use hydrotherapy

• Labor without medication if that's your plan

• Receive an epidural if you want one

• Have a vaginal birth

Your blood sugar will likely be checked periodically during labor to help keep both you and baby doing well.

Again, recommendations vary between hospitals, so ask your team what their usual practice is.

What Happens After Birth?

Here's one piece of good news:

Once the placenta is delivered, those pregnancy hormones disappear.

For most people, blood sugar returns to normal fairly quickly.

Your provider will usually recommend:

• A glucose test about 4–12 weeks after birth

• Ongoing diabetes screening every few years

Think of it as one last follow-up chapter—not a lifetime sentence.

Can You Prevent Gestational Diabetes?

Sometimes.

Sometimes not.

Healthy habits can absolutely support a healthy pregnancy, but they can't override placental hormones.

So if you develop gestational diabetes, please don't carry unnecessary guilt.

Your body isn't broken.

Your placenta just came with a little extra personality.

The Bottom Line

Gestational diabetes can change parts of your prenatal care, but it doesn't take away your ability to ask questions, make informed decisions, and have a positive birth experience.

Remember, recommendations are exactly that—recommendations. They're based on evidence, your individual circumstances, and your provider's clinical judgment. The best decisions are made when you understand why something is being recommended and how it aligns with your goals and values.

Whenever a new decision comes up, come back to B.R.A.I.N.:

• Benefits

• Risks

• Alternatives

• What does your Intuition tell you?

• What happens if we do Nothing (or wait)?

Those questions won't always lead everyone to the same answer—and that's okay. They'll help you have meaningful conversations with your provider and choose the path that's best for you and your baby.

Because birth isn't about following one perfect script. It's about making confident, informed decisions, one step at a time.

Explore More Pregnancy Resources

Every pregnancy brings new questions, and you don't have to figure it all out alone. These guides will help you understand your options, prepare for birth, and feel more confident as you move toward meeting your baby.

📅 What Happens at Every Prenatal Appointment?

Wondering what each prenatal visit is for? Learn what to expect from your first appointment through your final weeks of pregnancy, including common tests, screenings, and questions your provider may ask.

→ Read: What Happens at Every Prenatal Appointment?

🩺 Understanding Induction of Labor

If your provider mentions an induction, what does that actually mean? Learn the most common reasons for induction, the methods that may be used, and how to use your B.R.A.I.N. framework to make informed decisions.

→ Read: Understanding Induction of Labor

📝 Creating Birth Plans That Actually Work

A birth preferences guide isn't about creating the "perfect" birth—it's about communicating what matters most to you. Learn how to write flexible, practical birth preferences that support informed decision-making.

→ Read: How to Create a Birth Plan That Actually Work

🎒 The Ultimate Hospital Bag Checklist

Not sure what you'll actually use during labor? This complete packing guide covers what to bring for yourself, your partner, and your baby—plus grab a free printable packing list.

→ Read: The Ultimate Hospital Bag Checklist

👶 When Should You Take a Childbirth Class?

Timing matters! Find out when most families get the most benefit from childbirth education and what you'll learn before your big day.

→ Read: When Should You Take a Childbirth Class?

🧠 Learn to Use the B.R.A.I.N. Decision-Making Tool

Whether you're discussing glucose testing, induction, or any other recommendation during pregnancy, the B.R.A.I.N. framework can help you ask thoughtful questions and make decisions that align with your goals and values.

→ Read: B.R.A.I.N.: Five Questions for Better Birth Decisions

💙 New Here?

Browse the Birth Resource Library for evidence-based pregnancy, labor, birth, and postpartum articles designed to help you feel informed, confident, and prepared—one resource at a time.

→ Explore the Birth Resource Library

Additional Trusted Resources

Want to dive a little deeper? These evidence-based resources provide balanced, research-backed information about gestational diabetes, pregnancy nutrition, and current clinical recommendations.

📚 Evidence Based Birth®

Evidence Based Birth® offers in-depth reviews of the latest research to help families understand their options and make informed decisions.

Gestational Diabetes and Pregnancy

https://evidencebasedbirth.com/gestational-diabetes-and-pregnancy/

🩺 American College of Obstetricians and Gynecologists (ACOG)

ACOG develops clinical guidelines used by obstetricians across the United States. Their patient education resources explain gestational diabetes, screening, treatment, and what to expect during pregnancy in easy-to-understand language.

Gestational Diabetes
https://www.acog.org/womens-health/faqs/gestational-diabetes

🍎 Academy of Nutrition and Dietetics

Looking for practical nutrition guidance? The Academy of Nutrition and Dietetics provides science-based information on healthy eating during pregnancy, including tips for managing gestational diabetes.

Gestational Diabetes Nutrition
https://www.eatright.org/health/pregnancy/what-to-eat-during-pregnancy