‘I’m pregnant in lockdown, and it’s not only alcohol that’s off the menu – cake, chips or pasta could harm my baby’

Gestational diabetes affects approximately 16 per cent of pregnant women. Hannah Fearn is one of them – and the meticulous planning of every single meal is vital for her and her unborn child’s life

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Every day, the ritual is the same. Open the pot with a click, take out a testing strip and put it in the machine. Put a new needle in the lancet and prick my finger. Then I watch as the drop of blood seeps slowly up the strip, until the machine begins to calculate those crucial figures. This is the worst part. It takes only six seconds to register my blood sugar, but those brief moments feel interminable; I breathe slowly through the anxiety. A beep sounds and two figures flash up on the screen. And then there’s the moment of elation – or, on a bad day, hours of despair.

I do this four times a day, every day, just to keep my baby safe, because I’ve been diagnosed with gestational diabetes (GD). The process – as well as the careful planning of every single item of food that passes my lips – will go on until early October, when my second child is due to be born. And then, the moment the placenta is removed – as if it had never happened at all – my body will go back normal.

Gestational diabetes is a form of diabetes that only emerges in pregnancy, and affects approximately 16 per cent of pregnant women. Hormones excreted by the placenta cause insulin resistance. For most women this just means the baby has time to take energy from her food before it is transported to the mother’s cells. But for an unlucky few, insulin resistance is so high that the pancreas cannot produce enough insulin to compensate and blood glucose levels rise too high. These women become diabetic. GD can develop at any stage of pregnancy, although it is most common in the second or third trimester.

The numbers on that little screen dictate the future for me and my unborn baby.

If my blood sugar is under the targets set by my midwife, I can relax. If it’s too high, I need to know why, so I can be sure it doesn’t happen again. Did I eat a little too much wholemeal toast with breakfast? Should I have had just two new potatoes with my dinner, instead of three? If I can’t explain it, it’s time to call the midwife. I may have to start taking medication or even injecting insulin every day. Once I’m on medication my birth plans will have to change. I probably won’t be allowed to deliver any later than 38 weeks.

The thought of that, and of having to give an injection to myself, scares me a lot – but it’s a far better prospect than the potential complications for the baby and me if I don’t find a way to bring my blood sugar down.

When I was first diagnosed with gestational diabetes, late in my first pregnancy in 2017, I was shocked. I had none of the risk factors – such as a high BMI, a family history of diabetes, or suffering from polycystic ovary syndrome – and my midwife had said all my routine blood tests were normal. But I knew something wasn’t quite right.

While my new NCT buddies were blooming, I felt awful. I was exhausted, nauseous and no amount of water could slake my terrible thirst

While my new NCT buddies were blooming in their early third trimesters, I felt awful. I was exhausted, nauseous and no amount of water could slake my terrible thirst. Then I started getting daily migraines, with visual disturbances so bad that I had to stop driving. I had my blood pressure checked but that was normal. I went to the optician and, yes, my eyesight had deteriorated – but glasses made no difference and the blind spots kept coming.

One day, after spending most of the morning unable to work, I left my office and went straight to my hospital’s maternity assessment unit to be checked over yet again. The consultant who saw me sent me away with a blood sugar monitor and asked me to check my levels regularly and come back in 48 hours. Two days later, she took one look at the readings and sent me for a glucose tolerance test to confirm the diagnosis.

It came back positive. At 33 weeks pregnant, I was diabetic.

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By cruel coincidence, the final diagnosis came on my birthday. No celebratory cake for me! That night I made the mistake of googling “gestational diabetes” and frightening myself. If GD is detected early and well managed, the risks can be reduced. If not treated – by changes to diet, an increase in exercise and, if necessary, medication or insulin injections – it can cause major complications, including large babies who suffer injuries at birth, babies born with low blood sugar, which can cause brain damage, and even full-term stillbirth – though this is rare.

My midwife told me not to worry as I was being carefully looked after, but it was all the motivation I needed to get my diet in check.

Luckily, a quick lesson in nutrition and how carbs work was all I needed to get my blood sugar under control – and with only seven weeks left until birth, I had a relatively easy ride. Gone were the long-promised cake-and-tea afternoons of pre-baby maternity leave; in came meticulous meal planning, carbohydrate counting and a new set of digital scales to weigh out my tiny portions of wholewheat pasta, new potatoes and brown rice.

I lived on a diet of cheese, eggs, meat and vegetables; it was like an Atkins bootcamp

All sweet treats were gone, and every carb had to be paired with a high-fat or high-protein food to help slow down the glucose as it entered my bloodstream. I lived on a diet of cheese, eggs, meat and vegetables; it was like an Atkins bootcamp. The thing I missed the most was breakfast cereal, known among diabetic mums as “GD kryptonite”.

I had my daughter in August 2017. She was a dinky 6lb 2oz, but her blood sugars were stable and she was healthy.

I was the one who suffered most after delivery; despite keeping my readings under control, I still developed postpartum pre-eclampsia, a serious condition caused by high blood pressure and linked to GD. But, as promised, the diabetes itself disappeared the day I gave birth.

So, when I fell pregnant again, in January this year, I needed no warning. This time I had two risk factors – gestational diabetes in a previous pregnancy and being over the age of 35 – so I went straight to my GP and asked for a testing kit to keep an eye on things at home. By 15 weeks, my numbers were starting to creep up – even though, yet again, I was passing all the official tests.

With so few midwife appointments, due to the coronavirus outbreak, it’s been hard to get taken seriously. But now, at 21 weeks, I’m finally under the care of the diabetic team. I’m uploading my readings to an app so midwives can keep an eye on them without seeing me face to face, and using the time saved on commuting in lockdown to try out new low-carb recipes to stop the next 18 weeks from getting too tedious in the kitchen. And that’s also given me something to keep my mind off the fact that, being pregnant and diabetic, I’m high risk for Covid-19 complications.

Four months of summer, and stuck indoors, is a long time to go without ice cream. But at least I know that first 99 with a flake after birth will be well worth the wait.

For more advice on gestational diabetes, check out the latest information on the NHS website, and the dietary advice provided by Gestational Diabetes UK