Between all the appointments, blood work, and ultrasounds — to say nothing of the fact that your body feels completely different — in its worst moments, pregnancy can make you feel like a test subject. So it can make sense that some people, given the option of a test, would forgo yet another appointment and lab work. But Cora Bryant, who posts on TikTok as @weylynsmama, is urging all moms-to-be not to skip one very important test.
“Let’s talk about why I think you should never, ever, ever, ever decline the glucose test,” she begins in a recent video.
Content warning: child loss.
Bryant explains that she was planning a home birth with her first child. Her midwife offered the glucose test, which is a routine screening recommended for all pregnant people between 24 and 28 weeks gestation to check for gestational diabetes or GD. GD is a temporary form of diabetes wherein the body can’t make enough insulin to meet the increased need for it, leading to heightened blood sugar.
Mothers with GD are at increased risk of preeclampsia — dangerously high blood pressure in or immediately after pregnancy that can lead to liver and kidney damage, stroke, seizures, and death. Babies of mothers with GD are at increased risk of higher birth weight (notably developing very large at the shoulders, which can lead to them getting stuck during delivery); preterm birth, which can lead to a host of problems including difficulty breathing; hypoglycemia or low blood sugar, which can cause seizures; and stillbirth.
For the most part, GD does not have symptoms most people would notice, which is why screening via urine or blood tests is necessary. Bryant’s midwife did see signs that could point to a GD diagnosis, including sugar in Bryant’s urine and elevated blood sugar on a finger prick test (more on that in a bit), but was not concerned. But Bryant did, in fact, have GD, which went undiagnosed.
“I think we blindly choose to put faith in our providers,” she reflects. Tragically, her son, Weylyn Craig Allen Bryant, was stillborn at 37 weeks in March, weighing 10 pounds 5 ounces.
“I hope this video reaches crunchy mothers, who know I am absolutely not judging them for wanting or planning a home birth, but just that they may still have the best prenatal care they possibly can in order to ensure their safety as well as their baby,” Bryant tells Scary Mommy by email. “GD can truly happen to ANYONE with a placenta. You do not have to look a certain way or have an unhealthy lifestyle. I was a healthy weight, eating healthy, and working out … and still had it.”
So why are moms skipping this test in the first place?
Bryant, a self-described “crunchy mom,” says that, looking back, she didn’t have all the information about the risks.
“I don’t think I properly educated myself or was properly told what could happen besides just a big baby,” Bryant explains.
For similarly crunchy moms — who strive to limit interventions in pregnancy and birth and who may opt for a particularly conscientious diet — the idea of drinking down 50 grams of glucose at best sounds unpleasant and, at worst, might seem unhealthy or dangerous.
Indeed, across social media, you can find accounts proclaiming the toxicity of glucola — the usually orange-flavored, ultra-sweet drink given for the test. Wellness influencers decry the test as unnecessary, with one chiropractor calling it “the most upsetting test” and claiming healthy people have no reason to take it. This is untrue. While there are some who are more at risk for GD — including folks with higher than average body weight, people with a family history of diabetes — to quote Shannon Clark, an OB-GYN specializing in high risk pregnancies who posts across social media as @BabiesOver35, “Anyone, and I mean anyone, with a placenta can get gestational diabetes.” While some influencers rightly point to the presence of the now banned brominated vegetable oil or BVO in some, though not most, glucose drinks, the truth is the negative effects of BVO are cumulative: one drink once in pregnancy has been deemed safe, and is certainly significantly safer than undiagnosed GD.
But it’s not simply influencers encouraging people to forgo this important test. Ina May Gaskin is an iconoclast in the birth community, and her books are popular among those aiming for unmedicated or home births. (My own midwife recommended I read Ina May’s Guide to Childbirth in preparation for my VBAC delivery… “with a grain of salt.”)
In her Guide, Gaskin dismisses GD as “not really a disease” (it is) and that “the anxiety that is often produced by this test simply isn’t worth the information gained from it.” She derides the glucose tolerance test as “not very reliable” as most who fail the one-hour screening test will be found to have normal results after the second, three-hour test.
Like Bryant’s midwife, Gaskin notes she opts for urine dipsticks during prenatal visits to check for the presence of sugar (a telltale sign of GD) and use of a glucometer, which determines blood sugar levels in the blood at any given time, also known as a casual blood glucose test. However, a recent study out of Kobe University in Japan found that casual blood glucose tests miss a staggering 70% of GD diagnoses.
“The best evidence we have says there is no treatment for GD, either with diet or with insulin, that improves the outcome for mothers or their babies,” Gaskin claims, which is simply not true.
There are those who take a more middle of the road approach to the glucose test who also have a hearty presence on social media. They tout alternatives to glucola, from purpose made glucose test mixtures like The Fresh Test to fruit juices, jelly beans, soda, and other foods.
But while these alternatives will raise your blood sugar, they are untested in pregnancy. (While there was a 1999 test on jelly beans as a glucola alternative, recreating the exact metrics of the experiment has proven difficult and subsequent testing has found it to be less accurate than testing with glucola.) Moreover, food-based alternatives often do not have the same type of sugar (glucose, fructose, and sucrose all behave differently in the human body) and may react differently than straight glucose due to the presence of fiber, protein, and other naturally occurring chemicals found in food.
“The glucose test is not worse than anything else you put into your body, I promise you,” Bryant notes in her video. And it’s true: the ingredients found in glucola (dextrose, citric acid, citrus, sodium benzoate, artificial flavoring) are found across a broad variety of foods most of us probably eat every day.
Bryant is now pregnant again. She once again has GD but this time it has been properly diagnosed, and she’s monitoring her blood sugar multiple times a day to ensure a healthy pregnancy moving forward.
“I just think we need to educate mothers on why to take the GD [test] and not bully them into taking it,” she says in her TikTok post, which has more than a million views as of press time. “but I do think we should actually tell them the risk factors if they decline instead of just saying ‘You might have a big baby.’”
This article was originally published on scarymommy.com.