Well Rounded Birth Prep

Well Rounded Birth Prep

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Tuesday, January 4, 2011

Gestational Diabetes Myth-conceptions via Pregnancy App for phone

Expectant momma Julie Ann Samples shared on Facebook today, "One of my pregnancy apps on my phone updated me to 24 weeks today and informed me that if I am found to have gestational diabetes, then my baby will have to be born by cesarean section, ugh!!! I'm glad it was a free app!" Thankfully, Julie knew that this advice was wrong.

She said that the app is an Android app called Pregnancy Assistant. When she went to their website to leave a review, she saw that her fellow pregnant mommas gave it 4 1/2 stars! Augh! Most of the moms using the app are likely not reading all the Cochrane Reviews or Medscape journals or even ACOG's own recommendations and have NO IDEA what advice is evidence-based and what is thoroughly fabricated, such as advising a 24 week pregnant mother that if she is diagnosed with gestational diabetes, that a cesarean birth would be necessary.

The fact of the matter is that gestational diabetes alone is not a medical indicator for cesarean section. Cesarean birth has serious risks both to mother and baby. If gestational diabetes is poorly controlled or not managed at all, baby can possibly grow too large and need a cesarean. If gestational diabetes is well managed (by diet, exercise, and/or medicine under advisement of OB), mom and baby have the best chance for a vaginal delivery. Isn't it far better to empower mothers to know what their options are to safely control and manage their gestational diabetes from the earliest point possible and decrease their risks of needing a C-section?

It's easy to say, "Don't look a gift horse in the mouth," or "You get what you pay for," but I don't think this applies to a free pregnancy phone app. This is a damaging lie, one with far-reaching consequences. It would really be better to have NO ADVICE AT ALL than to have advice that's contrary to the evidence when it comes to your health and safety. This app needs to get their act together and give factual information or get out of the business of advising pregnant women altogether.

If any of you have tried out pregnancy apps for iPhone or Android, I'd be interested in hearing a product review in the comments here. Which are neutral ("Your baby is now 24 weeks along and has such-and-such abilities and characteristics"), which are helpful, and which dispense flat-out lies?

Childbirth Connection full chapter on Gestational Diabetes from A Guide to Effective Care in Pregnancy and Childbirth (pdf printable)

Edited to add: I just sent the following email to Pregnancy Assistant app's customer service address, along with the link to this blog:

"To whom it may concern,

"I am a childbirth educator. One of my clients informed me that she was using your Pregnancy Assistant app and received dangerously incorrect information in the 24 week gestation pregnancy notification. You have the duty and legal responsibility to include evidence-based information. I have blogged about this incorrect information with the hopes that pregnant women can learn the truth and avoid unnecessary major surgery.

"Sarah DeGroff
Well Rounded Birth Prep"

If you would like to send them a (professional, courteous, non-flaming) email, you may do so at info@apps.dzieciowo.pl


  1. Never mind that the very existence of "gestational diabetes" is controversial.... :-)

    "Gestational Diabetes: A Diagnosis Still Looking for a Disease?" (Dr. Michel Odent)

    "Gestational Diabetes: The Emperor Has No Clothes" (Henci Goer)

    "Gestational Diabetes: Myth or Metabolism?" (Joy Jones, RN)--on webpage

  2. Thanks for adding the links, JJ. I've read that before. It does bring up a lot of questions. Personally, I'm not convinced that gestational diabetes is myth. I think it is possible that uncontrolled gestational diabetes can make baby too large to be birthed vaginally. (Additional evidence of blood sugar issues come when baby has health problems as a result of mother's gestational diabetes.) I think the real questions are 1. prevention, 2. management after diagnosis (diet, exercise, and/or medication), and 3. improving outcomes. From what I've read, some traditional, conventional treatments/interventions are not improving maternal or infant morbidity/mortality outcomes. If outcomes aren't improved, then it becomes difficult to justify an intervention.

    I read this recently about a possible link between gestational diabetes and diet in the first trimester (specifically, protein intake).

    An ounce of prevention is worth a pound of cure. More and more complications are being linked to poor diet during pregnancy.

  3. Regarding the links posted in the first comment and Sarah's response, the issue with "gestational diabetes" is that it's "diagnosed" via screenings and tests that do not meet the criteria for a medically valid diagnosis, and its "treatment" is not proven to improve outcomes for mothers or babies, yet the GD "diagnosis" is more likely to result in labor induction and/or c-section birth which pose many risks to mom and baby. Now, obviously some women have issues with insulin and sugar metabolism during pregnancy, and that can lead to macrosomia and associated birth issues. But I believe that what we're really seeing is 1) women who were pre-diabetic prior to pregnancy and 2) the effects of poor diet in pregnancy due to a complete lack of nutrition knowledge in our culture. How many care providers spend more than 2 minutes talking about what to eat during pregnancy? Oh sure, they'll hand you the "do not eat" list (soft cheeses, deli meat, certain fish), but do they really talk to women about what a balanced diet entails? Do they provide sample meal plans, discuss barriers to healthy eating, and have an in-office nutritionist to provide consults? That's the kind of holistic care that we need, not a blanket requirement for a screening test at 28 weeks which has a false-positive rate of at least 20% and will result in a non-repeatable result HALF the time.

  4. Well stated, Rebecca M. Thanks for your input.

    Around here, women are not receiving counseling regarding nutrition & exercise (even fewer than in most areas of the country, probably). WV has one of the highest (if not the highest) obesity rates in the US. The usual plan for GD is early induction or scheduled C-section. There is no holistic care (unless the mother seeks it out on her own and sees a midwife, nutritionist, or other specialist--but who are we kidding, what percent of women do that?) and no prevention.

    Then, to make matters worse, many diabetic mothers are told by drs, nurses, and/or lactation consultants to formula feed and/or give glucose water to the baby instead of (or to supplement) breastfeeding. *sigh*


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