FAQs on Gestational Diabetes – HealthyWomen



As many as 1 in 10 pregnancies will be affected by gestational diabetes. Factors like the age of the mother and rising obesity rates play a role in this increasingly common pregnancy complication.

HealthyWomen spoke to Maureen E. Farrell, M.D., FACOG, an OB-GYN and Navy veteran, about what a gestational diabetes diagnosis means for you and your pregnancy.

What is gestational diabetes?

Gestational diabetes is glucose intolerance that is diagnosed for the first time during pregnancy. It often resolves shortly after delivery.

What causes gestational diabetes?

Diabetes is caused when a person’s body can’t produce enough of the hormone insulin to manage blood sugar levels, and they get too high. Some women and people assigned female at birth (AFAB) develop diabetes during pregnancy because of hormonal changes. The placenta — the organ in the uterus that nourishes the growing fetus — creates hormones that are needed for a healthy pregnancy. Those same hormones can make it harder to produce enough insulin.

Usually, the body will still manage to control glucose and keep blood sugar at healthy levels throughout pregnancy. But for some people, insulin production can’t keep up.

That’s when gestational diabetes mellitus (GDM) develops.

What are the risk factors for developing gestational diabetes?

Many factors contribute to the development of gestational diabetes, including:

  • Having pre-diabetes prior to your pregnancy — pre-diabetes is when your blood sugar levels are higher than normal but not high enough to be considered diabetes
  • Previous pregnancies with gestational diabetes
  • Having close relatives who have any form of diabetes
  • Pregnancies of multiples
  • Age — people above the age of 25 are at greater risk
  • Previous delivery of a baby weighing more than 9 pounds
  • Race — Hispanic, Black, Native American and Asian-American/Pacific Islanders are diagnosed at higher rates than non-Hispanic white people
  • Pre-pregnancy weight — those living with overweight and obesity are more likely to develop GDM
  • Trauma and PTSD

Can people who have normal blood sugar levels before pregnancy develop gestational diabetes?

Yes. Women who have normal blood sugar levels before pregnancy can develop gestational diabetes.

How is gestational diabetes diagnosed?

Gestational diabetes is diagnosed using a fasting glucose tolerance test. This is most commonly given during the second trimester, between 25 and 28 weeks gestation. People with a previous history of GDM or other risk factors may be screened earlier.

What are the risks of gestational diabetes to the mother?

Babies born to mothers with gestational diabetes tend to be larger than average, which increases the likelihood of delivery complications, including the need for a C-section, excessive bleeding after delivery and damage to the birth canal.

Gestational diabetes also increases the risk of pre-eclampsia. Mild forms of pre-eclampsia can be managed with careful blood pressure monitoring and regular checks on the baby. Serious cases can cause liver and kidney damage to the mother.

What are the risks of gestational diabetes to the baby?

Babies born to mothers with poorly controlled gestational diabetes are often large, which is called macrosomia. This can make delivery dangerous for the baby because they can get stuck in the birth canal. The extra sugar they receive also causes the baby to produce too much insulin in the womb. This can lead to dangerously low blood sugar after delivery. And it increases the child’s risk for developing Type 2 diabetes later in life, as well as obesity and metabolic disorder in childhood.

Pre-eclampsia in the mother, which often goes along with gestational diabetes, can only be treated by delivering the baby, so the risk of preterm birth increases with gestational diabetes, as well.

Severe untreated gestational diabetes can lead to miscarriage or stillbirth.

How do you manage gestational diabetes?

Many pregnant people can keep their blood sugar in check with healthy eating habits and regular exercise. If those methods don’t work, you may need to take insulin. Checking your blood sugar throughout the day, including before and after eating, will let you know if your lifestyle and diet changes are working. Your OB-GYN and possibly a nutritionist will work with you to keep your blood sugar at levels that are safe for you and your baby.

How does gestational diabetes affect long-term health outcomes?

For most women, once the pregnancy hormones are out of the picture, your body will go back to regulating its own blood sugar normally — but not always. Anyone who has had gestational diabetes should be screened six weeks after delivering the baby to ensure their blood sugar levels have returned to normal. Mothers who are diagnosed with gestational diabetes are also at increased risk for other cardiovascular complications after pregnancy, including high blood pressure and heart disease.

One out of every 2 women who develop gestational diabetes will go on to develop Type 2 diabetes. But healthy eating and regular exercise can help lower your chances.

This educational resource was created with support from AstraZeneca.

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Managing Uterine Health Conditions at Work



1 in 4 people who menstruate in the U.S. deal with period problems so bad they affect quality of life — including at work.

Many of them are dealing with uterine health conditions, such as:

  • Fibroids, non-cancerous growths in the muscle wall of the uterus, affect about 8 in 10 women at some point in their lives

  • Endometriosis, when tissue similar to your uterine lining grows outside your uterus and gets stuck to other organs, affects more than 1 in 10 women 

In addition to pain, these conditions can cause many other symptoms that can interfere with work. They include:

  • Heavy bleeding

  • Anemia caused by blood loss

  • Nausea 

  • Stomachaches

  • Increased need to pee

  • Diarrhea, constipation and other GI issues

What is a “normal” period, anyway?

Your period is considered heavy if:

  • It lasts 7 days or longer (not including spotting)

  • You lose more than ⅓ cup of blood during your period

  • You have to change your pad or tampon more than once every hour

  • You pass clots the size of a quarter or larger 

You deserve workplace support

All of these symptoms can be embarrassing, especially in a workplace environment. But they’re common if you have a uterine health condition.

While you’re figuring out how best to manage your condition with your healthcare provider, ask for accommodations at work such as:

  • Free menstrual health products (pads, tampons, period panties, etc.)

Other kinds of help are available, too. Talk to your healthcare provider about treatments and options to help you manage your condition. 

This resource was created with support from Sumitomo Pharma, a HealthyWomen Corporate Advisory Council member.



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Facts About Free Bleeding – HealthyWomen



Whoever said you can’t wear white after Labor Day didn’t have periods. For some of us, you can’t wear white — ever. At least not comfortably without feeling like Carrie at the prom.

That time of the month usually calls for a look only Morticia Addams could love: solid black pants to disguise any leaks and long, over-the-butt dark shirts for added protection. And don’t forget the trusted sweater to cinch around your waist if things get too heavy when you’re out just trying to live your life.

We’ve all had clothing maimed in the name of menstruation. But, for some people, flowing through clothes is intentional. It’s called free bleeding — and it’s been around forever. In ancient times, period blood was deemed powerful and magical. (And really, depending on your definition of magic, who’s to say it’s not?)

More recently, the “free bleed” trend has made the rounds on social media and ramped up interest in the pros of going with the flow (sorry, we couldn’t resist!).

If you’re curious, here’s more about the basics behind free bleeding.

What is free bleeding?

Free bleeding is just like it sounds. It’s when you have your period, but you don’t use period products like tampons, menstrual cups or pads to collect, block or absorb the blood. You just let the blood go wherever it goes.

Some people wear regular underwear and clothing during this time. Other people wear period underwear or period-proof clothing. While these products are technically period products, you’re not going out of your way to stop the bleeding, so you’re still considered to be free bleeding by the free bleeding community.

Read: 5 Women’s Health and Beauty Products Made by Women >>

Unrelated, free bleeding isn’t always a choice. Sometimes, it can be the result of period poverty, or the lack of access to period products because of financial burden. Free bleeding when you can’t afford period products isn’t the same as intentional free bleeding for personal reasons. It’s a serious societal problem that has been linked to mental health conditions including depression and anxiety, and it affects the health and well-being of people across the world — especially people of color.

Read: The Complex Crisis of Period Poverty >>

Why are people free bleeding?

There are a few reasons why people voluntarily ditch their period products.

To be natural. Periods are a normal bodily function, and some people feel that using period products disrupts the natural flow of things.

To normalize menstruation. For some people, period products send a message that menstrual cycles are shameful or should be hidden. No products, less shame.

To protest against the “tampon tax.” In some states, menstrual products are priced as luxury goods, which means there’s an added tax for anyone who wants to buy them. Although some states have stopped the tax in recent years, as of today, 20 states still have the “tampon tax.”

To raise awareness for period poverty. Too many people don’t have access to period products and ditching them can be an effort to draw attention to the issue and support people who don’t have access and can’t afford them.

Read: My Struggle with Period Poverty Motivated Me to Help Other Women >>

To help the planet. More than eight million metric tons of plastic waste go into the ocean each year. Most disposable period products are made with plastic (pads are typically 90% plastic and most tampon applicators are made from non-recyclable plastic) and add to environmental waste.

Is free bleeding healthy?

Free bleeding is generally safe. There’s no scientific evidence of health benefits to free bleeding, but it can be beneficial to some people. For example, if you’re not buying period products, you’re going to save some cash (although period-proof clothing also costs money, too). If you’re giving up tampons, you’re also reducing the risk of getting toxic shock syndrome (TSS), a rare but potentially deadly infection from bacteria that can come from leaving tampons in for too long.

Is free bleeding sanitary?

As you might imagine, free bleeding can be messy. And if you’re out in the world free flowing, period blood can leak onto surfaces. And period blood, like all other blood, has the ability to carry blood-borne viruses. These can include:

Read: What You Need to Know About Viral Hepatitis A, B and C >>

Blood-borne viruses are transmitted when the blood or fluids enter the body of another person. So, while it may not be technically impossible, it is extremely rare for someone to get infected via period blood on a chair.

But if you’re free bleeding, it’s worth thinking about the people who may come in contact with your blood.

Which leads us to free bleeding in the real world. It’s your choice to go where you want, when you want, but it may be a good idea to pack extra clothes or period underwear to minimize the chances of leaving blood behind.

Free bleeding may not be for everyone, but we can all respect doing what each of us feels is right for our own bodies.

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