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Welcome to the Great Birth Rebellion

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podcast. I'm your host Dr. Melanie

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Jackson. I'm a clinical and research

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midwife with my PhD and each

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episode I cast a critical eye

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over current maternity care practice by

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grappling with research and historical knowledge

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to help you get the best

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out of your pregnancy, birth and

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postpartum journey. To

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get access to all the research

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that I use to create every

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single podcast episode, you can join

0:28

the mailing list at melonythemidwife.com. Welcome

0:30

to today's episode of

0:33

the Great Birth Rebellion podcast. This

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is episode 100 and nearly two years

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of the Great Birth Rebellion podcast. We've

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surpassed 850,000 downloads and in the next few months

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we'll reach 1 million.

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This is an independent

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podcast. We don't have professional

0:53

representation or management so

0:55

we wouldn't have made it to episode 100 without you, the

0:59

people who listen to this podcast. This

1:01

is truly Grant's route to activity and

1:03

completely reliant upon our listeners. So thank

1:05

you to all the loyal listeners who

1:07

have been here from the beginning. There

1:10

is a unique cohort of people who

1:12

have listened to every single episode of

1:14

the Great Birth Rebellion and he stuck

1:16

with the podcast through the significant changes

1:18

that occurred from episode 75 onwards. I'd

1:22

love to take this opportunity to also

1:24

acknowledge Bea from Corin Flora's store, my

1:26

co-host for the first 75 episodes and

1:29

her contribution to the early success of

1:31

the Great Birth Rebellion. If

1:34

you love this podcast and want to see it

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keep going to 200 episodes and

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beyond, there are two ways you can

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help. They'll cost you nothing. Firstly,

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subscribe to the podcast on whichever

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from and leave us

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a five-star rating and if you

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really love it consider leaving a

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review. Everyone loves some positive feedback to

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keep them going and your review helps

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other people to start listening. and

2:00

learning to the podcast too. That said,

2:03

let's get started with today's episode.

2:07

Today is our third and final

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contribution to the topic of gestational

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diabetes. In episode 98, we

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covered gestational diabetes screening. In

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99, we were privileged to have Lily

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Nichols cover real food for gestational diabetes.

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And today, we're talking about the use

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of movement for the maintenance of blood

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sugar levels during pregnancy. It's

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for anyone, but with special consideration

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to women who are putting extra

2:32

efforts to managing their blood sugar

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in pregnancy. There are two types

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of research on the topic of

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using movement and exercise to control

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blood sugar levels for women who

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have gestational diabetes. There

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is research that covers if and

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how exercise or movement can lower

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blood sugar levels. And

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then there's research about the outcomes

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of using exercise to control blood

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sugar levels. And this

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looks at the long-term impact of

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having used movement and exercise in

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your pregnancy. These may

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look the same thing, but they're not.

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So today, I'm talking about if and

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how movement and exercise has

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the ability to help women control their blood

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sugar levels in pregnancy and give

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some really practical tips on how you can

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apply what you've learned today to controlling

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your own blood sugar levels, if that's what you're

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trying to do through your pregnancy. What

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I won't be talking about today is

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the pregnancy outcomes associated with this. So

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what I mean is there's

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a lot of research that, for

3:34

example, asks pregnant women to apply

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an exercise regime to their self-care

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practices. And then they do

3:40

research to see if it changed certain

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outcomes for their pregnancy. Did it affect

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the birth weight of the babies? Does

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it change the number of women who

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need caesarean sections? Does it impact upon

3:52

induction rates or the speed of labor

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progress? That's what I mean by

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outcomes. So today, I'll be looking at

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how to use movement. exercise to

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help manage your blood sugar levels

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in pregnancy but I'm not commenting

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on the research about how this

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kind of movement will or won't

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impact on overall outcomes of pregnancy

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and birth. If

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you have gestational diabetes and can

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effectively manage your blood sugar levels

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to keep them within normal limits

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using diet and movement then

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your body is completely unaware that

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you've been diagnosed with gestational diabetes

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which means you've effectively mitigated the

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risks of gestational diabetes and you

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or your baby won't have the

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side effects that can occur from

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unmanaged or poorly controlled gestational diabetes.

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If you can see that your blood sugar

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has been controlled you can confidently

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avoid all the interventions that women are

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offered at birth if they have gestational

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diabetes if that's what you want. So

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in the last episode Lily spoke to us

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about how to control your blood sugar using

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food and today I'll be

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sharing how to control your blood sugar

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using movement. So straight

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up I want to say that the

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research on the topic of exercise and

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movement for gestational diabetes management is

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varied and uncertain. This was a really

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tricky one to know what to say

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here because we know that movement has

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benefits for the human body there's no

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doubt about that but what there

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is doubt about is how

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much movement is required to impact

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on blood sugar levels of women

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with gestational diabetes. What

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we do know is that exercise and movement

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have the ability to make your

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body soak up excess blood sugar that's

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flowing around your body and

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suck it into the working muscles

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of your body independent of insulin. So

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Lily told us in the last episode

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that gestational diabetes is the result of

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a state of pregnancy induced insulin

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resistance and when your body is

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resistant to the action of insulin

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that means that your body has trouble soaking

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up and using the sugar that's in your

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body. from the food that you've eaten.

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So then the more and more sugar that

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builds up in your bloodstream with nowhere to

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go, then it creates

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a circumstance where when you measure your

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blood sugar levels, it's high. So

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normally insulin would unlock your body

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cells in your muscles and in

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your tissues and help

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move the sugar from your bloodstream

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into your body cells and then your body cells

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use it for energy. But

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instead the sugar gets stuck in your

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bloodstream. And what we

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know from exercise science is

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that circumstances where the activity of

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insulin is inhibited, such as in

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insulin resistance and gestational diabetes, that

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exercise and movement and the use

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of your muscles makes your body

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cells open up. They open themselves

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up. I mean, there's a more

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complex mechanism than that, but they

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open themselves up and they take

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sugar into the body cell independent

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of insulin. So

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by exercising, you can force your body to

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do the work of insulin, even

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though you have insulin resistance.

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And this theoretically reduces blood

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sugar levels. Now

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there are scientific explanations for exactly

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how this happens. And if that's

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what you need to know, the

7:20

exact mechanisms, how this works, please

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go ahead, sign up to

7:24

the mailing list for this

7:26

podcast because those papers are

7:28

in the resource folder for

7:30

this episode. The mechanisms behind impaired

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insulin sensitivity during gestational diabetes are

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not completely well understood,

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but it's thought that exercise may

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be an effective strategy to optimise

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glucose balance and stability as

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it can lower blood glucose levels. And

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also if you do it habitually, it

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allows your body not to work so hard

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in creating high levels of insulin because your

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body knows that it can rely on movement

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as a way of reducing your blood sugar.