Baltimore, MD—A few weeks ago, I was talking with a good friend who lives in the Philippines. She’s expecting her second child and experiencing all the excitement that a new baby brings. Joy. Anticipation. But also anxiety.
She’s worried that she might have gestational diabetes.
Following her doctor’s instructions, she’s watching her diet, increasing her exercise and monitoring her blood glucose (or blood sugar) level. She knows she’s doing all she can. She also understands that her health workers are making careful assessments, including monitoring her unborn baby’s health. These are good steps for a pregnant woman to follow, no matter where she lives. But throughout the developing world, these steps are often inaccessible to the very women who need them. In Africa and South Asia, for example, most pregnant women do not receive routine screening for diabetes.
Screening and prevention of gestational diabetes is a best buy, according to the World Health Organization’s plan for preventing and controlling non-communicable diseases. For years, gestational diabetes has been a source of great concern because it is associated with multiple complications during the prenatal and postnatal periods. Worldwide, one in six live births is affected by gestational diabetes. Women with gestational diabetes are at an increased risk of experiencing early labor and spontaneous abortion. Another danger is hypertension, including pre-eclampsia and a higher risk of hemorrhaging. High blood sugar levels can also cause problems for the newborn, such as large birth weight that can lead to issues like obstructed labor.
Some good news: at its recent World Congress in October 2015, the International Federation of Gynecology and Obstetrics recommended and endorsed universal screening for gestational diabetes in women who are 24–28 weeks pregnant. A simple blood test—which midwives and nurses can implement—is the best way to identify women who need additional care and intervention. I expect many maternal health programs will begin to make changes in their approach and offer this screening as part of routine prenatal care.
Universal screening is a good thing because gestational diabetes is a major risk to the health and well-being of the mother and her baby. As we approach and celebrate World Diabetes Day, we need to be especially thoughtful about the risks presented by gestational diabetes. We must implement universal screening to create better outcomes for mothers and babies and thereby reduce maternal deaths. It will be a great challenge for low and middle-income countries, but when realized, will ultimately help us achieve our global goals of ending the preventable deaths of mothers and children.
The care my friend is receiving in the Philippines can indeed be the norm throughout the developing world. We are ready for the challenge, for healthier pregnancies and for a brighter future for women and newborns.
Dr. Mychelle Farmer is Jhpiego’s Senior Advisor on Non-Communicable Diseases.