I am a midwife working in sunny Queensland. I spend my days supporting women through pregnancy, birth, and all the unpredictable moments in between. And yet, in this pregnancy, I find myself on the other side of the bed – the patient – waiting for pathology results and counting carbohydrates at the kitchen bench.
This is my second pregnancy complicated by gestational diabetes mellitus (GDM). My first was diet controlled. This time, insulin has joined the party. I was diagnosed at 16 weeks. It wasn’t a shock – I had half expected it given my history – but I hadn’t expected it that early. As a clinician, I know the risk factors, the recurrence rates, the algorithms. As a woman sitting in the consult room, all I heard was “You have GDM again.” Suddenly, knowledge didn’t feel empowering. It felt heavy.
The first time I was diagnosed, I responded like many of the women I care for: a swirl of guilt, anxiety, and a quiet sense of failure. Had I eaten too much? Exercised too little? Missed something? This time, the emotional response was more nuanced. I knew intellectually that GDM is largely driven by placental hormones and insulin resistance. I knew it wasn’t a moral failing. But knowing something professionally and believing it personally are not always the same. What has changed most over time is my understanding of the psychological load of GDM. It isn’t just about glucose levels. It’s about vigilance. It’s about the relentless mental arithmetic. It’s about carrying an invisible condition that dictates what, when, and how you eat – and occasionally, how you feel about yourself.
My day now begins before my feet hit the floor: check glucose. Breakfast becomes a strategic operation. Protein? Tick. Fibre? Tick. Carbohydrates – carefully weighed and measured. I review trends, not just numbers. I ask myself the same questions I ask my patients: was that spike food-related? Stress? Poor sleep? Do we adjust or observe?
In my previous pregnancy, I managed with diet and finger-prick monitoring. I am not a fan of needles (who is?), and the finger-pricks were, ironically, the most challenging part. In this pregnancy, insulin is part of my daily routine.
Initially, I had to psych myself up before each injection. Now, it’s almost second nature – a small act of self-care disguised as clinical intervention.
The biggest gamechanger has been continuous glucose monitoring (CGM). Being able to scan and see trends without another finger-prick has been transformative. It has shifted management from reactive to proactive. The “Mother” app allows me to log blood glucose levels (BGLs) and see patterns over time. I can correlate that sourdough wrap or late-night yoghurt with my fasting level the following morning. It has turned my body into a dataset in a way that feels empowering, not intrusive.
Still, data doesn’t silence the internal dialogue.
There is the “midwife voice” in my head: That bar of chocolate will definitely spike your BGLs.
Then there’s the more compassionate voice: It won’t if you have a small piece. You’re human.
Navigating those two voices has been one of the most interesting psychological elements of this pregnancy. I counsel women daily about balance and moderation. Applying that same kindness to myself has required conscious effort.
Balancing diabetes management with clinical work has required planning. Birth suite is not known for its predictable meal breaks. Emergencies do not pause for glucose monitoring. I’ve learned to carry snacks in every pocket and to advocate quietly for myself when I need a moment. I’ve made small adjustments – ensuring I have protected time to eat, scanning my CGM between patients and meetings, and being mindful of long stretches on my feet without hydration. I have been incredibly supported by colleagues. There is something profoundly humbling about being cared for by the team you usually work alongside. It has deepened my appreciation for workplace cultures that enable health professionals to be human.
At home, GDM has reshaped routines. Meals are more structured. Carbohydrate choices are debated. My family has learned more about glycaemic index than they ever anticipated. There are harder moments – birthday parties, spontaneous takeaway nights, and the mental load of planning meals ahead. But there is also pride. My children see me prioritising health. My partner has become fluent in reading nutrition panels. Maintaining normality has meant allowing flexibility within structure. A small piece of chocolate, not the whole block. Pizza, but with a side of salad and a post-dinner walk. It is less about perfection and more about sustainable compromise.
In my first pregnancy, being diet-controlled felt like a small victory. I wore it as a badge of honour. Looking back, I realise how subtly that mindset equated insulin with failure. This pregnancy has dismantled that belief. Insulin is not a last resort. It is a tool. A bridge. A way of supporting my placenta to do what it cannot. Emotionally, this pregnancy has been calmer. Physically, more regimented. Medically, more intensive. Technologically, infinitely more advanced. CGM has changed everything. I no longer wait anxiously for a single number at a single point in time. I see trends. I see context. I see patterns that would have been invisible with finger-prick testing alone. The lesson from my first pregnancy that has shaped this one most profoundly is this: rigidity is not resilience. Flexibility is.
The most prominent emotions this pregnancy have been responsibility and humility.
Responsibility because I know the potential risks.
Humility because now I feel them.
My coping strategies have matured. In my first pregnancy, I chased perfect numbers. This time, I aim for overall trends. I celebrate consistency over perfection. On difficult days, I remind myself that every insulin injection, every balanced meal, and every post-dinner walk is an act of love for my baby. There are moments of pride. The first time I adjusted a meal and saw a stable reading. The first week of consistent fasting levels. The evening I gave myself insulin without a dramatic internal pep talk.
Small wins. But meaningful ones.
Experiencing GDM has profoundly influenced my professional practice. I no longer say, “It’s just a small injection.” I now say, “It can feel like a big step – and that’s okay.” I understand more deeply the relentlessness of monitoring. The mental gymnastics around food. The exhaustion of being constantly evaluated by numbers. I have become more intentional about language. Less clinical. More compassionate. I ask women not just how their levels are, but how they feel about managing them. I also recognise the privilege and complexity of being a health professional-patient. I have health literacy, access to information, and a workplace that understands. Not all women do. That awareness has sharpened my advocacy.
If I could say one thing to health professionals, it would be this: GDM is never “just gestational diabetes.” It touches identity, autonomy, body image, and control. Speak to the whole woman, not just her glucose chart.
What would make the biggest difference for women like me?
Clear, consistent messaging. Access to technology like CGM. Flexible appointment models that accommodate working women and above all, conversations grounded in partnership rather than prescription. As I look ahead, I know balancing diabetes, family life, and midwifery will continue to require planning. But I also know this experience has strengthened me. It has softened my edges as a clinician. It has sharpened my insight as a woman, and it has reminded me that even those of us who guide others through pregnancy are not immune to its vulnerabilities.
I still wear two hats – midwife and mum.
But these days, I also wear a CGM, carry an insulin pen and a quieter, kinder internal voice, and perhaps that is the greatest lesson of all.
