Questions to Ask When Interviewing Your Provider, Red Flags and Choosing Your Best Provider

Here are some key questions to ask your midwife or obstetrician if you want a natural birth. Listen to them and within you. You will get your answers about best provider for the birth you want. And do pay attention to red flags.

Do you have training and experience supporting natural physiologic undisturbed birth when all is well?

What’s your rate of primary cesarean?

If I need a cesarean, are you or your collaborative obstetricians experienced and do with gentle/family centered version?

Do you encourage VBAC? What’s your rate?

Are you skilled and supportive of physiologic breech and twin birth? What’s your rates?

Do you support my birth preferences and my right to decline interventions?

Do you advocate for doulas and other support persons I want?

Do you support and have training/skills for vaginal breech and twin birth?

What’s your rate and policy for induction of labor - like going past due date, suspected big baby, water breaking before labor etc.

Is your setting when you practice in alignment with you? What restrictions might be placed on me becasue their protocol?

Most importantly, do support my legal and ethical right to autonomy over my body, birth and baby?

Will my rights to make informed decisions about my and my baby’s care be respected?

If they don't support natural undisturbed health birth or evidence based care, their rate of primary cesarean section is above 10-15%, they don't support your birth preferences & right to decline interventions, they don't advocate for doulas & any other support person you want, they don't encourage VBAC and have rates lower than 70-80%, they have high induction rates for things like going past due date, suspected big baby, water breaking before labor, they don't support and have lots of experience with vaginal breech and twin birth, and/or the setting where they practice is not in alignment with them & they place a lot of restrictions on you because of protocols and policies you have your answer. You can switch providers anytime and hire one that is most in alignment with what you want, who will work collaboratively with you.

Here are some red flags, but here are so many others, especially when all is well with mama and baby such as:

They don’t support natural physiological birth.

They don’t care to read your birth plan or respect your birth preferences.

They don’t do VBAC.

They don’t do vaginal breech or twin birth.
They advise frequent ultrasound, routine multiple tests and procedures without discussion.

They perform weekly internal exams at 36 weeks.
They induce everyone at 41 weeks or sooner.
They do not believe in or practice natural physiological birth.
They don’t like or support doulas.
They do routine episiotomies on all first time vaginal birthers.
They do immediate cord clamping, or rush clamping without waiting until it is limp, white and pulseless.

Their cesarean rate greater than 10-15%.
scheduling a cesarean because they tell you your baby is too big

Unless you are planning to birth in an out of hospital freestanding birth center or at home with authentic midwives, most maternity care practitioners and the settings they work have not seen natural undisturbed birth - and they are trained and quite used to disturbing it. They think it’s necessary to fix what isn’t broken when all is well. It’s like everyone trying to interfere with your heart beating or your lungs breathing when it’s doing just fine on it’s own. It is a sad state of affairs with what’s going on in most modern hospitals especially in the US. I’ve had obstetricians, nurses and even medwives (midwives who practice more medically like many OBs) tell me they have never seen a natural undisturbed birth. Some actually want to shadow me to see one! I love when I do hospital shifts and the med students follow me - it may be their only chance to see natural undisturbed normal physiological birth. That’s the vast majority of what I see and I don’t get how it can be otherwise. Why is this happening as if it were some cool freak show, when the research supports it, when it’s evidence based care, when this is how birth occurred for thousands of years since the beginning of time, and still is the way it happens for the majority worldwide.

Here is a wonderful testimony sent to me from a mama who took my online Guide to Pregnancy, Birth and Postpartum, prepared, informed and empowered herself to tell her obstetrician (the only provider in her rural area) who never saw natural birth, to do nothing but be a fly on the wall, just in case of emergency. He said he never did that, does mostly inductions, medicates births and cesareans. But she respectfully spoke up and he finally agreed. And who was touched to tears, crying the most at her beautiful natural birth? Think of the ripple effect that has on his care for other mamas? If you want a natural birth without disturbance-ask your provider if they’ve seen one. You’ll get your answer whether you should run or not, to a provider and setting where it’s the norm.

“I want to thank you for your online course. Because of it I was able to do a home waterbirth in Nicaragua where it is not common at all. I live abroad so it was my dream to have a natural birth in my home. Little did I know there are no doulas or certified midwives in the country. Your course helped me through it! My father-in-law who is an OBGYN in Brazil caught the baby and also has never done a home or natural birth. He only does cesarean. What a special moment for the family! Thank you again for the knowledge I was able to achieve online!!! Here’s a video of our special day :)
”

— — Brittany S, Nicaragua

If you choose to stay with such a provider with so many red flags, you have to prepare even more, fight even more for what you want, make sure to have an advocate, and know your legal rights to autonomy and informed refusal so you don't allow anyone to dictate you to do anything against your will or manipulate you with playing the fear of dead baby card when there is nothing wrong. Dig deep - is this what you want to be doing during your pregnancy and such a sensitive time as labor?

For more information on how to best prepare for having your baby, feel well educated and informed , confident and empowered, bust through fears and trust the process, and have the most beautiful birth of your dreams take my online signature comprehensive prep course - Anne’s Guide to Pregnancy, Birth and Postpartum and read my Natural Birth Secrets 2nd book edition. I created them for you to do just that, based on over two decades of holistic nurse midwifery experience and attending over 1000 births.

I’ve taken everything I’ve learned, trained, and supported women locally for over 28 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new and updated Pregnancy, Birth & Postpartum Guides. Same Beloved Content Plus Over 40 Added Bonus Videos! Buy Here Now!

They can be used via the mobile App or on your desktop! It’s the most up to date combination of Love Your Birth and Walk With Anne for Mamas online courses at a cheaper price! And they have an option for direct access to me for your questions and concerns!!

Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. The Prenatal, Birth & Postpartum Guides can be sold separately or in a bundle to buy only the section you need or get ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.

Can't Make up This Hospital Birth Story

True story TRIGGER WARNING

There are many wonderful, supportive obstetricians and I adore the ones I am blessed to work with. But sometimes I do hospital shifts, or help advocate for people in the hospital and have personally seen things that make me cringe.

I was to labor at home with a friend’s daughter expecting her first baby as long as possible. I brought her in fully dilated with no urge to push yet. At midnight, the only door open was through the emergency room. We were told to go the waiting room. Wearing eye pads and head phones in a public area, mama slow danced with me over 2 hours. Then she suddenly roared baby’s coming. I asked the person sitting at the desk several times to please get her up to the maternity unit as soon as possible. The staff person kept saying she needs to be seen first in triage, so need to go back to waiting room.

I said “she is pushing and saying her baby is coming as you can see. There is no more time to wait. We've been waiting over two hours.” Lady said it's hospital policy - she has to be seen first by a doctor in triage to determine if she needs to be admitted.” I said “I don't care about policies that make no sense. You can see this mama is having a baby, now. I'm a midwife, I know how to catch a baby here in the waiting room but I don't have privileges in this hospital and here is not the best place for her to give birth.” She rolled her eyes, told me there is nothing she can do, and said “next” to the person behind me. Mama is continuing to roar, saying “baby’s coming out!!!”

I rushed to a security guard standing in front of a bunch of wheel chairs. I told him I needed one stat to take this imminently birthing lady up to labor and delivery. He was at least nicer about it but said “he's sorry that he's not authorized to give one to me.” And what do you think I did? I stole one right in front of him, he looked stunned but did nothing, I took mama up to the maternity unit breaking all kinds of hospital rules.

But really? What would have happened if that was just herself and partner, no advocate? They would have had an ER waiting room birth, in an atmosphere of neglect and then chaos.

As soon as we got into the room, the staff was undressing her and put her into a hospital gown. Some battles aren’t worth the fight, and she did not care at this point, what she was wearing or not wearing. As I am supporting her in the hospital room, she assumed hands and knees position on the bed and continued to push. I could see baby’s head with each push. Multiple people came in, to draw blood, get her admitted by asking all kinds of irrelevant questions - like how much weight she gained in pregnancy as she was pushing; several nurses were trying to get her to lay down to get a continuous fetal monitor strip and start IV. I said she declines both, and intermittent listening to baby’s heart rate was her preference and is sufficient. Mama anyway kept insisting she needed to be on her hands and knees and resumed that position. I then see baby’s head crowning (emerging from the vaginal opening), and prepare for birth.

I suddenly heard mama shrieking, begging for me to help and make the doctor get out of her butt hole. I could not believe what I then witnessed. An obstetrician was doing a rectal exam, obviously without her consent, she was resisting, and he started yelling at her. Mama continued to scream to get him out of her. He continued to yell at her saying he needs to check if she is fully dilated. For those of you who don’t know, if baby is crowning, there is no more cervix, so of course mama is fully dilated. And to check the cervix you need to do a vaginal exam. It’s not accessible through the rectum. Nurses rolled their eyes as he was in the wrong place and his exam was not needed anyway. Help! Don’t let him touch me she pleaded.
I said I was a midwife, her advocate, her midwife is on the way (just changing) to take over as it’s her case, I am not sure why he was in there anyway, what he was doing was abusive, and he would be reported. He left in a huff.

I looked mama in the eyes, said I was sorry for what was done but she is safe now, it’s good to be on her hands and knees. I reassured her that Baby’s heart rate was fine by Doppler, and reminded her to breathe. We breathed together as her baby gently slipped into midwife’s hands. She cried, and was so thankful…but part of the tears was how she was treated initially. I held her in her pain. Just practicing midwifery. THIS ABUSE HAS TO STOP. He was reported to no effect!

Mama and baby were wonderfully healthy, she was amazingly able to tune it all out with her eye pads and head phones, and actually loved her birth but joked her situation at the hospital was like a sit com. But…”Next time just staying at home” she said. She did not want to pursue any other action against the doctor.

Share this! We must improve maternity care. We must know what is going on with our bodies and what to expect, have an advocate or doula especially if its your first and you are planning a hospital birth, speak up and make the choices best for us.

To learn more what you can do whether you are planning to birth in the hospital, at a birthing center or home, to have the birth YOU want & will treasure forever, check out my online Guide to Pregnancy, Birth & Postpartum comprehensive prep course and in adjunct my Natural Birth Secrets book 2nd edition, for deep dive into the hot topics and research.


Story told with permission.

Midwifery History and Witches

Just a taste of a much larger discussion. History for most of history was mostly ‘his story’. Through the majorly of it, women were mostly illiterate as they were not allowed to be educated like men. But until relatively recently, men would not provide care for women and their gynecological and childbearing needs even when they became physicians - as their reputations would be tarnished if they associated with women’s genitalia and their business. It was the domain of women. Women supported women.

Midwifery is mentioned as far back as biblical times, and recorded in Egypt as early as 1900 BCE. Birth was a normal part of family life, men were kept out, and certain women in each community took on the role as midwife, by following and learning from the elder midwives. They used natural remedies. Some did secretly train under physicians. In the medieval times, there are some conflicting historical accounts whether or not they were falsely accused of witchcraft and were persecuted- especially when some unsuccessful outcomes became apparent, their lack of formal training, and use of natural remedies - all a catch 22, as they were not allowed to do formal training or to practice medicine, had no access to medicines, so they used natural remedies, and were thought to go against the church, medical hierarchy and legislature which were often intertwined.

Today, thankfully there have been many beneficial changes like standardized formal education for women in the practice of midwifery, which includes sexual and reproductive health as well as equal rights of women in most developed countries. We do have a way to go in the United states and other countries, as barriers and obstacles to midwifery practice still exist. Midwifery is respected by the medical profession and encouraged for low risk population by leading health organizations. It’s now organized into a profession and supported by legislation as well as biblical religions. Hard to do the real history of midwifery justice in a blog, but at least I can reassure you I am a good witch.

I’ve taken everything I’ve learned, trained, and supported women locally for over 28 years in my private practice and I’ve poured all of my love, passion, knowledge, and experience into creating something truly special for you… my new and updated Pregnancy, Birth & Postpartum Guides. Same Beloved Content Plus Over 40 Added Bonus Videos! Buy Here Now!

They can be used via the mobile App or on your desktop! It’s the most up to date combination of Love Your Birth and Walk With Anne for Mamas online courses at a cheaper price! And they have an option for direct access to me for your questions and concerns!!

Whether you’re an experienced or new parent, there are hours of videos, workbooks, and PDFs to answer all of your questions. Everything is searchable, so you can just type or talk and it’ll bring you right to the exact moment in the video where I answer your question. It’ll blow your mind! If English is not your strongest language, you can even change the captions or even the audio to the language you prefer. The Prenatal, Birth & Postpartum Guides can be sold separately or in a bundle to buy only the section you need or get ALL of the guides for a limited-time offer of 50% off -> RIGHT HERE!

The key to a positive birth is feeling confident, strong, relaxed, and empowered during the entire process, regardless of the twists and turns it may take. I give my full heart and all I know in everything I do to support Mommas.

Upright Physiologic Vaginal Breech Birth

So grateful to Dr. David Hayes OBGYN @breechwithoutborders for their amazing continuing education workshop to thoroughly review the data and teach skills of attending vaginal physiologic breech birth globally. Some key take aways are: 📣Modern US clinicians and hospitals, and other countries that follow US, where only cesarean is taught and practiced for breech - please get back your skills and follow ongoing current impressive research and guidelines of other western countries where upright vaginal breech birth is being heavily studied and practiced as the norm, as it has been among community out-of -hospital midwives around the world through history.

More & more mamas don’t want c-section and all the risks associated with major abdominal surgery for them, their babies, and future fertility as the only option, and are seeking safe alternatives. Breech presentation occurs at term ~ 4% of the time ,vast majority are called frank with hips flexed, legs extended upward. Sometimes they can be turned head down to vertex presentation, sometimes they can’t and are breech for a reason. It’s very rare for a term baby to stand in the uterus, presenting one or two feet first - which is usually NOT footling (a common misdiagnosis) but complete or incomplete breech - hips flexed, buttocks in pelvis like a frank breech but one or two legs flexed, with one or two feet dropped down. These presentations in healthy pregnancy are fine candidates for term vaginal breech birth. It’s crucial for providers to know when to keep hands off, support mamas own movement and pushing efforts, upright positioning, how to resolve uncommon stuck arms, shoulders and head behind the pelvic bones, monitor baby’s condition, expedite birth and effectively resuscitate baby if needed.

Significantly less invasive maneuvers are required in physiological breech birth in upright positions with improved outcomes for mamas and babies. For mamas, breech birth is often claimed to be easier than birthing babies in head down position, with less injury to pelvic floor muscles and reduced tearing. Those I’ve attended all went well. The trouble and poor reputation associated with vaginal breech birth are mostly caused by unskilled providers, keeping mama on her back, impatience & pulling - which skewed the data of the older term breech trial they still quote. If you have a persistent breech baby know you have options. Get true informed consent!

If you’ve been told that your baby is breech at your mid pregnancy anatomy scan, know that baby is still swimming and it is likely they will be head down by term. If baby is breech later in the third trimester, don’t freak out. There are many ways to gently and lovingly ease your baby into vertex. Since there is slightly greater risk to breech babies born vaginally and by cesarean, and many people do not have providers near them who are skilled to attend them for a vaginal breech birth, it is ideal to try to encourage baby to turn head down.

Towards the end of pregnancy, the baby settles into its favorite position. Ideally, this position is vertex, meaning that its head is down towards your pelvis and its bottom is high up in your abdomen.

Less commonly, the baby is breech (with its head up and its bottom down towards your pelvis).

It’s not always known why a baby is breech at term. Sometimes it has to do with:

• Relationship between the shape of the baby and the shape of mom’s uterus or pelvic bones

• Location of the placenta

• Issues with the umbilical cord

• Excessive amniotic fluid

• Lax abdominal or uterine muscle tone

Labor and birth does carry more risk of complications when the baby’s head is not down towards the pelvis, even though breech is a variation of normal. So, when a baby is breech by the 30th week of pregnancy they should be encouraged to convert to the ideal vertex position. That said, the majority do turn by themselves at the beginning of the ninth month.

What to do When Baby is Breech

If your baby is breech at 30 weeks, consider doing a couple of the following exercises 10-15 minutes 2-3 times each day until your baby turns.

1. Belly massage. Massage your abdomen GENTLY in the natural direction the baby will turn. But stop if you meet any resistance, and never attempt to forcefully turn the baby yourself.

2. Visualization. Close your eyes and imagine your baby with his or her head moving down in your pelvis.

3. Coaxing. Play classical or relaxing instrumental music by your pelvis, so that the baby will turn towards the soothing sound. Or shine a flashlight by your pelvis, so that the baby may move towards the light.

4. Go for a swim. Swim laps and do some handstands in the pool.

5. Pelvic rocking. Shift your pelvis up and down and side to side while on your hands and knees.

6. Act like an elephant. Walk around the house on your hands and feet.

7. Bridges and inversions. If you have an established yoga practice, go upside down with any of the inversions, using props for supportive modifications. Headstands and downward-facing dogs work wonders.

Beginners should start with bridges. To do this, simply lie on your back with your feet flat on the floor approximately 1 ½ - 2 feet apart and your knees bent. Elevate your hips 9-12 inches higher than your shoulders. You can support yourself in bridge with a yoga block under your sacrum.

Alternatively, lie on your front in the same “upside down” position, keeping your weight on your forearms and knees wide, with your bottom in the air. Lying on three pillows or a beanbag chair can help further elevate your hips.

Or, lie bent over the edge of a sofa or top of a staircase with your legs on the floor and your body lying down the sofa or stairs. Support your body with your hands or forearms so that your torso is inclined upside down.

Gently roll your hips side to side while in any of these positions.

Taking homeopathic Pulsatilla 30C will help the above exercises be more successful. Allow 4-5 pellets to dissolve under your tongue 3 times daily for 3-5 days. As with any homeopathic remedy, avoid eating or drinking for 15-20 minutes before and after.

Natural Remedies for Breech Babies

In addition to exercises that help your baby move into the best birth position, there are a few techniques that can be administered by care providers. If you’ve tried the above suggestions without success, look for a practitioner that practices one of the following.

MOXIBUSTION

Find an Acupuncturist or Doctor of Traditional Chinese Medicine who has had success turning  breech babies to vertex with moxibustion. The technique involves burning certain herbs close to the skin at specific acupuncture points.

WEBSTER TECHNIQUE

A chiropractor trained in the Webster Technique can use this sacral adjustment to help facilitate the pelvic alignment needed for your baby to get into birth position.

MANUAL TURNING (External Cephalic Version)

If all else fails, you can opt for having your baby turned manually if the right conditions are met (such as no cord around the baby’s neck or short cord, adequate amniotic fluid, and healthy baby as detected on ultrasound with a normal fetal heart beat). Sometimes this is can be easily done in your birth practitioner’s office at 34 -36 weeks, especially in a woman who has delivered vaginally before, while carefully assessing the baby’s heartbeat. It has a high rate of success in skilled hands and supportive conditions.

Experienced midwives can turn breech babies. Most obstetricians prefer to do it in the hospital, often with medication to relax your uterus, ultrasound guidance, and continuous fetal heart monitoring. But it can safely be done out in of hospital settings while monitoring baby.

Ask for a wedge pillow to support you in a tilted pelvic lift position, or a bed that can be placed at an angle, with your legs higher than your head to help baby out of pelvis. Also, having it down while in deep meditation being supported in a pool of water has been effective and a wonderful experience.

Once the baby is turned to the head down position, stop inverting yourself, wear an abdominal binder at all times to prevent the baby from turning back to breech.

If your baby insists on being breech as you approach your due date, discuss your options with your provider. If they are not supportive of your choices for a vaginal breech birth, find a different practitioner, optimally one who has the essential skills and philosophy of birthing breech babies vaginally when appropriate and safe to do so. You can ask for recommendations at Breech Without Borders.

A baby lying in the transverse position, however, can only be delivered safely by cesarean section.

For more information on having the birth of your dreams, check out my Guide to Pregnancy, Birth and Postpartum

If you desire personal guidance, schedule an online or in person coaching call with me.

Gestational Diabetes Screen & Alternatives

Gestational diabetes is rare in the healthy population. Occurring in about 6% of pregnancies, it’s incidence is increasing largely due to the growing obesity, insulin resistance and adult onset diabetes, poor diet and lifestyle habits in the United States. There is much controversy around gestational diabetes, how it is screened for and diagnosed, and whether universal screening improves outcomes as opposed to testing when there are risk factors. If you do have it, however, treatment that includes appropriate actions like maintaining ideal weight, enhancing nutrition and exercise habits does make a significant difference in reducing the serious health consequences for both you and your baby.

In the US, it is standard of care that all women are screened for gestational diabetes at 24-28 weeks of pregnancy, although in some other European countries, only women with risk factors are screened. Screening that is most common involves giving pregnant women a “Glucola” drink that has 50 grams of sugar in the form of dextrose, and then testing blood sugar an hour later. Many holistic providers and the families they serve are concerned about this potentially toxic drink laden with chemicals that may make them feel sick, harm them and their babies, and can be associated with false positives that label them unnecessarily as high risk. This increases stress and angst, leads to more testing, monitoring and potentially other risky interventions. They want alternatives.

While it is within your right to refuse the test, you may want to consider screening for gestational diabetes in another way and discuss your concerns and options with your provider. If your provider is unwilling to work with you on this, consider switching providers to one who will. Although we do not have enough evidence that alternative screens are as accurate as using the more extensively studied Glucola drink to screen for diabetes of pregnancy, alternatives are not to be easily discounted, and may be a viable option in the low-risk healthy population. 

It is recommended according to evidence based care, but you have the right to make an informed decision to decline. The evidence does support screening for diabetes of pregnancy (GDM), as the benefits of accurate diagnosis and treatment outweigh any potential risks of the screening blood test.  Treatment does impove health and birth outcomes, whereas untreated abnormally high blood sugar levels in pregnancy carries substantial risks to mamas and babies. In the early 2000s, the US  only screened those with risk factors, but since the rates of GDM are increasing, and rarely found in those without risk factors, it has become standard to screen everyone. In the UK, only those with risk factors are advised to get the one 3 hour glucose tolerance diagnostic test. There is disagreement on the best screen to use, and what numbers are diagnostic. In the US, standard of care is to use a two step process in which the pregnant mama drinks 50 grams of a Glucola drink made of dextrose and blood is drawn 1 hour later.  Some practitioners and labs use 140 as the cutoff blood sugar level indicating a positive screen others use 135, and some use 130. The lower the cutoff number, the increased number of false positives along with a slight increased ability to diagnose true GDM, whereas the higher the cutoff number the opposite effect can result.  So it depends on the cutoff number your provider and lab uses, each showing different degrees of sensitivity and specificity. Levels of 135-140 are considered normal according to the Mayo Clinic, ADA, ACOG and other highly medical sources.

There is an option for screening for gestational diabetes by home testing. This involves checking your fasting blood sugar at home when you wake up in the morning, and then again 1 hour after eating your usual breakfast, lunch and dinner. While approved for monitoring blood sugar once diagnosed with diabetes, this method of screening is less studied and without clear standards. It is also more cumbersome and costly, as you need to get the supplies to do it, then take the time to get it right and keep records to discuss with your provider at your next prenatal visit. 

I discuss natural alternatives to the chemically laden Glucola drink in my Natural Birth Secrets book 2nd edition….but here are some basic tips if you want a more natural approach.

Alternative Gestational Diabetes Screening Options to Glucola

Starting three days before your appointment, increase complex carbohydrates such as whole grains, sweet potatoes and winter squash.

The meal before the test should only contain protein, vegetables, and unsweetened dairy. A veggie cheese omelet is a great choice! Avoid sweetened foods, fruit, and carbs. If this last meal before the test is lunch or dinner, you can eat a normal breakfast, but avoid carbs or sweets for the rest of the day.

Fresh Test is a new organic alternative that is also said to taste good, with only three ingredients. It has exactly 50-grams of glucose yet is void of unnecessary artificial additives, and is laboratory tested to be virtually equivalent to the Glucola without the unhealthy ingredients. To make your own drink that is most equivalent to Glucola without the chemical additives, dissolve 50 grams of organic dextrose in 8 ounces of water. You will need to do some math. If there are 20 grams of dextrose in 2 Tbsp for example, then you need 5 Tbsp of the powder. You ideally want dextrose, as it is the sugar made from corn that makes up the Glucola drink, and it is most bioidentical to the sugar in your blood called glucose. Therefore, it is the best alternative to screen for gestational diabetes as the standard Glucola drink does, according to the laboratory parameters designed and tested for this purpose.

Another alternative is to drink an equivalent amount of pure corn syrup dissolved in your tea, since the sugar in corn syrup is dextrose. You can find organic non GMO varieties in the health food store, but you still need to do some math, to get 50 grams of sugar total. 

Reputable research indicates that you can instead, eat 28 all natural organic jelly beans or enough that equals 50 grams of sugar, which is studied to be a reliable alternative to the 50 gram glucose beverage. It is not standardized as is the Glucola drink, amounts and types of sugars vary with each product, so you need to do the math and make sure you are eating 50 grams of sugar. The study was relatively small but results can certainly be considered.

Other less ideal options are iced tea, organic Gatorade or a cola drink that has 50 grams of sugar added in the form of added table sugar or dehydrated cane juice (sucrose) - similar to the kind of sugar in jelly beans. They are not a first choice because they are not as extensively researched, the form of sugar is different than dextrose, and thus may have a different effect on your blood sugar levels and test results, designed to screen for diabetes based on your response to dextrose. 

The blood test to screen for gestational diabetes was studied and formulated to test your reaction to ingesting 50 grams of dextrose. Sucrose is made up of 50 % glucose and 50 % fructose. You will need to read ingredients and nutrition labels to use an alternative, an important skill to develop anyway. And you still need to do some math, as the nutrition label might say something like 23 grams of sugar per 8 ounce serving. 

When going for sugars that are not dextrose extracted from corn, you can choose any sugar sweetened drink without added fruit juice. Fruit contains a different type of sugar called fructose that makes the test less accurate as it has a different effect on your blood glucose levels than does dextrose and sucrose. If you can not find or have no time to figure it out and have low risk of gestational diabetes, Snapple 16 oz raspberry peach drink is second choice. Although it is mainly sweetened with sugar (sucrose), it does have a little fruit juice, which again is mostly fructose.

Coconut water is another, but less than ideal option, as it contains sugar in the form of mostly sucrose and glucose, and it does have some fructose as in fruit. ZICO coconut water 16.9 ounces has 20 grams of sugar, so you would need to drink 2 ½ bottles. Honey is another alternative, but it is also not made up of an equivalent sugar - it is sucrose and fructose. Again, you need to read the label. Different honeys have different amounts of sugar per serving size. 

Hopefully there will be more studies on these alternatives, but for now, are listed here to consider with your provider, if for some reason you can not take the dextrose or corn syrup equivalent and you are healthy, with healthy weight and lifestyle, with low risk for diabetes. 

45 minutes before your appointment, eat the jelly beans or drink an amount that equals 50 grams total of sugar, then nothing until the blood test, which will be drawn 1 hour after you consumed the drink or candy.

If you have time, do some form of exercise like taking a brisk walk for 20-30 minutes after drinking, but before the test.

Bring a high protein, whole carbohydrate and healthy fat snack to eat after the test if needed, to keep blood sugar stable. This will help you avoid unpleasant symptoms once your blood sugar drops, like shakiness, lightheadedness, fatigue, anxiety and irritability.

Rest assured, most healthy pregnant women (about 94%) do not have gestational diabetes. A positive screen simply means you need more testing to confirm it or rule it out. And if you do have it, you can learn how to keep your blood sugar normal throughout the rest of your pregnancy and life. 

If you need more guidance,  schedule a coaching call with me.

Be informed, empowered & educated with my online course Guide to Pregnancy, Birth & Postpartum - sold separately or in a bundle.