Gestational Diabetes Is Under-Diagnosed, and It’s Contributing to the Black Maternal Health Crisis

Childbirth, a moment of joy and celebration, should be a time to welcome new life into the world after weeks of pregnancy. However, for Black women in the U.S., this long-anticipated milestone is overshadowed by an increased risk of developing diseases and, even worse, the risk of death.

The dangers don’t end after childbirth, either. When we explore factors contributing to the maternal mortality crisis among Black women, diseases such as a gestational diabetes — which can affect maternal health both during and after pregnancy — should not be overlooked.

What is gestational diabetes?

Gestational diabetes is a condition specifically associated with pregnancy, not preexisting, and is distinct from type 1 or type 2 diabetes. Typically, it is screened for between the 24th and 28th week of pregnancy. Although the exact cause remains unknown, it is believed to be linked to pregnancy hormones.

Symptoms may include increased thirst, frequent urination, and fatigue. Some women may experience no symptoms at all, making it a silent disease. Further, gestational diabetes increases the risk of premature birth, stillbirth, larger infants, and the need for a caesarean section. It can also impact the baby, leading to respiratory issues, obesity, and the risk of developing diabetes later in life.

Gestational diabetes and the Black maternal health crisis

What’s particularly concerning is that gestational diabetes increases the risk of developing type 2 diabetes after childbirth. In fact, according to studies, 1 in 5 Black women is diagnosed with type 2 diabetes after experiencing gestational diabetes, which can potentially lead to severe health complications, including potentially fatal ones, if left undetected and unmanaged.

Type 2 diabetes arises when the pancreas doesn’t produce enough insulin to transport sugar (glucose) to vital organs in the body or when the body becomes insulin resistant. This form of diabetes can have far-reaching consequences, affecting vision, causing chronic yeast infections, tingling in the fingers and toes, and increasing the risk of kidney and heart diseases, conditions which Black people already experience higher mortality rates.

Research suggests that while the diagnosis rates for gestational diabetes are similar across different ethnicities, the diagnosis of diabetes after childbirth is more common among Black women. This could indicate that screenings for the disease are not consistently — or readily — offered to Black women after childbirth. Without such screenings, symptoms of type 2 diabetes may go unrecognized or dismissed as postpartum fatigue.

That means it’s vital for Black women to advocate for themselves both during and after pregnancy.

Advocacy plays a crucial role in addressing the maternal health crisis, as the pain experienced by Black women is frequently dismissed or ignored due to systemic racism and unconscious biases within the healthcare system. As a physician who is privileged to work in healthcare, I almost died during childbirth due to my own pain and concerns being ignored.

If you’re diagnosed with gestational diabetes, be sure to request screenings for diabetes immediately after giving birth. Those of us in the medical field should continue to address unconscious biases and eliminate race-based medicine, which have no place in healthcare. In doing so, we can work together to solve the Black maternal health crisis and improve health outcomes and longevity for all mothers and children in our communities.