Gestational diabetes rates among Indian American women are rising, prompting a call for culturally inclusive prenatal care that honors individual identities and dietary practices.
As I stared at the orange soda, a wave of nausea washed over me. The sickeningly sweet taste lingered in my memory, but I forced myself to drink it quickly. The nurse set a timer, and I felt a knot form in my stomach as I awaited the results. Soon after, the test confirmed my fears: I had gestational diabetes.
This diagnosis was unexpected. I had experienced no warning signs, which I later learned is common. My obstetrician promptly referred me to a dietitian specializing in diabetes prevention and management. During our session, I found myself confronted with menus filled with vibrant vegetables, whole grains, and animal-based proteins. However, these options felt foreign to me. Where were the dals, lentils, and staple proteins that my ancestors had relied on for sustenance for centuries?
As an Indian American woman, I quickly realized the need to advocate for a healthy pregnancy while honoring my cultural identity within a healthcare system that often favors a one-size-fits-all approach. This should not be the case. All women deserve access to prenatal care that addresses their unique needs and identities. Earlier this year, the American College of Obstetricians and Gynecologists released new recommendations for personalized prenatal care. This was a promising first step toward supporting the diverse cultural, social, and structural needs of expectant mothers. Now, it is crucial to implement these recommendations effectively.
The rates of gestational diabetes in the United States are on the rise, affecting approximately 8 out of every 100 births each year. Women who are less active or have a higher body mass index are at an increased risk of developing this condition. Alarmingly, Indian women in the U.S. experience the highest rates of gestational diabetes, with about 16 out of every 100 births impacted. Diagnosing and managing this condition is vital due to potential risks, including increased neonatal birth weight, high maternal blood pressure, and a heightened long-term risk of developing type 2 diabetes for mothers.
As a prevention scientist, I immediately sought ways to adjust my lifestyle to manage my condition. While lifestyle changes may not work for everyone, my obstetrician assured me that this approach often yields positive results.
Being a vegetarian is not just a dietary choice for me; it is deeply intertwined with my Indian heritage and identity. Growing up vegetarian, following in my ancestors’ footsteps, and choosing to maintain this lifestyle as an adult are rooted in my ancestral Jain value of ahimsa, which promotes peace and respect for all living beings. This value has been passed down through generations.
My one-hour session with the dietitian turned out to be one of the most impactful clinical experiences I have ever had. I learned how to read food labels, track my dietary intake, and make informed decisions about my daily choices. It also became clear that I had conflated vegetarianism with a plant-based diet over the years. Out of convenience, I had been consuming an imbalanced amount of pasta and bread, which did not align with my traditional Indian vegetarian diet.
Feeling overwhelmed by the prescribed diet, I turned to my mother for reassurance. She reminded me that generations of women have had healthy pregnancies and babies while adhering to a traditional Indian vegetarian diet. This conversation inspired me to integrate our ancestral foods with the strategies I learned from the dietitian. I began replacing convenient, simple starches with pre-cut vegetables and pre-cooked and frozen traditional Indian vegetarian dishes made from dals, vegetables, herbs, and spices.
These changes allowed me to honor my cultural identity and values while effectively managing my gestational diabetes. During subsequent prenatal care visits, my obstetrician confirmed that my glucose levels had returned to normal.
Years later, I continue to apply the lessons I learned during my pregnancy in my daily life, practicing prevention through my lifestyle choices and advocating for culturally inclusive care. The memories of this experience remain vivid. As a nation, we must strive for truly personalized prenatal care that provides equitable access and meets the diverse cultural needs and identities of all expectant mothers. Indian American women should feel fully included and empowered to lead their own health decision-making. Combining prenatal care with lifestyle changes that reflect my Jain Indian values allowed me to maintain a healthy pregnancy without compromising my identity.
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