Years ago women who suffered from diabetes – either Type I or Type II – were generally advised not to become pregnant because the risks involved for mother and baby were simply too high. Fortunately these days that is no longer the case. However, in order to have the very best chance of enjoying a healthy pregnancy and having a healthy baby there are a number of things that a Mum to Be with diabetes will have to do that other women do not.
The biggest key to a successful pregnancy for a diabetic woman is managing to keep her blood glucose levels within a target range. Those suffering from diabetes are used to this but both before and during pregnancy it is more vital than ever before, both for a Mum to Be’s health and that of her unborn baby.
Successful blood glucose management is especially important during the first trimester of a pregnancy and even before that, at the time of conception. That is why careful planning is the best course of action for any diabetic woman who wants to have a baby.
Pregnant with Diabetes – Before You Conceive
The first eight weeks of a pregnancy are crucial for the development of any baby but for a baby being carried by a woman with diabetes they are even more so. In the first seven weeks of a pregnancy most of the major organs begin forming and it is at this point that much of the damage that can be done by a mother’s high blood glucose levels and or the presence of ketones in her blood occurs.
These substances, which can of course be poisonous to the body in large doses, as every diabetic knows, can be passed to the fetus through the placenta and result in a much higher risk of birth defects, complications at and after birth and even miscarriage.
Given that many women do not even know for sure that they are pregnant until they are at least a few weeks along then pre-pregancy planning is crucial for a diabetic woman. Getting blood glucose levels well under control before conception even occurs decreases the risks to both mother and unborn baby very significantly.
Pregnancy for a diabetic Mum to Be needs to involve both a gynae and her diabetic specialist. If at all possible she should plan to work with an OB GYN who has experience working with diabetic women as they will have a better knowledge of the complexities that are involved in these pregnancies.
After you have selected the right gynae it is important to meet with them before you ever begin trying for a baby. At this appointment, or in many cases appointments, all the plans for maintaining a healthy blood sugar level for nine months of pregnancy can be made and you can begin working on any diet, exercise and lifestyle changes you might need to make to get yourself in the best possible health to conceive.
Pregnant with Diabetes – Prenatal Care
The one thing that distresses many would be first time mums with diabetes is that she will hear her healthcare team describe her pregnancy as ‘high risk’ from the beginning. This does not necessarily mean anyone expects anything to go wrong at all, it just indicates that you are a special Mum to be who is really going to need some special care and that everyone involved in your medical care has to made aware of that fact.
Because a woman’s body changes so much during pregnancy keeping track of your blood glucose levels – which you are probably quite used to – is going to become more of a challenge. Hormonal changes affect blood sugar levels and sometimes pregnancy can make the symptoms of low blood sugar harder to detect. This will usually mean you find yourself testing at home more often than you used to but your doctors should advise you how often is enough – and that may change over the course of your pregnancy.
Insulin and Pregnancy
If you have Type I diabetes the good news is that the insulin you use to help control it is completely harmless to your unborn baby because it is a substance that cannot cross the placenta. The baby’s growing presence will change the amount of insulin you need to manage your condition and may change it quite often so staying in touch with your doctor about insulin levels is a must.
If you have Type II diabetes and take an oral medication to control your blood glucose levels then you may face changes as well. Often these oral medications that work so well when you are not pregnant will become ineffective once you are and very often a doctor will have a pregnant woman switch to an insulin regime right away.
Pregnant with Diabetes – Diet and Exercise
Maintaining a good diet and getting the right amount of exercise is a must for any Mum to Be and that is certainly the case for a diabetic Mum to Be. The old diet that you used to follow to stay healthy and help keep your sugar levels in check may not be appropriate anymore, which is why a consultation with a dietitian will usually be a part of your prenatal care.
In terms of exercise pregnancy is not the time to start a strenuous exercise regime for any woman but some regular exercise is a must. Great choices include low impact aerobics, yoga, Pilates, swimming and even just making it a habit that you take a walk every day.
Pregnant with Diabetes – The Delivery
In the final weeks of your pregnancy you will usually find that you and the baby are monitored even more often by your medical team. If you would like to try to have a natural birth that may very well be possible, but you do need to be prepared for the fact that if at any point your doctor feels either you or your baby are at risk they will normally recommend a Cesarean section be performed and that is certainly advice you need to listen to.
Throughout your labor your blood glucose levels will be monitored constantly. Insulin needs tend to drop during labor and many women on a regular insulin regime do not actually need any for up to 72 hours after delivery.
After Baby Arrives
The arrival of a beautiful baby is the thing that all pregnant diabetic woman are striving for but when that happens as busy as the new Mum might be her health still needs to be watched very carefully. Often blood glucose levels are very up and down after a diabetic woman gives birth and that extra testing will still be required for at least several weeks after Baby is born.
Contrary to what some people may think breastfeeding is usually fine for diabetic women as long as they are very diligent about their blood sugar levels and they get in immediate contact with their doctor if things are not quite right.
Weight loss after pregnancy will be important, especially since being too overweight is not healthy for a diabetic person in general. However a proper, sensible weight loss plan needs to be established that takes into account the special needs that a diabetic new Mum has.
In the end careful management, lots of self discipline and a great support team – both a medical one and your partner, family and friends – are the keys to a successful pregnancy for a diabetic woman. Having a happy, healthy baby is not something that is out of reach for most pregnant women as long as you – and everyone around you – is ready to put in that extra work.
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