Why is diabetes pre-pregnancy counseling important?
Having a baby and deciding to become a parent is a big decision. Most women with diabetes can have healthy babies, but it's important to get the facts in order to reduce the risk of problems and anticipate the demands of a high-risk pregnancy.
Learning about the care that is involved for diabetes during pregnancy can help women make informed decisions about when to have a baby, how to plan for a healthy pregnancy, and what to expect during pregnancy.
What is pre-pregnancy counseling?
Talking with your primary care doctor/endocrinologist about diabetes and your desire for pregnancy or contraception
Working with a team of diabetes specialists who are knowledgeable about diabetes and pregnancy care
Talking with your doctor about health risks for you and your baby
Planning the best time to have a baby
How Does High Blood Glucose Before and During Pregnancy Affect My Baby?
When a mother's blood glucose is high, her baby is at risk for:
Birth defects, especially of the heart and spine
Miscarriage or stillbirth
Being abnormally small or large in size
Too much amniotic fluid, which can cause discomfort and lead to preterm labor
Problems controlling glucose and electrolyte levels
Problems breathing after birth
How can diabetes affects me during pregnancy?
Diabetes damages blood vessels in the eyes and kidneys. If diabetes has damaged eyes or kidneys before pregnancy, these problems may get worse with pregnancy
Diabetes puts women at risk for high blood pressure during pregnancy
Women with type 1 diabetes are at higher risk for developing diabetes ketoacidosis during pregnancy
What can I do before pregnancy to decrease my risks?
See a specialist who is experienced with diabetes and pregnancy care
Do not become pregnant until your blood glucose is well-controlled (check with your provider regarding specific glucose and A1c goals)
Make sure you've had a complete physical, dental exam, dilated eye exam and kidney screening in the last year
Monitor blood glucose before and either 1 or 2 hours after meals
Switch to medications that are suitable for pregnancy; this may mean switching from diabetes pills to insulin
Take prenatal vitamins when you decide to try to become pregnant
Stop smoking, consuming alcohol, or using recreational drugs
Share what you have learned with family and friends
What other information will I need to know?
When and where to obtain care during pregnancy
What to expect when you have diabetes and are pregnant
Changes involved with caring for your diabetes during pregnancy, managing morning sickness, etc.
Nutritional needs, weight gain goals, exercise recommendations
Changing medications for pregnancy
Increasing frequency of doctor and other medical appointments, including ultrasounds and other diagnostic tests
What if I decide not to become pregnant at this time?
Remember that it is always important to take care of your diabetes!
Find out about contraception and what to do if an unplanned pregnancy occurs
Have a complete physical each year, along with diabetes screenings of the eyes, kidneys, and cholesterol levels
See your doctor at least twice each year for diabetes care
Have your A1c measured every three to six months (recommended A1c goal when not pregnant is 6.5)
See your dentist twice a year
Exercise and eat healthy
Stop smoking cigarettes and/or using recreational drugs; use alcohol with caution and discuss the guidelines for this with your health care provider
Do your best to find coping mechanisms to handle stress and lead a happy, balanced life
How can I take the next step?
The Center for Perinatal Care at Meriter Hospital helps women greatly reduce the risk of problems during pregnancy. We recommend pre-pregnancy counseling for all women with diabetes that is preexisting including pre-diabetes, type 1 diabetes, type 2 diabetes and cystic fibrosis related diabetes. Improving glucose control to normal levels and other pre-conceptional (pre-pregnancy) care helps to decrease risk for miscarriage and birth defects associated with diabetes.
Our diabetes and pregnancy program team consists of maternal-fetal medicine doctors, nurses, a diabetes nurse specialist, dietitian, social worker and others who can assist you in having a healthy pregnancy and baby. Our diabetes self-management education program is dedicated to helping you obtain your goals.
If you are interested in having diabetes pre-pregnancy counseling, contact your doctor for a referral to Meriter Hospital's Center for Perinatal Care.