Family planning with diabetes

minute read
August 7, 2023
A type 1 diabetic checking the results of a pregnancy test.
Note: Image for illustration only. Photo credit - Cottonbro Studio.

As a 29-year-old type 1 diabetic woman, I’m weighing the practicality of family planning.

I know my diabetes presents several complications – Complications that will make both conception and pregnancy a challenging journey.

I’ve struggled to convince myself to start family planning and to actually conceive. I’m constantly wrestling with the idea of having a family – Will I survive? Will the baby? Will I live long enough to be a protective mother?

Nonetheless, my husband and I have been trying to conceive. And while we’re still waiting on good news, we remain positive in our efforts and hopeful against our struggles.

And I want to share my struggles with you because it’s not easy, and it’s definitely not straightforward.

So what does getting pregnant as a diabetic involve, and how does it feel to go through it?

Intense pre-planning

First and foremost, diabetes requires daily management. While trying to conceive, I need to maintain tight control over my blood sugar level.

This means constant monitoring of my blood glucose, frequent insulin injections, and careful attention to my diet and exercise routine.

Before I can even start trying to conceive, for the best chance of healthy success my HbA1c needs to be under 6.0% for 3-5 months.

Intense management during the process

Trying to conceive while living with diabetes is challenging. I’m acutely aware my diabetes management needs to be precise and am in constant communication with my healthcare team to ensure my blood sugar level is under control. My partner and I have also made lifestyle changes (such as improving our diet and exercise regimen) to optimise our chances of conceiving.

I’m also keenly aware that if I don’t take the management of my condition seriously, this can lead to complications for both me and the baby. High blood sugar levels during pregnancy can cause problems with the baby’s development, including birth defects, miscarriage and stillbirth – I’m not emotionally ready to face these, and couldn’t bear triggering such complications.

One of the most important parts of managing diabetes during pregnancy is checking your blood sugar level regularly. This will mean checking my blood glucose level multiple times a day, and making adjustments to my insulin dosage as needed. My healthcare team has helped me develop a plan for managing my blood sugar level throughout the day, including what food to eat, when to exercise, and how much insulin to take.

Associated risks

As a diabetic, I know I’m at higher risk of complications during pregnancy.

For me, this could include high blood pressure, pre-eclampsia. For the baby, there’s a higher risk of preterm delivery, which can lead to problems with the baby’s lungs, brain, and other organs. Babies born to mothers with diabetes are also at a higher risk of jaundice, respiratory distress syndrome, hypoglycemia, and other health problems.

One of the most serious risks is macrosomia. This is where high blood sugar levels can cause the baby to grow too large. This can lead to problems during delivery, including shoulder dystocia (the baby’s shoulders get stuck in the birth canal). This can injure both the baby and the mother and may require an emergency C-section.

These thoughts haunt me and make me doubt myself and my decision – Should I keep trying to conceive or simply stop?

Extra check-ups and medicines

As the risks are so much higher with a diabetic pregnancy, it’s important to have extra check-ups.

As well as monitoring my blood sugar levels, I know I’ll need to be diligent about attending prenatal appointments. These appointments will be essential for monitoring both my health and my baby’s. My healthcare team will check blood pressure, weight and urine for signs of complications. They’ll also perform regular ultrasounds to monitor the baby’s growth and development – This will add extra cost, but when we’re successful I know it’ll be worth it.

What to do when any complication is spotted

If complications arise during pregnancy, my healthcare team has told me to take immediate action and head to the hospital as quickly as possible.

Depending on the complication, I may need to adjust my medication, monitor my blood sugar level more closely, or even deliver the baby early.

Final thoughts

For a woman with type 1 diabetes, the journey to motherhood presents unique challenges and risks. Knowing this, maintaining my confidence can be hard, and requires a level of commitment that sometimes feels overwhelming.

But despite the challenges of a diabetic pregnancy, I refuse to let my diabetes dictate my life. I know that if I put the right care and support in place, it’s possible to have a healthy pregnancy and a healthy baby.

So we’re staying positive, and we’ll keep trying.

Graphic of a female profile picture.
Editor's note: The opinions and experiences reflected in stories from the diabetic community belong to the authors, and do not necessarily represent the views of InDiabetes.

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