During pregnancy, diabetes impacts the health of the mother and baby in many ways. Pregnant women with poorly controlled diabetes are at higher risk for miscarriage, stillbirth, premature birth, larger than average babies, and birth defects.
Fortunately, women with diabetes can take several steps to protect their health and the health of their babies before and during pregnancy. If you’re planning to get pregnant, work with your doctor ahead of time to get your Hb A1c level as close to goal as possible. Review your medications with your health care provider and pharmacist to make sure that they will be safe for the baby when you do conceive.
Remember these tips and be assured that mother knows BEST…
Blood glucose. Tight control of your blood glucose can dramatically lower the risk of birth defects, premature birth, and stillbirth. Work with your provider to set—and achieve—an A1c goal that’s appropriate. Often, the A1c goal in pregnancy may be stricter than in non-pregnant adults to ensure optimal health of the mother and baby.
Eye exams. If you’re pregnant, call your eye doctor to schedule a screen for diabetic eye disease (known as retinopathy) particularly if you haven’t had an examination in the past year. Eye disease often gets worse during pregnancy.
Set treatment goals with your provider. Women with well-controlled type 2 diabetes or gestational diabetes may benefit from a low-carb diet or pills, while women with poorly controlled blood glucose levels might require daily insulin injections to control their blood glucose. Keep in mind that you may need more insulin than usual during your pregnancy, but your insulin requirements should return to normal after your baby is born. The abdomen is the best place for insulin injections during pregnancy. If done correctly, there is no risk to the baby.
Testing is key. Medical tests are performed more often in women with diabetes than in other pregnant women. Your health care provider will monitor your kidney function closely as you and your baby grow, and don’t be surprised if you’re sent for ultrasounds more often than other pregnant women. Ultrasound images are very helpful in determining when you got pregnant, monitoring the baby’s growth, checking for birth defects, and predicting your due date as accurately as possible.
In The Delivery Room
Women who have diabetes will be carefully monitored during the last few weeks of their pregnancies.
When you go into labor, your doctor will likely administer IV insulin to make sure that your blood glucose is tightly controlled during labor and delivery.
Larger than average babies: If ultrasound images suggest your baby is larger than 10 lbs, the provider will likely recommend a cesarean section. While a vaginal delivery may be possible, larger babies face a three times higher risk of getting lodged in the birth canal—a life-threatening condition known as shoulder dystocia. A scheduled cesarean section can avoid this complication and ensure a healthy delivery.
