Updated September 24, 2009

Pregnancy With Diabetes
A Doable Challenge

by Gabrielle Kaplan-Mayer

It is critical that all of your doctors and other health-care professionals be willing to communicate with each other as a team. Often that step is made easiest when they all work together at the same hospital, but that does not always have to be the case.

In addition to your other care providers, you may also want to find a nutritionist who can help you make adjustments for eating during pregnancy and possibly a personal trainer who can help you adjust your exercise routine for pregnancy. Many women who experience high levels of stress during pregnancy also seek out a psychotherapist or support group for help.

And don’t forget about your baby’s medical needs: When selecting a pediatrician, you want to find one who understands the issues connected to babies of women with diabetes. For example, sometimes the babies of mothers with diabetes can be bigger than other babies, due to increased glucose levels in the womb. A baby’s size will eventually even out though, as he grows to meet his natural genetic endowment in the months after birth. An experienced pediatrician will recognize this phenomenon.

For women not living in or near a metropolitan or university area, the choices in physicians may be more limited. According to Dr. Jovanovic, it is critical to find an obstetrician-gynecologist who delivers at least five babies of mothers with Type 1 or Type 2 diabetes (not gestational diabetes) every year. If that means traveling within a radius of a hundred miles, she encourages people to do so.

Support and adjustments
Many women who become mothers discover that the "superwoman" ideal is truly a myth: No one can be all things to all people or do all things perfectly all of the time. For women with diabetes who are pregnant, the extra time, energy, and pressure of blood glucose management and scheduling medical appointments may feel overwhelming at times.

It is important to think about what life adjustments can be made so that you can give your pregnancy the focus it needs. For Jennifer Ferry, that meant leaving her job during her first pregnancy so that "being pregnant could be my job," she says. If you are fortunate enough to be in a financial position to do so, you may consider that option. Sometimes women with diabetes can qualify for short-term disability if work proves to be too stress-inducing or will not allow time for frequent blood glucose monitoring and making insulin adjustments. Ideally, your employer will work with you to create the flexible time you need for medical appointments or allow you to go to a part-time schedule for some of the pregnancy as needed.

Some women feel all right about maintaining their usual work schedule but feel overwhelmed by the demands of housework, yard work, or care of older children on the home front. Hard as it may feel, it is important to ask for help from partners, relatives, and friends during your pregnancy so that you can take care of yourself. An hour or two of child care here and there can make all of the difference in terms of giving you the time you need to rest, cook healthy food, or exercise. While it may feel selfish asking for this time, you’re doing so to take the best care of your unborn child.

"During my pregnancy, I asked for more help from others," Bjay Wooley recalls. “I’m the kind of person who hates to ask for help. I’m kind of a trouper. But because I made my pregnancy a priority, I started to ask for help."

Some women also discover that their friends without diabetes have difficulty understanding what they’re going through during pregnancy. One woman I spoke with talked about how frustrating it felt when a couple of her girlfriends who were pregnant at the same time frequently made plans to get together at a restaurant to pig out. "I explained to them that I really needed to stay on my meal plan to keep my blood sugars in check,” she said, “but they would try to encourage me to go for that extra slice of pizza or huge dessert. Maybe they felt guilty eating that way if I wasn’t, but it got so that I didn’t want to go out with them anymore."

Also in this article:
Preconception Planning Checklist

Gabrielle Kaplan-Mayer is a writer and educator based in Philadelphia. She is the author of the book Insulin Pump Therapy Demystified.

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