Pregnancy Planning Essentials for Women with Diabetes
Long before diving into the apps that inform you of the week-by-week development of a baby from “lentil to grape to watermelon,” pregnancy planning is highly recommended.
Pre-conception planning is the first step to creating your own little bundle of joy and enables you to be the healthiest version of yourself, with the best possible diabetes management along the way.
While adding Type 1 or Type 2 diabetes to the pregnancy algorithm may mean there’s a little more to consider, according to Credentialled Diabetes Educator Leanne Mullan, if blood glucose levels are well managed before and after conception, pregnancy often results in the normal birth of a healthy baby.
One of the most important considerations in “getting pregnant” is in pre-pregnancy planning and care. To help you on this exciting journey, here is Leanne’s checklist of things you can do prior to falling pregnant.
Speak to your GP
Make an appointment with your doctor to discuss general pregnancy planning advice. Your doctor should review any medications you are taking to ensure they are safe during pregnancy. They may also check your blood pressure and discuss any immunisations that are recommended. It is most likely that your doctor will also request some blood tests. In most cases, it is desirable to discuss the most appropriate contraception to use until you are ready to start trying to conceive.
Meet with your diabetes specialist
Make an appointment with your diabetes specialist/team (such as a Credentialled Diabetes Educator) and let them know you are wanting to get pregnant. They can provide you with guidance about blood glucose management and your current treatment. Your diabetes team will also provide recommendations regarding individualised blood glucose and HbA1c targets prior to conception. Your diabetes team will support you on your journey to conception and assist you in maintaining good blood glucose management throughout the pregnancy, so it’s important to have a good connection with the health care professionals around you.
Start taking pregnancy specific supplements
Start taking a high-dose (2.5-5mg) folic acid supplement each day, noting these recommended doses are higher for women wishing to get pregnant and living with diabetes. You can discuss this with your doctor as well as any other nutritional supplements recommended.
Get a full diabetes complication screening
This includes blood tests and eye, feet and teeth checks. Talk to your GP about getting these tests completed pre-conception – occasionally some diabetes complications can worsen during pregnancy, so it is good to have a baseline prior to conception so any complications can be monitored and managed throughout the pregnancy.
Adopt healthy lifestyle habits
Aim to be in the healthy weight range by adopting good nutrition and regular exercise. You may consider making an appointment with a dietitian specialising in diabetes to discuss your individual needs and to assist you with blood glucose management and nutrition.
Why should you manage your blood glucose levels during pregnancy?
During the first eight weeks of pregnancy the baby develops its major organs. According to Leanne, this is part of the reason why it is very important to have good blood glucose management prior to conception.
“Suboptimal blood glucose levels before and during early pregnancy may increase the risk of miscarriage and birth defects,” she said.
If blood glucose levels are elevated during pregnancy, some other possible risks to the baby include premature delivery, large birth weight, low blood glucose at birth or breathing difficulties. For mum, the risks include the worsening of some diabetes complications, high blood pressure during pregnancy and difficulty birthing which can result in an intervention such as a caesarean section.
“Although the above risks may seem to paint a grim picture, with good blood glucose management mum and baby are normally healthy and well,” Leanne said.
Diabetes can be overwhelming at times and even more so when considering pregnancy, so keeping in close contact with your diabetes team and having a pre-pregnancy plan will assist you and your future baby to be as well prepared and as healthy as possible.
“They will be able to remind you that the hard work is worth it!” said Leanne.