Women's health

During pregnancy, control of your blood glucose becomes more difficult — and more important. The extra risk of high blood glucose means extra risk for both you and your developing baby.

Pregnant women with diabetes have a higher than normal risk of urinary tract infection, pregnancy-related high blood pressure, and cesarean delivery (C-section). Pregnancy can also speed the development of diabetes complications such as eye and kidney disease.

Risks for the Baby

Babies of women with diabetes have increased risk of birth defects and even death during the pregnancy (miscarriage or stillbirth). Their births tend to be more difficult. For example, babies of women with diabetes may be born too early or be very large and hard to deliver. After birth, babies of women with diabetes are more likely to have jaundice, low blood glucose, and trouble breathing.

During the first seven weeks of pregnancy, a baby forms vital organs, tissue, and bone. If your blood glucose isn’t well controlled during these early weeks — or if you’re taking a medication that shouldn’t be used during pregnancy — the risk of a problem with your baby’s development is especially high. Yet you may not even know you’re pregnant during this early, critical time.

Plan Ahead

If you plan your pregnancy, prepare your body, and control your blood glucose, you can lower risks almost to the same level as a woman without diabetes. A planned pregnancy is safest, especially for women with diabetes. Good planning — and tight control of your diabetes — can lower risks significantly.

Prevent pregnancy until your diabetes is well controlled for three to six months. Use some form of birth control while you work to achieve and maintain good control. A good, specific measure is to maintain an HbA1c of less than 6.9% for at least three months — preferably 6 months — before getting pregnant. This will give you the best foundation for a healthy pregnancy and baby.

Talk to your diabetes care team and an obstetric provider (OB doctor) now, before you become pregnant. Your medical team can:

• Explain the possible effects of diabetes on your pregnancy and provide family planning services.
• Help you gain better control of your blood glucose. Your providers will review all parts of your treatment and recommend any improvements.
• Review your medications to ensure safety during pregnancy. Some medications that are commonly used by people with diabetes — for example, certain cholesterol and blood pressure medications — can cause birth defects. Tell your team about all the medications and supplements you take.
• Advise you about other aspects of good preconception care, such as getting vaccinations, becoming more physically fit, and taking a daily vitamin with at least 400 mcg of folic acid. (Taking this vitamin before and during pregnancy can help prevent some birth defects.)
• Evaluate your risk for diabetes complications and provide treatment if necessary.

With special planning and care, women with diabetes can have healthy pregnancies and healthy babies.

Plan for a healthy pregnancy and a healthy baby before you become pregnant. If you are diabetic and thinking about getting pregnant, you should:

• Visit your diabetes doctor and an obstetrician (OB) for preconception planning. Review ALL your medications together (some medications can harm a fetus).
• Reach and maintain good control of your diabetes. Aim to keep your HbA1c less than 6.9% for at least three months before becoming pregnant. (Six months is best.)
• Take 400 mcg of folic acid every day (may come in a prenatal vitamin).

If you are diabetic and already pregnant, you should:

Visit your doctor as soon as you know you’re pregnant. Keep all follow-up prenatal appointments.

• Keep taking 400 mcg of folic acid every day.
• Follow your medical team’s advice in all areas of your diabetes treatment.