Diabetes & Pregnancy
I am a person living with type 1 diabetes since 1979, a PhD Candidate looking at the journey of pregnancy and motherhood for women with diabetes, a blogger, founder of an online diabetes counselling service and ex-diabetes counsellor. Most importantly I am mum to 3 sons.
When I was diagnosed with type 1 diabetes in 1979, I was told that along with all the terrible complications of diabetes, I would never have children and if I dared, they would be born deformed or even worse, stillborn…this messed with me greatly but I was determined to prove them wrong. And prove them wrong I did, with 3 beautiful boys, born in 1993, 1998 and 2008. I have had many ups and downs in life, and with my diabetes, but am generally healthy and thriving WITH Diabetes.
I have done many things but my research in pregnancy and diabetes is perhaps the most exciting for me, as it is the next part of my work in contributing to the improvement of information, support and services for women living with diabetes, during their journey into pregnancy and motherhood.
Life is fleeting and complicated. Life with diabetes is filled with numbers and tests and a need to plan everything. Pregnancy is a time where this increases but it should also be a time to celebrate and enjoy, despite living with diabetes.
If you are a woman with diabetes, starting on the journey of planning a pregnancy, you may have all sorts of thoughts, feelings, worries and concerns. It is completely expected that you would want to get as much information as possible.
We know that women with type 1 and type 2 diabetes have higher risks of problems for both themselves and their babies. But with the right information, support, care and planning – you can have a healthy pregnancy and baby. It is easy to get overwhelmed with all of the medical information and the things that can go wrong.
While it is important to know these things, it is just as important that you feel supported and connected as you go through this journey.
Planning your pregnancy is so important. In an ideal world this would always be the case, but we know lots of women (me included) have unplanned pregnancies or get pregnant sooner than expected. This is why it is important to know as much as possible and be as healthy as possible even before you consider pregnancy.
I believe that we can do better. Despite all of the risks and the increased chances of things going wrong, women with pre-existing diabetes can and should have wonderful pregnancies, remarkable births and spectacular lives with their babies and children. I believe that with better understanding, better information, better technology, better services and communication between health care teams and women with diabetes, we can create better experiences and better outcomes for all mothers living with diabetes and their babies.
Other women with diabetes
Relationships and support from people who have shared this journey can be wonderful when you have diabetes. Some women feel they are alone and may find talking to women who are pregnant but don’t have diabetes isolating. They may not understand the extra complications and stress associated with pregnancy and diabetes.
Connecting with other women who do understand via places like Diabetes Can't Stop Me, can help you to feel connected and experience pregnancy in the best way possible.
Sharing the journey really helps.
You may find hearing that other people feel the same as you, or have ideas and tips, really helps you and offers great reassurance, particularly in pregnancy and early motherhood. You can find our Pregnancy and Diabetes Facebook group here
A good relationship with your partner is very important. Your relationship will change and there will be a focus on your diabetes management, the pregnancy and later, the baby, which can cause problems for some couples. However, many couples have a great working relationship and support each other through everything. Working as a team is the way to go.
At the start, your partner may want to be involved in the planning, or they may feel overwhelmed by the things you need to do to ensure tight diabetes control. It may depend on how much they were involved in your diabetes before. It may also depend on how much they know and educating your partner by taking them to some medical appointments can be helpful.
Talking about what is important for you to do to ensure a healthy pregnancy and baby, and working out how your partner can help, can make it easier for both of you. It may be that you need your partner to take on more roles in the household to allow you to care for your health more. It can help to involve your partner in visits to your health care team from time to time, so they gain first hand understanding and be able to offer support around the hard work you will need to undertake.
Some people find pregnancy puts extra strain on their relationship with their partner, particularly if you have other children to care for. The rest of your life continues despite your focus on planning for a pregnancy. If your control was not very tight prior to pregnancy you will have an even bigger task. Taking time to rest and focus on your health needs can lead to conflicting feelings and guilt that you are not keeping up with usual responsibilities, but this is a time that you have to make yourself and your baby number one priority.
Keeping open channels of communication with your partner is important. Talk about how you are both feeling, both the worries and excitement. Your Partner will have to learn new things too and may have worries and fears of their own too, or anxiety about the health of your baby. Having plans in place before things happen is the way to go.
In my first part of my PhD study – you can read the paper here – we described and developed a model of the pregnancy journey for women with type 1 diabetes.
My second study is focusing on contemplation of pregnancy and how we can improve Preparedness for pregnancy for women with type 1 and type 2 diabetes, through better communication between health care professionals and women with diabetes.
This is being done through development of a survey tool that can be used when you are considering a baby in the future, encouraging access to information and supports. I am hoping this can increase Preparedness and a more positive experience of pregnancy for women with diabetes.
One of the things I am most interested in, is the wellbeing of women and their babies, and improved communication between health care professionals and women. We know people with diabetes are at risk of reduced wellbeing, with higher rates of depression and many people experiencing diabetes-specific distress.
In my first study, diabetes specific distress (experiencing distress about things related just to diabetes) was most common for the women during Contemplation and again in Motherhood. During pregnancy, social identity and peer support were extremely important. Negative emotions in Pregnancy, while connected to diabetes, also centred on the unborn baby. In Motherhood, diabetes-specific distress and depressed mood increased. Medicalisation was expected and offered reassurance during Pregnancy; however, some women still worried, with peer support offering the most reassurance.
The findings from my first study indicate that the provision of resources for women contemplating, planning or during pregnancy and early motherhood needs to balance risk information with accounts of positive experiences and signposting to sources of peer support. If not, information about the risks and potential for poor outcomes may have a negative impact, with women less inclined to seek pre-pregnancy counselling.
We recommend that information resources are delivered via a variety of sources/media that are relevant, accessible and able to be revisited when needed; and include accounts of real-life experiences – to ensure normalisation of the experience of pregnancy with diabetes, offer reassurance to reduce distress and anxiety, and ensure that a woman’s own expertise and history in relation to their diabetes is respected and included in the collaborative development of management plans throughout the pregnancy journey.
While women with diabetes experience a pregnancy journey that appears similar to any woman’s pregnancy journey, the eight themes identified suggest additional diabetes-specific challenges and greater risks to both physical and mental health outcomes among women with diabetes.
"Outcomes from this study suggest a high need for and acceptance of non-traditional health information sources and peer support for pregnant women with diabetes. The ability to augment and strengthen holistic care for women during this journey is an exciting prospect with the potential impact yet to be fully realised and forms the next stage of my research."