Pregnant With Diabetes: Finding Support
It hasn’t always been possible for women with diabetes to have children. Before the discovery of insulin in the 1920s, completing a pregnancy was impossible for women with type 1.
The discovery of insulin marked a huge step forward, but it took decades before women with type 1 could comfortably contemplate having children. Though it saved many lives, early insulin was hard to administer and control. The difficulty of measuring blood glucose and keeping it tightly controlled meant pregnancy remained risky for decades. “In the ’40s and ’50s, there was a 50 percent neonatal mortality rate,” Castorino says.
Wendy Williams, a music teacher in Batavia, New York, had her first child in 1990. Partway through the pregnancy, she was diagnosed with gestational diabetes. She worked hard to get her blood glucose under control, but her son was born oversized and had to be treated for hypoglycemia right after birth—a situation that usually clears up after a few days.
The experience was jarring. “When I started all this 25 years ago, the conventional opinion was diabetes and pregnancy did not mix well,” says Williams. “My first OB encouraged me not to have any more children.” Three healthy pregnancies later—the last at the age of 45, after a diagnosis of late-onset type 1—Williams says supportive health care providers and a new generation of diabetes management tools helped her prove that obstetrician wrong.
Yet even today, the past still colors some doctors’ approach to preexisting diabetes and pregnancy. “In some places, if you say the words ‘I have type 1’ it’s like a scarlet letter,” says Kristin Castorino, DO, a research physician at the Sansum Diabetes Center in Santa Barbara, California. “But it’s slowly getting better.”
Still, it’s crucial to have strong support going into pregnancy from doctors familiar with the challenges and risks. “I encourage women to find a care team that deals regularly with type 1 and pregnancy,” Castorino says.
And although every pregnancy is different, it can help to have support from other women with diabetes who have faced similar challenges. Olivia Bitter, an Ohio nurse with type 1 diabetes, contacted her local ADA office when she was planning for pregnancy. They put her in touch with women in her area who were pregnant or who recently had children. “That was the most helpful,” she says. “When you go through it for the first time, you’re so scared and don’t know what to expect.”
The ADA’s website also offers discussion forums for parents-to-be to share their experiences.
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