They say it takes a village to raise a child, but if you have diabetes and are contemplating or are in the midst of pregnancy, it also takes a village just to have the child. There are so many challenges you must face, since diabetes makes the pregnancy more complicated, and pregnancy returns the favor by making diabetes management more difficult. Facing it alone simply isn’t an option. That’s what this article is all about – resources to help support and guide you, emotionally as well as physically, through the whole baby-making process.
Your Healthcare Team
If you’re thinking about a vacation, a remote tropical island might sound like the perfect setting. Nothing but white sand, palm trees, and blue water all around. But if you have diabetes and want to have a successful pregnancy, isolating your self is not the way to go. Surround yourself with the best healthcare professionals you can find.
If you are not currently working with an endocrinologist for treatment of your diabetes, it is important to do so. This is especially helpful during the pregnancy planning phases, when tight glucose control starts to become very important. An endocrinologist can also introduce you to technologies that can help you before and during your pregnancy, such as insulin pump therapy and continuous glucose monitoring. Ask your primary care physician or friends who have diabetes for a recommendation.
If you’ve been seeing a gynecologist, ask for a referral to a high-risk obstetrics practice. A high-risk obstetrician is to a general gynecologist what an endocrinologist is to a primary care doctor. Most high-risk obstetricians are quite adept at working with women with diabetes through their pregnancies. If you use an insulin pump, ask for someone is comfortable working with women on pumps.
Another valuable member of your healthcare team is a Certified Diabetes Educator (CDE). A CDE can take the time to coach you on all of the various aspects of diabetes self-management, and guide you in making insulin adjustments as your proceed through various phases of your pregnancy. My practice, Integrated Diabetes Services, happens to specialize in this type of service, offering expert consulting before, during and after pregnancy. We do this via phone and the internet for women worldwide, so geography is never an issue. For detailed information, visit http://www.integrateddiabetes.com/prego.shtml.
Hopefully you’ll have some quiet time for reading before and during your pregnancy. And when you do, there are a couple of books that I would highly recommend:
Balancing Pregnancy With Pre-Existing Diabetes, by Cheryl Alkon, serves as an excellent “how to” guide. It covers finding the right doctor, pre-pregnancy planning, special considerations for the first, second and third trimesters, labor & delivery, and taking care of yourself along with your baby. Cheryl is an accomplished writer, researcher and editor who manages a diabetes blog, thesweetnesswithin.blogspot.com. Find out more at CherylAlkon.com.
What to Expect When You’re Expecting, by Heidi Murkoff, is considered the “bible” on pregnancy. The sections covering diabetes are not all that detailed, but it remains the most comprehensive self-help resource on pregnancy in general.
The Nursing Mother’s Companion by Kathleen Higgins is perhaps the most comprehensive book on the topic. Given the immense value of breastfeeding to both mother and infant, this is a subject you’ll certainly want to familiarize yourself with.
One of the great things about the world wide web is that it allows people with common needs and interests to network, provide support, and learn from eachother. Here are some of the best online resources:
Diabetic Mommy features bulletin boards and resource lists for all forms of diabetes and all phases of pregnancy.
Dedicated completely to supporting wellness for women with diabetes, the Diabetes Sisters site features expert panelists, blogs, and extensive information on a variety of topics, including diabetes & pregnancy.
Yahoo Groups includes a number of particularly relevant areas, including “Positive Diabetic Pregnancies”, “Pregnant Pumpers”, and “Diabeticmoms”.
The National High-Risk Pregnancy support network links phone buddies and other resources for women confined to bed rest, including women with pregnancy complications such as diabetes.
Produced by PregnancyToday, this site guides you through the creation of your own personalized birth plan.
La Leche League International’s official site, offering support, encouragement and information/education on breast feeding. For detailed information on breastfeeding and diabetes, go to www.llli.org/cbi/bibdiabetes.html.
Type-1 University features a series of topic-specific webinars for insulin users. One of the courses focuses on managing pregnancy with type-1 diabetes. It covers glucose management, nutrition, exercise, weight control, and many other pertinent issues.
Postpartum Picker Uppers
Whether you deliver vaginally or by c-section, the delivery process is going to take a lot out of you. Then you get to take care of yourself, your diabetes, your newborn, your home and the rest of your family, all with limited sleep and an almost endless list of chores. If (maybe “when” is a better word!) all the extra work becomes more than any mortal woman can handle, reach out to friends and family. This is a time when the people closest to you want to help and be involved. Give them that opportunity – for their sake as well as yours.
If you prefer to not have friends and relatives involved, consider calling on the aid of a doula service (pronounced doo-la). Doulas are women who are trained to help take care of you and your home so that you can focus just on the needs of your baby. For many women, that extra support can mean the difference between sanity and total chaos.
If breastfeeding is becoming a source of frustration, ask your obstetrician for the name of a lactation consultant, or attend a La Leche League meeting in your area. There are probably simple solutions that an experienced expert can find for you quite easily.
If lack of sleep is taking a toll, negotiate with your partner to tend to the baby during certain hours of the day or night so that you can get some uninterrupted Zs. Pumped breast milk can allow your partner to participate in feedings and strengthen the bond they have with the baby while alleviating you of a small portion of your onerous responsibilities.
So there you have it. Resources up the wazoo, as they say. Health care experts, web-based communities, local services, and the many people around you who love you and your baby. Make good use of them, and have a happy, successful pregnancy!
Note: Gary Scheiner MS, CDE is owner and clinical director of Integrated Diabetes Services, a private practice specializing in blood glucose regulation and advanced self-management training for people who utilize intensive insulin therapy. One of the specialties of his practice is pregnancy and type-1 diabetes. He and his staff of CDEs offer their services remotely via phone and the internet for clients throughout the world. A devoted husband and father of four, Gary has had type-1 diabetes for 28 years and makes extensive use of both pump and CGM technology. For more information, contact him at email@example.com, or call him in the US: 877-735-3648, or outside the US: +1-610-642-6055.