BY CLAIRE HARDING (GUEST WRITER)
Claire is going to be sharing her story of experiencing pregnancy with type 1 diabetes. We hope you find this post helpful, insightful & educational!
Being a mummy and being a diabetic are two things that I am, they are two things that I don’t think about very often, they are life, they are me.
I can’t imagine life without either diabetes or our sons.
PREGNANCY WITH TYPE 1 DIABETES
I don’t remember much about life before being diagnosed with Type 1 Diabetes when I was 10 years old. It’s something that has just always been there and thankfully has, mostly, been a positive part of my life, something to embrace. It’s been hard work but thanks to my fantastic parents, brother and husband it’s never been a fight, it’s never been a hassle, it’s been a positive (being able to eat snacks in exams was a definite positive when I was a teenager). It’s never been a hindrance, it’s never stopped me from doing something I wanted to achieve.
What is Type 1 Diabetes?
In my experience there is a general confusion as to what diabetes is, lots of people think it’s caused by eating too much sugar, that insulin helps when you feel faint, that there is a cure, that you are elderly or that poor management of weight has caused it – non of these are true for me!
Diabetes is a lifelong condition that affects your body’s ability to control its own blood sugar levels with insulin. There are two main types, type 1 and type 2. Type 2 diabetes is the more common, in the UK around 90% of all adults with diabetes have type 2.
Diabetes is where your body can’t produce enough or any insulin to break down the sugars in food, for type 1 diabetics their immune system has destroyed the cells that produce the insulin whereas for type 2 diabetics their body doesn’t produce enough insulin.
The treatment type 1 diabetes is insulin injections or with an insulin pump. When I was first diagnosed I had two injections a day, one at breakfast and the other at supper. When I became a teenager it went up to 4 injections a day, at breakfast/lunch/supper and one long lasting insulin at night. I then I went onto an insulin pump, I was one of the first paediatric patients in my hospital to go on one which was exciting. A pump is a small electronic device that is attached to the body using a cannula, a tiny tube which you replace every 2-3 days, it allows more flexibility and freedom with when and what you eat as well as allowing tighter control of sugar levels. It is attached to you 24/7 but, for me, it’s the best piece of equipment!
Preparing for pregnancy for diabetics
When my diabetic consultant learnt of my engagement he immediately recommended meeting with a diabetic obstetrician. A sudden worry came over me, will being diabetic stop me from becoming the only thing I’ve ever wanted to be, a mother.
Coming out of the very positive, somewhat premature, meeting with the doctors, we were aware that a bit more work may need to go into the planning for a baby than for someone without diabetes. It wasn’t just going to be about how diabetes could affect the pregnancy but how being pregnant could affect my diabetes.
After our wedding, a move to the South West and buying our first house, we began to think about starting a family. Diabetes very much came to the forefront of our thoughts, management of sugar levels had to be tighter than ever before, I would also need to be on a higher dose of folic acid from when we started trying to when I was around 12 weeks pregnant to help me to have a healthy pregnancy.
Pregnancy with Diabetes
When I saw the positive pregnancy test I was overjoyed and relieved but those happy feelings were paired with a worry that our preparation would not be enough, that the work in the months leading up to getting pregnant hadn’t been enough to help this baby through the next 9 months. I knew I needed to start booking doctor appointments, it gave me peace of mind to know that the team that look after me were aware of the pregnancy as early as possible to allow for as much support as possible.
Due to the increased risk of miscarriage and stillbirth, diabetic mothers attend more scans and more obstetrician appointments than most women, especially from 20 weeks onwards. I am so thankful for those extra opportunities to see our son, to make sure everything was going ok, to have the chance to ask questions and get reassurance. I don’t remember overly worrying about the pregnancy on a day to day basis, I’m sure my husband would disagree, but the day before each scan I had overwhelming fear that we would receive bad news the following day, I would question whether I had felt him kick the normal amount. From 20 weeks I had appointments and scans roughly every 4 weeks and then from around 30 weeks every 2 weeks with both the obstetrician and my diabetic consultant. I also had email contact every few days with the diabetic team. The amount of insulin needs to be reviewed and changed constantly. Babies born to women with pre-pregnancy diabetes have a risk of twice as many complications as babies born to women without diabetes, these risks can be reduced with really tight control of the diabetes before and during the pregnancy.
I had always been under the impression that diabetics had to have a caesarean delivery and that there would be a lot of medical intervention for the baby when they are born, but from our first appointment I was told that labour and delivery could be how I wanted it to be, although diabetics are induced between 37 and 38 weeks to reduce risk of stillbirth. We were also told that 45 per cent of women with pre-pregnancy diabetes have c-sectionscompared with 27 percent of women without diabetes.
One Friday we had a routine scan and obstetrician appointment, I was 36+3 weeks pregnant. We found out that our son was a bit too big, roughly 9lbs, and that I was showing signs of pre eclampsia so we were told that we needed to go home and get our bag and that I was being admitted to hospital, our son will be delivered by c-section on the following Monday! We were totally unprepared and scared. A fear of c-section and panic for his life was all I could think about as we drove home, we hadn’t even packed the hospital bag at this point! After an incredibly quick trip home, a panic phone call to my mother, a cry and a pot noodle for my husband, we returned to be admitted to the prenatal ward.
It was such an odd weekend, I didn’t feel like I should have been there, everyone around me was in labour and in a lot of discomfort whilst I was just bored of having to stay in bed being constantly monitored, both for the baby and the diabetes. I was given steroids over the weekend to help speed up his lung development, it gives preterm babies a much stronger chance of surviving. On the Sunday night we were told that I would be the first in the next morning, bright and early, so my husband decided to stay the night, he still hasn’t got over the fact that he had to sleep on the floor with only a couple of towels as a mattress due to all the reclining chairs being used elsewhere.
A few hours before the section I was taken off my insulin pump, a pump allows insulin to drip into me continuously thereby giving me a tighter control of my sugar levels, and the hospital took over control of my insulin via a continuous drip, I then went back on the pump once I was well enough to eat again after the baby was born. It was so nice not having to think about the diabetes whilst worrying about everything else that was happening at the time.
The section went as planned, the epidural had made me feel really light headed but everything else went well. At 12:31pm I became a mother, our first son was born. We had a quick glance at him and then he was given a check over by a specialist team who were thankfully very happy with him and all his observations so no further medical care was needed for him then. They weighed him and were chuckling away whilst doing so, we were asked what we had been told his predicted weight would be, to which we responded 9lbs, this was met by more chuckles, we were then told that he weighed an incredibly healthy 10lbs 13oz! A large baby is one of the tell tell signs of a diabetic mother.
Once our son was born the diabetic management didn’t just stop. Juggling the diabetes whilst being a new mother was a huge learning curve and extremely tiring, especially while breastfeeding as your body uses glucose to produce the milk thereby affecting the mother’s blood sugar levels, drumstick sweets were my best friend whilst our son was feeding! It took around 6 months to adjust to motherhood whilst making sure the diabetes continued to go smoothly.
This pregnancy was normal for me, just like many other things it was just how it is with diabetes, I don’t and won’t ever know any different. It was both mentally and physically tough, it was definitely a challenge but it wasn’t enough to put us off doing it all again 14 months later with our second son.
We hope you discovered something new reading Claire’s post on her experience of pregnancy with type 1 diabetes.