It’s taken five years, but we’re finally ready to do it all again… All going to plan, in October we’ll welcome the newest member to our little whanau (family). Baby number two!
With every pregnancy there’s a chance things will go wrong, add a Type 1 diabetic mother to the mix and the list of complications increase drastically. But I get strength from knowing I’ve done this before. In December 2010 after what I thought was a relatively straight forward pregnancy and a rather traumatic birth (some of this was due to diabetes, other parts completely unrelated) Olive Mākere arrived. She was beautiful, round (9.2lb at 38 weeks) and healthy. She was perfect.
During my first pregnancy I worried about every blood sugar result and rightly so. Poorly controlled blood sugar levels before and during pregnancy increase the risk of:
Malformations of the fetus
The fetus becoming overweight
Spontaneous premature birth
Changed heartbeat which can threaten the fetal life*.
And for me, the risks are:
Severe hypoglycemia in insulin treated women
Development of hypertension and proteinuria – known as preeclampsia (women with preeclampsia can experience greater complications during pregnancy, several of which may be life-threatening to the mother and/or baby*).
It’s frightening to read. This time around, things feel a little different. I’ve definitely experienced the extreme hypos. This was why I was on the verge of diabetes burnout last month (check out the Diabetes burnout, you’re not welcome here blog). To try and avoid getting preeclampsia again (diagnosed at 37 weeks last time) I’ve been taking Aspirin daily to reduce my risk of heart attacks and strokes (a complication of preeclampsia).
Due to the ongoing help of my diabetic team the majority of my blood sugar levels fell between the target range of 4-8 mmol (70-140 mg/dl) during my last pregnancy. I thought I had brilliant control. I quickly learnt that pregnant women with diabetes should aim for blood sugar levels between 4-6 mmol (70-110 mg/dl) before meals. I still remember one diabetes appointment vividly. I arrived feeling like a diabetic rock star, internally celebrating the best control I’d ever had. Unfortunately it wasn’t good enough for the experts. I held my head high as I walked out of my appointment and went straight to the bathroom and burst into tears. Sobbing in a toilet cubical I felt like an absolute failure and worried my diabetes was damaging my growing baby, who at this stage we only knew as Algernon.
So what’s changed? Have I mastered diabetes and eliminated blood sugar levels outside the ‘optimum range’? Of course not! (I’m still not convinced this is even possible.) I do know that with the help of an insulin pump, a steep learning curve and choosing to focus on my health, my blood sugar levels are better than they’ve ever been. I’m working damn hard to give this baby the best possible start. If things turn to crap, well… we’ll cross that bridge then.
Even though I have more confidence this time, I’m very aware that a Type 1 diabetic mother, previous preeclampsia and an emergency caesarean means this is a high risk pregnancy. However now 21 weeks in with only 17 more to go (It’s pretty standard for diabetic women to be induced at 38 weeks) I think it’s about time I allow myself to breathe a little easier and get excited…
OMG – we’re having a baby! Our little family of three is expanding. Bring it on :)
Resources: *Pregnant with Diabetes App & www.preeclampsia.org/health-information/faqs