Pregnancy and other special concerns of women

Posted under Pregnancy Care by Don

You may be one of about 1 ½ million women in their childbearing years who have diabetes . You can deliver healthy , normal babies even though you are diabetic . With carefully supervision and control of your disease and your chances of fertility and delivery are nearly as good as those of nondiabetic women .

Because you are diabetic , you will face more stress during pregnancy than a nondiabetic women . You will also contend with the same uncertainties shared by all expectant mothers . You will face some occasional discomfort , such as “ morning sickness “ , an increased chance of having bladder infections and varicose veins , and weight gain . You will be aware that your physician appearance is changing and that you are treated in special ways by the family members . At time you might feel irritable and depressed for no apparent reason . You may notice that interest in affection and sex may increase or decrease for you and your spouse . Still , despite these concerns , your pregnancy will be a time of happy anticipation and shared expectations with your husband and family .

Better management of diabetes as well as pregnancy have improved the outlook of childbearing by the diabetic women over the past 25 years . Because , however , the statistical chances for a diabetic women to deliver an infant with a birth defect are greater than for nondiabetic women , it is essential that your pregnancy may be diagnosed early and that you have regular blood tests and examinations to monitor blood factors important to control your diabetes and to your baby’s growth and development .

Special Care during Pregnancy

While all 40 weeks of your pregnancy are important to your baby’s growth and development , the first 1 weeks are the most important and critical time for normal fetal organ development . Keeping control of your diabetes can prevent damage to your baby at that time . During the first trimester you will also store nutrients , largely in the form of fat , which the fetus will use later on . Having your diabetes well under your control can prevent problems such as excess insulin production in the baby , which in turn can cause the baby to have low blood pressure after the birth or possibly genetic changes that may contribute to a potential for developing diabetes .

A known diabetic should try to avoid entering into pregnancy without a period of tight control before the pregnancy . If your diabetes was under control before pregnancy , you will probably be able to control it easily during your pregnancy and have few new difficulties . If it was not under control prior to pregnancy , however, you may find that you have even high sugar level . Also , you may find that you need a reduction in insulin , if you are an insulin dependent diabetic , and that you will require a diet adjustment .

Complications of Complicate Diabetes Pregnancy

If you have any complications of diabetes , you may have additional difficulties such as toxemia during your pregnancy . For example , if you have kidney disease , edema may be aggravated . Also , the level of protein in your urine may increase . If you had high blood pressure . Many diabetic women who did not have high blood pressure before may find that they have it during pregnancy .

Your physician will outline a special program of daily rest and relaxation for you and if you have kidney disease or high blood pressure . If your symptoms become severe , your physician may even recommend hopitalization for a few weeks to assure that you are getting adequate rest . If you work outside your home , you may find that you have to leave your job earlier than anticipated for this reason .

Hospitalization

During your early consultations your physician will explain to your that women who have diabetes usually are hospitalized for a week or more before the delivery . This is done to assure you that your diabetes is under control and that any fetal difficulties can be detected before the birth process begins .

Being in the hospital will assure that your baby’s activity and heart rate are being monitored carefully . You will be confident that you are only minutes away from the delivery if any difficulties arise . While hospitalized before the birth you will meet other expectant mothers who also have diabetes with whom you can share experiences and concerns .

Estriol tests may be done every day , and the non stress test or oxytocin stress test will be done about twice a week . Your physician may recommen that you also undergo amniocentesis , a test in which a needle is inserted through the skin of your abdomen directly into the uterine cavity . A sample of amniotic fluid surrounding the fetus will be withdrawn from the uterus . when properly carried out , this test is not expected to affect the pregnancy .

Your physician will outline a special program of daily rest and relaxation for you if you have kidney disease or high blood pressure . If your symptoms become severe , your physician may even recommend hospitalization for a few weeks to assure that you are getting adequate rest . If you work outside the home , you may find that you have to leave your job earlier than anticipated for this reason .

The Diabetic Nursing Mother

You will be advised by your physician about returning to your prepregnancy program of diet , insulin and exercise . If you plan to nurse your baby , and physicians say that diabetic women can do as well as nondiabetic women , you will need an insulin dosage adjustment . If you have gestational , or pregnancy , diabetes , you may be advised to stop taking insulin soon after the delivery .

Sexual Activity and Contraception

Sexual activity can be energy expending . If you are sexually active and have insulin dependent diabetes , you will want to remember to have additional glucose in form of nutritional snacks available for use around the time of such activity , especially if it takes place at a time of diminished food intake and continued insulin availability , such as late at night , early in the morning , or before meals .

Mot physicians advise women who have diabetes to have any children they want while they are young ; they suggest that up to age 30 is the optimal period . Women who have diabetes usually are advised to not to use oral contraceptives because they may adversely affect metabolism and accelerate vascular disease . Most doctors advise diabetic women to use other methods , such as an intrauterine device or diaphragm .

As a woman with diabetes , you can plan to enjoy a normal life cycle . With supervision from you physician and health care team and appropriate control of your disease , you life can be filled with joys and enrichment .

The Birth of Your Baby

Until the specialized tests were available to permit physicians monitor your baby closely most of babies of mothers with diabetes were delivered before or during the 35 – 37th week . Now it is likely that your baby can remain in you uterus longer and that the fetus will be more mature at the time of birth . While you may have heard that many women with diabetes have cesarean deliveries , it has become more likely that you will be able to have a vaginal delivery . You physician will discuss these possibilities with you as you pregnancy progresses . However , if this is not your first delivery , and you have had a cesarean section once or more often , you will probably deliver the same way to protect you earlier incisions Cesarean section will also be done if the fetus is in difficulty or is mature enough for birth and labor cannot be induced .

During the first few days after the birth you will probably have a marked decrease in you insulin requirement . Within another few days , however , you will return to your prepregnancy state and will be able to return to former habits of controlling your diabetes . women with gestational diabetes may become less insulin dependent for an indefinite period , but insulin should not be discontinued entirely until enough time has passed to determine whether diabetes can be controlled without it .

If you are an insulin dependent diabetic , as your pregnancy progresses you may find that you need for insulin doubles or even triples . This is no cause for alarm . It simply means that your pregnancy is progressing as expected . As your blood sugar rises , however , there is increased danger of ketoacids , but if you test yourself frequently , you will be aware of any changes in your control and you can act accordingly.

When you visit your physicians office for routine examinations your medical team may recommend ultrasound techniques to be sure that your baby’s growth is progressing well . Ultrasound is a technique in which sound waves are used to determine the size , position , and rate of growth of your baby and other factors concerning your pregnancy .