Diabetes and Pregnancy: The Battle to Have a Baby
When I was diagnosed with type 1 diabetes 23 years ago, I remember being told that having children would be a very difficult challenge. I was seven years old at the time - still a child myself - and had no interest in becoming a mom. My own mother was very distressed at this news, but I didn't pay it any mind. I had other things to focus on: trees to climb, bikes to ride, and friends to play with.
But as I grew older, I realized that having a child was important to me. Long before I met my husband or even entertained the thought of getting married, I was thinking about my future child. Would it be a boy or a girl? Would it inherit my blue eyes? My stubborn streak? My diabetes? Would I really be able to carry a child, despite the fact that my pediatric doctors had said it would be very difficult?
When they tell you "no," it makes you want to work that much harder to succeed.
After my wedding, I worked for over a year to tighten up my diabetes control, tracking everything from my blood sugars to my food intake to my determined attempts at regular exercise. A few months before trying for a baby, I was advised by my endocrinologist at the Joslin Clinic in Boston to switch over to the diabetes and pregnancy clinic at Beth Israel Deaconess, so I could tighten my control even further in preparation for my future child.
My medical team, knowing my history of struggling for an A1C under 7% without excessive hypoglycemic episodes, advised me to shoot for 7% flat before trying to conceive. After two months, I finally hit my goal, and my husband and I took that leap of faith.
I worried that it would take months for me to get pregnant, but we had the blessing of a pregnancy in our first month of trying. Actually, we found out at a routine check-up at the pregnancy clinic.
"It's early, so the test might not show a positive result, but we should do one anyway. But remember, it might not be positive because you wouldn't be very far along." The CDE gave me a warm smile while the nurse went to test the sample.
We didn't know how long it would take to get the results back, so my husband went to loiter in the waiting room while I waited with my CDE in the hallway, talking about fasting blood sugar goals if I were, indeed, lucky enough to be pregnant at that moment.
Then the nurse opened the door of the lab and came out with the test in her hand. "Oh, she's definitely pregnant. Look!" Those two pink lines on the pregnancy test caused me to gasp, and the CDE clapped excitedly. "We never get to tell people! They usually come in to tell us!"
My husband heard the commotion from the waiting room and came over, his eyes shining. I wish I had told him with even a scrap of grace, that I'd whispered, "We're pregnant!" or "We're having a baby!" or even, "Oh my God!"
"It's on!" is what I said. (Super classy.)
During the next eight months, diabetes management was the focus of most of my life. I have never stalked my blood sugars with more rapt attention than I did while I was carrying my daughter. Every fasting blood sugar was logged and analyzed, and I wore my Dexcom CGM every day to help me keep tabs on my numbers. There were dozens of ultrasounds, two fetal echocardiograms, bimonthly lab work sessions, and countless appointments with CDEs, my endocrinologist, and the high-risk OB/GYN team at the pregnancy clinic. Nothing mattered more than keeping myself healthy so that my baby would be healthy.
There were many scary moments. When I was seven-and-a-half weeks along, there was an afternoon of bright red spotting. I spent the day in the emergency room, praying for the safety of my baby while they scanned me with the ultrasound machine. Every high or low blood sugar gave me pause as I frantically worked to correct the numbers and protect my growing child. And when my medical team advised me that a C-section delivery was best, due to my diabetic retinopathy, I felt defeated. Like any parents-to-be, my husband and I worried incessantly, prayed consistently, and loved our child-to-be intrinsically.
The last few weeks of my pregnancy were very stressful. In addition to managing pre-existing type 1 diabetes, I ended up with pre-eclampsia and spent the last month of my pregnancy on bed rest in the antepartum suites of Beth Israel in Boston.
"We're going to do our best to keep your baby inside of you until you hit 37 weeks, okay? That's the best chance for a healthy baby and a healthy momma. We're going to work together to keep you both okay," my OB/GYN said, holding my hand the morning after I was admitted.
The hospital stay was very taxing, both emotionally and physically. I wanted to be an example of a healthy diabetic pregnancy, and I felt like I was failing with every passing day. I wanted to have my baby without surgical assistance, full-term and without complications. I was furious at diabetes for making my pregnancy feel less magical and more clinical, and I was upset with my body for creating a difficult environment for my growing baby.
But, despite these challenges, April 15, 2010, dawned sunny and bright. My husband and I were brought to the operating room, and what seemed like just moments later, the sound of my daughter's cry pierced the air. The medical team cleaned and swaddled my child and then brought her pouting self over to me.
"Oh, my baby. It's you. I'm your mommy. I love you." I remember murmuring the same sentences to her, over and over again, marveling at the fact that this tiny baby had just been tucked inside of my body, and now she was breathing the same air as I was, nestled between her mother and father for the first time in all of our lives.
Even though it took about 40 minutes for the surgical team to close me up and finish the surgery, I was completely absorbed by my child. Her long eyelashes and her tiny nose. I thought about how hard I had worked to make my baby healthy and strong. How hard I would continue to work to ensure that she, and I, and her daddy, would have a long, healthy life together.
Diabetes wasn't part of these moments. My heart didn't have room for anything that hurt. There was nothing to focus on but this incredible moment, the moment that my daughter became part of our family.
Diabetes may have impacted much of my pregnancy, but it didn't touch my daughter. She is strong, healthy, and the greatest joy I have ever known. Women with diabetes have healthy babies all the time, and I'm proud to be an example of that fact.Click Here To View Or Post Comments