Contemplating pregnancy with preexisting or gestational diabetes can be a scary thing. There is a lot of bad information out there, and it can be hard to find a provider who is positive and encouraging: After all, it’s their job to inform you of risks and complications!
The problem is, a lot of moms are left feeling scared and overwhelmed, and it doesn’t help that other moms unknowingly spread myths that scare us even further! As someone with type 1 diabetes, I’ve experienced this first hand.
Here’s what you need to know about diabetes and pregnancy:
MYTH 1: IF YOU’RE PREGNANT, DIABETES WILL ALWAYS GO AWAY AFTER YOU DELIVER
Technically this IS a myth, but only for a relatively small percentage of moms! MOST moms with diabetes in pregnancy return to “normal” after birth. Allow me to explain:
“Diabetes” actually a generic name used to refer to very different ailments that all involve the same organ: the pancreas.
There are several different types of diabetes, but the three you’ll most often hear about are type 1 diabetes, type 2 diabetes, and gestational diabetes.
Type 1 diabetes is an autoimmune disease. The body’s immune system mistakenly attacks the part of the pancreas that produces insulin, rendering it incapable of producing any insulin at all. Since insulin is a hormone necessary for survival, people with type 1 diabetes must inject insulin to stay alive.
Diet and exercise do not produce insulin, so these by themselves are not enough to treat type 1 diabetes. And since the body stops producing insulin, this kind of diabetes most certainly will NOT go away after pregnancy.
Type 2 diabetes happens when the body is unable to effectively use the insulin it still produces. It is usually seen in the elderly or in people who are overweight and who live sedentary lifestyles. Because people with type 2 diabetes still produce insulin, most can rely on oral medication, diet changes, and exercise to manage and sometimes even reverse their condition.
Unfortunately, type 2 diabetes also never really goes away: A return to old habits and lifestyles will bring back the condition.
Gestational diabetes happens only in pregnancy and is the only type of diabetes that can go away permanently. When a woman reaches her second trimester of pregnancy, her insulin needs slowly increase–as much as two or three times what they were before–as a result of pregnancy hormones and the placenta.
The pancreas can usually keep up with these increased insulin needs, but when it doesn’t, you get gestational diabetes. Once the placenta is delivered at birth, symptoms of gestational diabetes go away almost immediately.
MYTH 2: GETTING PREGNANT WHEN YOU HAVE DIABETES IS RISKY AND DANGEROUS
Pregnancy is a risky and dangerous endeavor for anyone. Diabetes does increase the risk, but excellent glucose control and healthy habits mitigate this risk dramatically–a truth few providers emphasize enough.
As a high-risk mother with type 1 diabetes, my pregnancies have actually been less complicated than those of several of my close friends!
MYTH 3: IT’S YOUR FAULT THAT YOU HAVE DIABETES DURING PREGNANCY
Nope! As an autoimmune disease, type 1 diabetes is completely unpreventable.
As for type 2 diabetes, consider this: Nearly 70% of Americans are overweight or obese, but certainly not all of these people have type 2 diabetes. So while it is true that diet and lifestyle can contribute to developing type 2 diabetes, there is clearly a critical genetic component for type 2 diabetes for which a person simply cannot be blamed.
And as for gestational diabetes, it is completely normal for the body to require more insulin during pregnancy. While there are certain factors that increase your odds of having GD (including being overweight, prediabetic, having a family history of type 2 diabetes, and certain hormone disorders, among other things), none of these are guarantees you will get it.
Some women with all the risk factors never get it, and some with no risk factors wind up with it. Either way, it’s not your fault!
MYTH 4: IF YOU EAT WELL AND EXERCISE, YOU WON’T HAVE TO TAKE INSULIN
See Myth 1 above! A mother with type 1 diabetes will always have to take insulin. She was probably taking insulin for years prior to even getting pregnant and she will continue to take it from conception to birth and beyond.
A mother with type 2 diabetes is likely to need insulin during pregnancy if the oral medication she has been taking proves insufficient.
A mother with gestational diabetes may require insulin if diet, exercise, and oral medication are not treating her condition effectively.
MYTH 5: THE BABY WILL AUTOMATICALLY HAVE DIABETES
A baby of a mother with diabetes is more likely to have episodes of low blood sugar after birth. A lot of moms assume this means that the baby has diabetes, but this simply isn’t true! Even babies of mothers without diabetes occasionally have low blood sugars after birth!
The baby of a mother with diabetes still has a functioning pancreas, and only genetics and time will tell if diabetes will ever be in the child’s future.
MYTH 6: YOU ARE GOING TO HAVE A BIG BABY
While it is true that a mother with diabetes is statistically more likely to have a larger baby, keeping your blood sugar in control and eating well yourself makes it extremely likely you will have a perfectly average sized baby.
And if you don’t? You have to remember that genetics are a big deal! We you or your partner a large baby? Some people simply make big babies, diabetes or not.
MYTH 7: YOU WILL HAVE TO DELIVER EARLY / BY C-SECTION
A mom should always consult with a trusted provider about her delivery options since every mother’s health situation will be different.
While there are times in which mothers with certain diabetes complications may benefit from a c-section, mothers with diabetes are, generally speaking, perfectly capable of delivering vaginally!
In an otherwise healthy mother with diabetes (type 1, type 2, or gestational) and no pregnancy complications, delivery before 40 weeks isn’t necessary, although it is often done to prevent fetal macrosomia–or a “big baby”–which can lead to shoulder dystocia and other birth complications.
The practice of routinely inducing mothers with diabetes at 37-38 weeks, however, is an outdated one, and most up-to-date providers will allow an otherwise healthy and complication-free mother to make it to at least 40 weeks (mothers with diabetes are usually advised to deliver by 40 weeks, since the risk of stillbirth is increased for this population).
Timing of delivery can be a complicated question when diabetes is a factor. You can read more research about the timing of delivery in women with diabetes here.
MYTH 8: YOU WON’T BE ABLE TO BREASTFEED
False. There is some evidence that in mothers with diabetes, it can take closer to 4-5 days (normal is 2-5) for mature milk to come in, but this doesn’t always happen (my milk came in the evening of day 2!).
And while it is true that breastfeeding can make glucose management difficult in mothers with preexisting diabetes, a mother committed to breastfeeding can overcome this obstacle–and many do!
Breastfeeding with preexisting diabetes presents mothers with unique challenges, and these mothers should not be afraid to seek out specialized support in the form of Facebook groups, free in-person meetings, or professional help from an IBCLC (international board certified lactation consultant).
Do you know the #1 reason moms quit breastfeeding?
Learn exactly what to do (and what NOT to do) if you think you have low milk supply, or if you’re worried about it.
Fortunately, the principles of milk production and best practices for breastfeeding remain the same regardless of whether or not you have diabetes! The best thing you can do to prepare yourself for breastfeeding is learn about it. And you’re in luck! I have a resource for you here:
Have you experienced a pregnancy complicated by diabetes? What myths were you told?
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