The Effects of Diabetes on Fertility, Pregnancy, and Postpartum

Planning for pregnancy for most women usually starts a couple of weeks after they develop the yearning desire to have a baby. Growing up, I thought becoming pregnant was simple. Little did I know what challenges women endure while trying to conceive and birth a healthy baby. Did you know infertility could be a complication of uncontrolled diabetes? Did you know that being diagnosed with gestational diabetes could make your pregnancy high risk? Maybe you are trying to conceive or know someone who is. No matter the reason, understanding how diabetes can affect a woman before, during, and after pregnancy is important.

Preconception Planning

Preconception planning is an overlooked step that helps achieve the best outcome for both mother and baby. Women in particular who have diabetes should seek out preconception counseling. When speaking with your provider, I encourage you to discuss healthy lifestyle choices, medications, and blood sugar goals you can work on during the preconception phase to increase your chance for a healthy pregnancy.

Preconception Checklist

Blood Sugar Management: Establish a safe blood sugar range. Reaching and maintaining a healthy blood sugar range before becoming pregnant is vital in having a safe and healthy pregnancy. Developing healthy habits before you become pregnant will make it easier to continue those habits during pregnancy.

Medications: Not all medications are safe during pregnancy. Meet with your provider to discuss what medications should be discontinued before becoming pregnant. You and your provider can agree on what alternative medications will be best for both you and the baby.

Healthy Diet: A healthy diet is a key to maintaining healthy blood sugar levels and reaching a goal A1C level. A healthy diet should include fruits and vegetables to provide you with necessary nutrients. Some providers will also encourage starting a prenatal vitamin and folic acid even before you conceive.

Infertility

Even when some women with diabetes complete preconception counseling, they can still experience infertility. Many times women with Type 1 and Type 2 diabetes can experience menstrual abnormalities. These abnormalities are noted as irregular or absent cycles that can make planning to conceive difficult. Controlling blood sugar levels can help regulate cycles, increase libido, decrease the risk for miscarriage, and reduce health concerns once a baby is born.

Gestational Diabetes

Gestational diabetes is diagnosed during pregnancy. Women who are overweight, have a family history of diabetes, are sedentary, African American, Hispanic, Asian or Native American, or older have a higher risk for gestational diabetes. Some warning signs of gestational diabetes include fatigue, frequent vaginal infections, excessive thirst, and frequent urination. Yes, some of these warning signs are common symptoms during pregnancy, but do not hesitate to discuss these symptoms if they occur during pregnancy. Listen to your body and voice any concerns you may have.

Tips to Decrease Your Risk for Gestational Diabetes:

Healthy Diet: Eat a well-balanced diet (fruit, vegetables, whole grains). Limit high-carb processed foods in your diet.

Exercise: Get regular exercise. Discuss an exercise routine with your provider and start before pregnancy and stay consistent. Exercise is a great way to reach and maintain healthy glucose levels.

After Delivery

Women who have Type 1, Type 2, or gestational diabetes should follow the same healthy diet and exercise routine they developed before or during pregnancy. Be sure to discuss elevated blood sugar readings with your provider if they are experienced after childbirth. In some cases, oral medications are needed to control blood sugars post-pregnancy. Be sure to notify your provider if you are breastfeeding so that the safe and appropriate medication can be prescribed.

Be aware that women with gestational diabetes are at higher risk for postpartum depression. Before the baby is born, have a discussion with your partner and family about the signs and symptoms of postpartum depression. If you are experiencing symptoms of overwhelming exhaustion, anxiety, or having thoughts of harming yourself or the baby seek help immediately.

If you have the desire to breastfeed please make sure that you are making healthy choices and eating enough calories for both you and the baby. For some, breastfeeding can be a great way to help lose weight after your pregnancy.

Don’t worry about “snapping back” to your pre-pregnancy weight immediately after giving birth. While the goal may be to return to your pre-pregnancy weight, I encourage you to focus on your mental, emotional and physical state of wellness.

If you are considering becoming pregnant, are currently pregnant or postpartum remember that it is never too late to make healthy lifestyle changes. You don’t have to make all the changes at once, just take it one day, one meal, and one workout at a time. When you get discouraged, just remember that it may not be easy but it is always worth it to Make Wellness your BEST Accessory!

Your Sister in Wellness,

Lauren