Pregnancy not recommended?

[CarrieScott]

I just got back from an appt with my Dr. She had a long discussion with my husband and I about pregnancy and about my current condition.

I got my A1C down to 7, which she says is an improvement, but she wants to see me at a 5.5. I had mentioned to her briefly that my husband and I had been considering having a child in the next few years. She responded with a lot of concern. She told me that she strongly recommends that I research other options (adoption, no children, contributing my time to other things). She said that my T1 is very stressful on the body as is pregnancy. She told me that the two combind are extremely dangerous. It is possible for me to have a healthy pregnancy and a healthy baby, but having the baby would certainly take years off of my life and could cause renal failure requiring dialysis. My husband was not very happy to hear this. He doesn't like the idea of me risking my body in any way.

I see so many people affected by Diabetes on this site and elsewhere having healthy babies and I am overwhelmed with emotions. I respect my Doctor and her medical advice, but I wonder if she is being too careful?

Is there anyone who has any advice or could share personal experiences when dealing with T1 and pregnancy?

[SueM]

Hi carrie,
If I were you I would find a good endo who can he of more help to you.
With good control there is no reason what so ever for a type 1 to have children.
You just need to put the effort and comitment into controling your diabetes for the sake of yours and the babies health.
there is nothing wrong with an A1c of 7. How the heck does your Dr think people managed before meters were available?

[xMenace]

Do some research too.
Diabetes Research Summaries - Pregnancy - American Diabetes Association (http://diabetes.org/diabetes-research/summaries/pregnancy.jsp)

[CarrieScott]

I've been hearing a lot of this.

I won't give up hope so soon. I think that she is just being super careful and somewhat overprotective. I am definitely committed to controlling my BS. It has been a long time coming, as I spent years uncontrolled and rebelling against treatment. (I was young, and an idiot!) Maybe she needs me to prove it to her with some better numbers.

Is the information about me shortening my life true? Do you think that T1 women who have given birth do not live as long?

[CarrieScott]

Do some research too.
Diabetes Research Summaries - Pregnancy - American Diabetes Association (http://diabetes.org/diabetes-research/summaries/pregnancy.jsp)

Thank you for the link.

I am reading now. The problem I have been having, is that I can find limited information about Pregnancy and Type I specifically. There are studies linked to for gestational & Type II pregnancies. I will try to sift through these for helpful information.

[xMenace]

You can ask them questions too.

[cheryl]

Girl i had four boys, got diabetes at the age of 12 your only flippin 24. Your still young and need to do it while your young. In my opinion if a type 1 wanted a child they should consider it as young as they possibly want one, I have no renial faliure, my kidney function is book picture perfect and all my a1c's were bad when i got prego with the first three, my last one I had a good one, but it is better to have a good a1c but 6.5 should be fine.....i was in the 12's with the first two and 8's with the third one, but don't worry i got it down in the 5's 6's while prego, my kids were all healthy I had no complications not one, all came out vaginally, all delivered just fine, I recovered fine, but after my fourth one it was harder to get my sugars back down it took a long long time, so i got my tubes tied cause i figured now my body had enough....

Still I hardly think your gonna take years off your life, I am fine i am 114 pounds bp is good, kidney are awesome I have one broken vessel in my eye but that was because i was out of control, not from the pregnancy cause that was a year after my last one was born.....

Sorry, i think as long as your strict while your prego eat well, exercise keep bg's under 120 your fine i was highly strict and ate very well and i did fine, and i rarely gave into cravings.....

Cheryl

[June91]

I have a lot of problems with what your doctor says...

A1c of 5.5 is unrealistic for most diabetics. (Please don't start a debate on this, low-carbers, i said most). I'd also love to see what data your doctor refers to when making statements about pregnancy "certainly taking years off your life".

Keep in mind that most doctors find it easier to make ridiculous sweeping statements like yours did, instead of putting a bit of effort into helping a diabetic through pregnancy.

I am sure that with good control you will have no problems whatsoever that can be traced back to diabetes.

I look forward to seeing photos of your baby in the DF gallery.

[shabbie6247]

my family doctor told me that an A1c in the 7's was quite acceptable and totally went off on one when i told him i was targeting an A1c of 5.8 (its currently 6.2)

does your doctor actually know what she's doing? please get a second opinion!

[DeusXM]

Most guidelines (including WHO ones) basically say that anything below 6.5% is, well, fantastic and what everyone with diabetes should aim for. That's mostly because the range of A1Cs for non diabetics is generally between 4.5 and 6%. An A1C of 7 is 'good' and provided you can maintain or improve this during pregnancy, I don't see why diabetes should have any significant bearing.

Obviously pregnancy is stressful on the body but when you think about it logically, it's sorta what every woman's body is designed to do, so it stands to reason that your body is designed to cope and recover from that stress. Poorly controlled diabetes will impede that recovery but you're not poorly controlled. I don't see how anyone can guarantee that pregnancy will take years of your life or why renal failure should even be an issue - unless there are other issues with your health that you haven't mentioned.

As June said, it sounds to me more like your doctor is worried about being out of her depth.

[Emm]

I'd suggest a second opinion on that one!

Go back 30 years ago, or maybe more, and your doctor would be right (Steel Magnolias anyone?) But these days, no way! We have pumps, we have better insulins, we have BG meters, we have diet knowledge. We can do pretty much anything so long as we're keeping an eye on our BGs!

Personally I'd suggest anyone keeping their A1c under 6.5 if they can do it without risk... and I've heard that 5.5 or under is recommended for pregnant diabetics (even non diabetics have lower A1cs when pregnant). So at your current levels maybe it's not a good idea.

BUT... if you want a baby, do what you can to get that a1c lowered, and then (assuming there's no other reason you can't or shouldn't get pregnant) I can't see why Diabetes would stop you!

Please, make an appointment with an endo! Get some FACTS! And keep talking to us here and on other forums & D websites, get the info from people who have been there & done that.

Perhaps your doc needs a refresher course... sounds to me like she's caught in the past.

[cheryl]

The lowest i got my a1c's while prego was 5.9, you can't low carb it when your pregnant there is no way no how.....I have had four kids....5.5 would of been really hard or I would have had to suffer major low's. I would not starve myself with 60 carbs a day to achieve a 5.5 while being pregnant my highest a1c was 6.2 i kept within those ranges.

Here is the key 100% honestly why your a1c's should not be high when you get prego, because lowering it too fast will result in a miscarriage most likly. I am talking a major high a1c not a 7 or anything.

Here is my story, OK, I was pregnant my a1c was 12.4 i remember this quite well. They immediately(doc's) pumped me up with insulin, telling me it needs to be lowered my bg's now, I have not been a controlled diabetic since I was about diagnoised. my bg's constantly dropped into the 30's and 40's and back up and up and down and down. I argued with them saying to them I think we should slowly drop my bg's I think it would be better for the baby, they thought I was stupid because I was 18 and had had a horrible a1c, so I listened to the doc's because I had thought they knew best......I had a miscarriage.

So when I found out I was pregnant the next two times, I slowly dropped my blood sugars on my own baby steps, refused to go to the doctor, I was about 11 weeks a long with my next two, my a1c right before was in the high 12's again but by the time they did my blood work i had got them in the 7's and then by three months along i was in the healthy low 6 range.....my first two boys are extremely healthy and I had no complications at all....

So my point is really honestly you should have your a1c's as low as you possibly can when you want to become pregnant but if it is 7, I think it would be fine. I know everyone is different, but then again they say every pregnancy is different, I had five pregnancies and four live births, because the last four I did what I knew was best....anyway, I hope you decide to get a second opinion, some doc's really don't know what they are talking about. Diabetes is not always predictable, and I think the important question here is will you be controlled as best as you can while your pregnant, your dr, might think you won't be so is scaring you, I am sure if I tried to plan all my pregnancies, they would of done me the same way because i was way out there.

What dr's don't realize though, that though I was selfish to myself and didn't care, I was a mother at heart and would do anything even if it meant being good to have a healthy baby. So if your that person just like me then you should be fine, if you have self control for that little person that will be growing inside of you go for it. I know I did. I couldn't do it for myself but every time I was pregnant I did it for them.....and now I do it for myself, and because i want to live a long time to raise my grandbabies someday,oh well......

Good luck...
Cheryl

[poper77]

My obgyn wants my a1c to be below 7- it was 6.2 last time it was checked. I asked my endo what i need to do if I want to get pregnant - he said "Get pregnant. As long as your your below 7 you don't need to do anything special"

Get another opinion! My obgyn I think is a little more conservative and gave me the whole lecture on high blood sugar and defects and said that when I do want to concieve I should see a high risk preg. doctor.

[Chris Graham]

Hi Carrie!
I am 37 weeks pregnant and doing great! The baby is right on target...not too big. I haven't had any diabetes related complications.

My endo wanted my BG to be 5.5 or less. I have been able to do this, even with some crazy highs! Basically, I eat a lot of small healthy snacks all day. This type of eating compliments pregnancy so it hasn't been that hard or depriving.

You should check out the web site diabetic mommy. You will find a great resource of other women with diabetes who are pregnant or have had kids.

You can do this!!!

[sleepy_hound]

Doesn't having kids take years off your life anyway??? ( I just had to be the smart a**)

[Keezheekoni]

I have five children. My A1c sucked with the first two, got better with the third and I was extraordinarily good with my last two.

All are fine, none were over 7#5oz. None are diabetic, one had a low bg when born but it came up after nursing...

I agree with another poster about the Steel Magnolias stereotype that some doctors subscribe to. Don't worry about having problems! They just don't happen like that anymore.

[soremom]

My youngest was 6 this past March. I had gestational with my first, though we now think it was actually when I should have been diagnosed T1 but that is another story, so with the 2nd I had it from the beginning. I waited almost 9 yrs to have the 2nd because I didn't think I could. After talking with the dr and her telling me what I needed to do, I did it and had him.

If you aren't on a pump, I would do it for the pregnancy, it does make things easier to adjust. Between the 2 pregnancies, I had more problems with the first. The other problems I had with the 1st had nothing to do with the diabetes, they all happened before I was diagnosed. My point being, you never know what is going to happen. No one does. You can be the healthiest person, do everything right and have a bad pregnancy. I have had no complications from the pregnancies or the diabetes, but I believe that has to do with the way I control my diabetes, nothing to do with being pregnant. If that makes any sense.

I would get a 2nd opinion, maybe another dr willing to work with you and give you the encouragement you need to do this. This day and age with all the technology we have, there should be no reason not to have a baby unless you already have problems.

Kim

[CarrieScott]

Thank you everyone so much for your responses!

I discussed this more with my husband. He offered this theory:

From the ages of 18-23, my BS was out of control. Really low lows, and really high highs. I drank a lot and ate whatever I wanted, (I was in college :stupid: ). I would go months without seeing the doctor and at one point a year without checking my A1C. I was prescribed Lantus and Humalog, but would rarely take the Lantus. I mainly used the Humalog in emergencies when I felt horrible to get my BS back down under 4, 5, and even 600's. Only recently (after my marriage over one year ago) did I start paying attention to my BS & truly wanting to take better care of myself for my husband and our (possible) future family. *On a really personal note, I struggled with Bulemia for approx. 12 years and am treated for being Bipolar. I am stable and medicated for this condition* My husband says that because of all of this, my doctor doesn't trust me to take care of myself. He thinks she is scaring me because she doesn't have faith in my ability to monitor myself consistantly.

I think that it makes sense, and although I don't appreciate her exaggerating the facts (if that is the case), I do understand why she would be very apprehensive about this.

I am 100% dedicated to getting myself healthy and have been for over a year. I will work on my A1C and try to drop a few pounds to show myself and anyone else who doubts me that I am determined.

Thank you again for all of the encouragement to seek a 2nd oppinion and for sharing your stories and knowledge with me!

:flowers:

[DeusXM]

I think I agree with your husband. Your doctor is being overcautious because she feels you haven't proven yourself to be responsible just yet. However you're already showing that you really want to take care of your health and you've got the best incentive in the world to - if you're in great shape you can have a baby!

One thing I would flag up just in case you might want to think about it is that you've mentioned bipolar disorder - have you thought through about problems that you may at this stage be at risk from PND if you have a baby?

[CarrieScott]

One thing I would flag up just in case you might want to think about it is that you've mentioned bipolar disorder - have you thought through about problems that you may at this stage be at risk from PND if you have a baby?

I'm sorry, PND?

:confused:

[SueM]

I'm sorry, PND?

:confused:

Post natal depression:)

[CarrieScott]

Post natal depression:)

ahhhh... I see.

I was thinking Pediatric Neurotransmitter Diseases :o

I hadn't really thought about that. I guess I am definitely more susceptible to any type of psychological issues. Luckily, I have a very supportive and very compassionate husband. I know I could conquer anything with him helping me. (can you tell I'm still a newly wed ?;) )

I am planning on seeking a Dr who specializes in Diabetic Pregnancy next week. I'm also discussing the possibility of taking some time off work to really devote my attention to my BS, meal portioning and planning, exercise, and overall health. (not to mention a reduction in stress!)

[KickStart101]

Hi :), Ya I was wondering why your Dr. wasn't
suggesting and encouraging you to get your
sugars in order, etc. and then have Kids. No Kids?
Adoption? Well, lots of adoptions have created lots
of Wonderful Happy Families.

Then, as Deus mentioned, I was also considering
the Bipolar and maybe your Dr. was afraid of the
Prenatal Depression. One of my Friends had that.
Not pretty. I don't know how frequently that
happens, however.

I originally wanted 12 Kids like my Grammy. :D Some
Drs. at that time weren't thrilled about Diabetics
having Babies either. My GP(I didn't know what an
Endo was at that time)said I'd either have kidney
failure, go blind or both. :eek:

My Son was a surprise. I was alarmed when my
GP's secretary phoned me at work to give me the
GOOD NEWS!!! For myself, I didn't believe in abortions.

My GP did refer me to an Endo(Great Lady)and a Gyn/Ob
(Smart and Funny, French eh. ;) Wears an impressive rock
on his pinky).

Anyways, my A1c was 7.4 and my Endo wanted me
down to 6.5, which wasn't a problem. I did get it down
even though I didn't have a meter(just Chemstripes :P)
and went through my pregnancy good until the 8th mth.
My sugars started rising and I ate less and I took more
Insulin. My Endo put me in the Hospital and tried as they
may couldn't get my sugars down either.

One morning the Nurse hollered. Wow! You're having
high contractions. Don't you feel those?? I was surprised. I
didn't feel anything. Anyways, my Surgeon came in and
asked if I wanted my Baby before or after breakfast. :eek: My
Son was born at 11:32 am and when they laid him on
my chest, I named him. Funny, it wasn't any of the names
me and Hubby had on our list. They did have to shave the
side of his head to put the I.V. in for glucose.

I also had a Sweet Baby Girl but since I've Yapped so much,
I'll just say that she was born early also and had jaundice.
So they had to keep her under the lights in the Hospital for
a week extra. Both our Kids are healthy and taxpayers ;)...
and I'm fine. :D

[CarrieScott]

I originally wanted 12 Kids like my Grammy. :D Some Drs. at that time weren't thrilled about Diabetics having Babies either. My GP(I didn't know what an
Endo was at that time)said I'd either have kidney
failure, go blind or both. :eek:

:hello:
Thank you so much to you (and everyone) for sharing your personal experiences with me. It is comforting to know that your GP responded similar to mine. (I'm not alone!)

I was told by some other (don't remember who or how reliable they were) people that I may never be able to conceive, much less give birth to a baby. I spent years treating this as the gospel truth. (how naive of me!) :o

My husband and I used no protection or birth control method for 6-8 months without getting pregnant. To me, this was confirmation that I was infertile. Not that we were trying to have a baby, but I figured why pay for BC if I can't get pregnant anyway? It wasn't until my best friend and her husband (both with no health problems) started trying to get pregnant that I realized I should seek more information about D and pregnancy.

As you can see, I had and still have a lot to learn.

:D

[panda1076]

This is all great info. Just to add to the information... My endo not only recommends that i be at 6.5 or lower before getting pregnant, but also that post meal BG readings (2 hours after meals) are 140 or lower. The pregnancy goals at my clinic are much lower than regular goals.

My clinic also says that they like to see people's A1C's down to this target of 6.5 at least 6 months before you plan to get pregnant. I think their reasoning for this is so that they can see you are managing well and can maintain a good A1C, and that 1 A1C of 6.5 is not a fluke. For me, I am already under 6, so she said whenever I want to get pregnant I could. the reason they stress the 6 months ahead of time is also because they say that most of the baby's organ development and most critical growth occurs in the first 12 weeks. And sometimes, by the time people realize they are pregnant, the critical growth has already occurred. And if you have high A1C's, you could affect your baby's development without even realizing. that being said, it seems like people on this forum have had high A1C's and have had healthy babies. But I am just reiterating the Joslin Clinic perspective that I have learned thus far.

[Georgia]

Hi Carrie

I think you need to find a new Endo. My baby son is 8 weeks old & I enjoyed my pregnancy with an A1c between 5.2 - 5.9. And he was not a big baby weighing in at 5lbs 8.5oz As Chris mentioned, check out diabeticmommy.com where you will find that the women there have had healthy babies. Don't give up - being a Mom is the best :)

Good luck!

[CarrieScott]

Thank you Georgia!

[Rebecca]

Type 1's can and DO have healthy pregnancies. I know of several Type 1 females that have had 3, 4 and 5 children SINCE being diagnosed with diabetes.
Your doctor wants your HbA1c down because of the importance of YOUR blood sugar levels on the embryo and fetus.
Diabetics DO have very huge babies, if their control is not up to par (10, 12, and sometimes 17 pounders). That is why she wants your HbA1c down to 5.5, so you can safely have a pregnancy without any complication.
Durring the pregnany you will have to keep your blood sugars between 60 and 80 at ALL times. and more so durring the third trimester, for that is when the fetus is growing the most.
You do not want a huge baby, and a baby that for the first couple of days to be a hypoglycemic, because your sugar level goes into his system, and his little beta cells are over producing insulin in regards to your sugar, and therefore will over produce insulin, even though the sugar is not there.. and it can last hours to a couple of days after birth.

[June91]

Durring the pregnany you will have to keep your blood sugars between 60 and 80 at ALL times.

Just how REALISTIC is that for a Type 1? I honestly don't see how the rest of your "facts" can be encouraging for someone who says she's already overwhelmed. I think it would have been more helpful if you'd shared an experience as opposed to quoting from a manual.

What really scares is me that your profile says that you're a Fellow of Paediatric Endocrinology @ Emanual and Doernbecher Childrens Hospitals and a diabetic who thinks 60 is the number to aim for...

[birdyland]

My endo and gyno have helped me work towards a goal of 6.2 or better before giving us the all clear to try. I reached that on the last test, just this week. The Gyno says that is when complications from high BS all but disappear, but I'm T1, not T2, I realize it IS riskier for T1... bit if you control and are committed and careful?? Your doc's comments don't make much sense to me.

[Tricia452008]

OMG Carrie i would have slapped that doctor!! uggh doctors.....

anyway i know exactly what you are going through....i had a real bad time with my diabetes during the going to college, getting out on my own, getting married phase..... my last A1c in Jan was 10.7 so i am not doing too well....

I actually just left my old endo cause he was an *** and found a new doctor at UPenn. I love her and im soo happy i found someone else.....i def agree you should go for a 2nd opinion cause 5.5 is great but very unrealistic for most of us. but you need to go speak with other doctors. My old one refused to put me on any other treatment or the pump and told me i was a "bad diabetic" cause my A1c was so high. I left him and found my doct at UPenn a month later and within 2 visits with her i was getting approved for the MiniMed insulin pump. So you really shouldnt believe all of the doctors out there. Plus like your husband said the doctor just doesnt think you can take care of yourself during pregnancy which is untrue. I say work on getting your sugars down even more then try to get pregnant. I cant wait to see baby pics from you soon :)

but dont listen to this person listen to what you feel is best for you and dont give3 up on babies just cause some idiot told you too....

[amyjo29]

I agree with what our diabetic friends are saying and I agree with what your doctor is saying. Although I'm a T2 I've been told not to have anymore children as well. I became diabetic through my pregnancy and my numbers were very good but I LOST a LOT of weight and my health was at risk because for some reason eating low carb and healthy I lost 20 pounds in 2 months and no matter what I did I couldn't gain any weight. I still struggled after my pregnancy. Weighed 123 when first pregnant, weighted 141 when DX with GD; weighted 115 walking out of the hospital after giving birth. Offically DX with T2 6wks after birth and now weight 98lbs!

Anyway, you have the right to a second opinion. Remember EVERYONE is different. Just because nothing happened to others doesn't mean it won't happen to you. Do as much research as possible talk to 2-3 different endocrinologist and from there you and your husband can take what you've learned and decided for yourself. I think the reason why she said it can take years off of your life is because for T1 it puts more stress on your body than T2 and your sugars can go wild but then again they might not. It's a lot to think about so you need to think really hard and weigh all the options before getting pregnant. A baby is a blessing no matter if it's your own or you decide to adopt. If you decide to go for it and have one of your own just commit to eating the very best you can get lots of exercise and test test test.

[blue_eyed_devil]

i am so glad that this has been brought up.

i have been terrified of having children (in general, but the diabetes made that fear a LOT worse) since i was a child.

as i have gotten older i have become more and more worred about children. i keep hearing horror stories about mothers losing their baby at the last minute and multiple miscarages due to diabetes.

it is really cool to hear about diabetics having healthy pregnancies - multiple times. it restores some of my faith -granted i am still scared...!

lauren.

[steph1]

Definitely get a new endo!!

I know how you feel, I was terrified too! My A1C was 7.1 when I first asked my Obstetrician about getting pregnant and he gave me the "go ahead". I am happy to report that I have the most Beautiful and HEALTHY baby girl (ok, I am bragging a little) who is now 8 months old. She is such a miracle for us! The only positive thing I can say about having diabetes and all the added stress during pregnancy is that it really makes you appreciate your child on such a deep level! I am so thankful for a healthy child.

The pregnancy was definitely lots of work and I was always so worried, but it was worth it a MILLION times!! She weighed 8 lbs. 3 ounces (but my husband is big, so it may have had nothing to do with the diabetes). And during my pregnancy, I had many highs and lows with my levels...but all you can do is eat well, exercise and do your best. The rest is out of your hands. Good Luck!!