I have diabetes. Should I get pregnant now?
Introduction
You may want to have a say in this decision, or you may simply want to follow your doctor’s advice. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Key points in making your decision
Here are some things to consider if you have diabetes and are thinking about getting pregnant:
- Is your blood sugar in a normal or near-normal range? Women with diabetes who want to get pregnant should have blood sugar levels as close to normal as possible before they get pregnant. This lowers the chance of birth defects, miscarriage, and other problems. Check your blood sugar throughout the day to see if it is in a near-normal range. If not, consider using birth control until your blood sugar is in that range.
- Do you take pills to treat diabetes? Your doctor may have you switch to insulin or take a different pill before you get pregnant. If you are changing to insulin or a new pill, make sure that the medicine is controlling your blood sugar before you try to get pregnant.
- Do you take insulin? Talk to your doctor before you try to get pregnant to see if you need to change your dose or how you take it (such as through an insulin pump or as shots). If you figure out the right dose of insulin to take before you get pregnant, you are less likely to have problems with high and low blood sugar during your pregnancy.
- Do you take medicine to treat other problems? Talk to your doctor before you get pregnant to see if you need to stop or change your medicine.
- Do you have complications from diabetes, such as eye or kidney disease? If you do, being pregnant can make some of these problems worse. Also, high blood pressure can create problems for you and affect your baby's growth during pregnancy.
- Do you have other children? If so, how did the diabetes affect your pregnancy?
- Do you take a folic acid supplement? Taking a daily multivitamin or prenatal vitamin with folic acid reduces the chance of having a baby with a birth defect.
Medical Information
What should you do before you get pregnant when you have diabetes?
You can have a healthy pregnancy if your blood sugar is in a normal or near-normal range before you get pregnant and you don't have high blood pressure or problems from diabetes, such as kidney disease. Keeping your blood sugar at a normal level lowers your risk of birth defects, miscarriage, and other problems. Experts recommend keeping blood sugar levels as close to normal as possible—called tight control—for 3 to 6 months before you get pregnant. To do this, get plenty of exercise, eat healthy foods, lose weight if you need to, and take medicine if your doctor prescribes it.
For more information, see:
What should you talk to your doctor about?
Medicines
It's important to let your doctor know if you are thinking about getting pregnant. If you take pills to treat your diabetes, your doctor may want to switch you to insulin or to a new pill before you get pregnant. And if you take insulin, your doctor may need to change the dose or how you take it, such as through an insulin pump or as shots. You also need to let your doctor know about any medicine you take to treat other health problems. He or she may have you stop or change your medicine before you get pregnant if you are taking any medicines that could harm your baby.
Screening
When you have diabetes, you need to see your doctor regularly to check for problems from the disease. It's especially important to do this before you get pregnant. Screening tests include:
- An eye exam to look for signs of retinopathy.
- Blood and urine tests to look for kidney damage.
- Blood pressure checks. High blood pressure can cause problems with the mother and the baby. When blood pressure is very high, the placenta may not work well and the doctor may need to deliver the baby early.
- Blood sugar level tests. Your doctor will talk to you about keeping your blood sugar in a normal or near-normal range at all times before and during your pregnancy.
What are the risks from getting pregnant when your diabetes is not controlled?
Uncontrolled diabetes increases the risk of problems for both the baby and the mother.
Risks for the baby include:
- Birth defects.
- Early (premature) birth.
- Jaundice.
- Low blood sugar.
- Larger-than-normal size at birth, which can cause shoulder and other problems in the infant.
- Smaller-than-normal size at birth caused by high blood pressure, kidney disease, or problems with the placenta.
- Death, although this is not common now that more women use insulin to control their blood sugar.
Risks for the mother include:
- Miscarriage.
- Kidney damage if creatinine levels are above 2.0 mg/dL.
- High blood pressure during pregnancy.
- Eye problems during pregnancy that may get better after the baby is born.
For more information, see the topics:
Your Information
Your choices are:
- Try to get pregnant now.
- Don't try to get pregnant now.
The decision whether to try to get pregnant when you have diabetes takes into account your personal feelings and the medical facts.
Deciding about pregnancy when you have diabetes Reasons to try to get pregnant now
Reasons to not try to get pregnant now
- Your blood sugar is in a near-normal range and has been for at least 3 months.
- You have talked to your doctor about what medicines are safe to use when you are trying to get pregnant.
- You have checked with your doctor, and you don't have any complications from diabetes.
- You have had another pregnancy, and you and your baby had no problems related to your diabetes, and you kept your blood sugar under control during the pregnancy.
Are there other reasons you might want to try to get pregnant now?
- Your blood sugar is not in a near-normal range.
- You haven't talked to your doctor about what medicines are safe to use when you are trying to get pregnant.
- You have complications from diabetes, and being pregnant may make these problems worse.
Are there other reasons you might not want to get pregnant now?
These personal stories may help you make your decision.
Wise Health Decision
Use this worksheet to help you make your decision. After completing it, you should have a better idea of how you feel about trying to get pregnant now. Discuss the worksheet with your doctor.
Circle the answer that best applies to you.
My blood sugar is under control. Yes No Unsure I have complications from diabetes. Yes No Unsure I have talked to my doctor about what medicines are safe to take. Yes No NA* In past pregnancies, I was able to keep my blood sugar under control. Yes No Unsure I am worried that my diabetes may cause health problems for my baby. Yes No Unsure I want to try to get pregnant now. I don't want to wait. Yes No Unsure I want to wait until my doctor says it is safe before I try to get pregnant. Yes No Unsure I want to get my blood sugar levels under control before I try to get pregnant. Yes No Unsure *NA=Not applicable
Use the following space to list any other important concerns you have about this decision.
What is your overall impression?
Your answers in the above worksheet are meant to give you a general idea of where you stand on this decision. You may have one overriding reason to try or not try to get pregnant now.
Check the box below that represents your overall impression about your decision.
Leaning toward trying to get pregnant now
Leaning toward NOT trying to get pregnant now
Return to the topics:
| Author: | Merrill Hayden | Last Updated: February 5, 2008 |
| Medical Review: | Caroline S. Rhoads, MD - Internal Medicine Kirtly Jones, MD - Obstetrics and Gynecology | |
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