Navigating Diabetic Pregnancy without an Endocrinologist: Know Your Hospital Policy

Amylia Grace Yeaman Health Guide
  • Despite all my OB appointments, I have had no appointments with my endocrinologist, and will not have any until after baby is born. I bring this up because it is a policy I was unfamiliar (and unhappy) with when I discovered this is how the high risk OB clinic handles their type 1 diabetic mommies. If you’re considering pregnancy, I urge you to find out your clinic’s stance on this prior to becoming pregnant.


    Personally, I believe I am the expert on my own body and my own experience of this diabetic pregnancy should be an important piece of the puzzle when figuring out care. While I need and desire help and assistance, I feel like my experiences should be heard more instead of being plugged in to some average or general guideline.  This is where the support of the diabetes online community (DOC) and online support groups have proved invaluable.

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    While my OB has been great and is a big advocate of baby and me, the diabetes nurse and high risk team here are rigid in their approach to me. Truth be told, were it not for this little peanut I want so very much to be perfect and healthy, I wouldn’t put up with what I perceive as a sometimes dismissive and condescending attitude.  That said, there’s only one major hospital in town equipped to handle what could be a complicated delivery and a high-risk pregnancy, so I’m limited (unless I want to move away from my husband and family for the 2 ½ to three months and deliver elsewhere, which is not something I wish to do). It’s not a great feeling, and it’s caused me stress and unhappiness throughout my pregnancy, but I’m finally accepting this is where I am and trying harder to work with the team I’ve got in the best interest of baby girl.


    Being able to see my endo is something I fought for, but ultimately lost due to hospital politics. At the hospital where I’m delivering, they believe the diabetes nurse and high risk OB team should handle everything baby and I need throughout the pregnancy, claiming they have different guidelines for bloodsugars, etc (60-95 mg/dl at all times whenever possible) than endos and are the only ones handling diabetic pregnant women. My current endocrinologist is no slouch, but I’m not allowed to see him until post-pregnancy. My former endo in WI specialized in type 1 pregnancies, and I sure wish I could transport her to Iowa for my pregnancy, but I can’t and am not going to change the minds of the powers-that-be (despite my protestations), so I go without endo support throughout the pregnancy.


    That said, I am not without support from the diabetes nurse and high risk team, particularly the diabetes nurse who is in charge of dealing with all the type 1 pregnant mommies.  She/they do want what is best for baby, and think they know what that is. That notion is a bone of contention right now because I have my own experiences and opinions about what is best for me and baby and those experiences and opinions doesn’t always mesh with what they perceive to be best (based on their cumulative years of experience dealing with many diabetic pregnant women).


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    I believe these relationships work best when both parties listen to one another, validate each other’s experiences, and keep open minds. I find that hard to do when I feel as though I’m not being heard. I tend to go into defiant mode and want to ignore their chatter and follow what I believe to be the best course of action for me. Since pregnancy is a new experience for me, I know I am not an expert on pregnancy and much of what I knew before has gone out the window with this pregnancy. Still, I know myself and my body, as wonky as it is, and the ups and downs, highs and lows, ebbs and flows of daily life as a pregnant diabetic mother should be heard and considered when drawing up changes to insulin adjustment, basal rates, timelines, etc.


    I certainly understand that most realistically well-controlled diabetics have healthy babies –my own twin sister navigated three pregnancies as a type 1 diabetic with grace and dedication, but I still worried. I know that a high or low bloodsugar isn’t going to hurt baby, and that it’s the long-term trends/effect of my bloodsugars on baby that are of primary concern, but it’s not easy to see a 263 mg/dl without feeling bad about myself.


    This is my first baby, and I’m experiencing all this while dealing with raging hormones and the sometimes uncontrollable emotions that can overtake me, courtesy of this pregnancy. This could very well be my only baby, and frankly, I just don’t know how to tell myself everything is going to be okay, and then to really believe that beyond a shadow of a doubt.


    I’ll believe it when I see it—see her—my precious baby girl here and breathing on her own and safely delivered into my arms at the end of all this. In the meantime, I remind myself to be gentle with myself and to take it moment by moment and soon, the big moment Daddy and I have been waiting for will be here and our lives will be forever changed the presence of our sweet baby girl. I. Can’t. Wait.


    Until then, I gain great support from drawing on the diabetes online community, reading positive brith stories, and really listening to my body and taking being loving and kind to myself and this amazing life growing inside me as much as possible. I try to keep it simple and as routine as possible (food wise, activity wise, schedule wise) and find sticking close to home and simplifiying my life has helped me regain some semblance of control and peace of mind as I enter the home stretch of this difficult and amazing journey to motherhood. Thanks for coming along with me.

Published On: August 08, 2013