Family Planning: Diabetes Edition

When are you having a baby?

Asking this question, while never actually being an appropriate question to ask anyone, can bring up a lot of different emotions, especially for someone with a chronic health condition that is greatly impacted by pregnancy, like diabetes. 

Approximately 14.9 million or 1 in 9 birthing people have diabetes in the Unites States (1). Diabetes is a chronic medical condition caused by high levels of blood sugar (glucose) in your body. Someone who has diabetes has to check their glucose levels multiple times per day and depending on the type of diabetes they have, take pills or insulin to assist with managing their blood sugar levels. In addition to medication management, people who have diabetes also have to learn how to count carbohydrates, be mindful about what and when they eat, move their body and manage stress levels, which all impact blood sugar levels. 

Having diabetes on its own is stressful, but once you decide to add family planning to the mix, anxiety levels increase. Birthing people who have diabetes, are at risk of having a baby born with birth defects, have an extra large baby that requires c-section delivery, high blood pressure (preeclampsia), preterm birth, miscarriage or still birth (2). This pregnancy complication information, along with comments from medical providers such as “don’t get pregnant without planning, your life will be at risk” can make someone with diabetes feel discouraged about starting the family planning process.

Unlike people without diabetes, birthing people with diabetes have additional people involved in their family planning process: specialty medical teams. This may include an endocrinologist (diabetes doctor) and diabetes educator/dietitian. More frequent visits with these providers may be required to discuss pregnancy, complete additional tests and make changes to medications/lifestyle prior to getting pregnant.

Family planning can feel overwhelming, but it’s not impossible. Birthing people with diabetes have babies every day. Take it one step at a time. Find medical providers that make you feel empowered and collaborate with you to manage your diabetes care. Once you become pregnant, you can work with a doula to help with advocating for your needs during the pregnancy and labor/delivery. Let your partner/family/friends/therapist support you during the process.

We know that having a chronic medical condition, like diabetes, can make family planning more complex. Just know that you are not alone. We see you, we hear you, we are you.

1. Britton LE, Hussey JM, Berry DC, Crandell JL, Brooks JL, Bryant AG. Contraceptive use among women with prediabetes and diabetes in a US national sample. J Midwifery Womens Health 2019;64:36–45

2. Center for Disease Control and Prevetion. https://www.cdc.gov/pregnancy/diabetes-types.html