If you have diabetes

There are two important things to remember if you have diabetes and you're considering pregnancy:

Most pregnant women with diabetes have healthy babies. There have been many strides made in managing this disorder in which the body doesn't produce enough insulin or doesn't use it properly.

You must see your doctor or health care provider months before conception. Your blood sugar levels need to be in good shape months before you become pregnant to reduce the risks to you and your baby.

Risks to the fetus

There is a direct relationship between stable blood sugar control and having a healthy baby. Women whose glucose levels (blood sugar) are poorly controlled are several times more likely to have a baby with a serious birth defect, such as a heart problem or a neural tube defect (problem with the brain or spinal cord). Other risks include:

Having a very large baby (10 pounds or more), increasing the incidence of a cesarean section
Having a baby with breathing difficulties, low blood sugar and jaundice
Having a baby who is at risk to become obese and develop diabetes as a teenager or young adult

If your blood sugar is high, you may be advised to wait to become pregnant until your levels are even lower than those usually considered within normal range. It may take weeks or months to get this kind of control and to keep it stable throughout the day.

Your doctor may recommend:

Monitoring your blood sugar levels more often. Urine tests are not a good way to monitor your blood sugar. Instead, use a blood glucose monitor for the most accurate results.
Increasing your folic acid intake. You may be asked to take more than the recommended 0.4 milligrams each day.
Changing your diet. You may be asked to eat different kinds of foods in different quantities than you have been eating. Not eating right can cause problems with your blood sugar levels.
Exercising to help achieve stable blood sugar control. Your health care provider will work with you to decide what type of exercise and how much you need.
Changing your prescription or over-the-counter medications.

Finding a healthcare team

Choose a doctor who is an expert in the care of people with diabetes and who has experience caring for pregnant women with the condition. The American Diabetes Association also recommends:

An obstetrician who is experienced with high-risk pregnancies, especially those involving diabetes
A perinatologist who specializes in the fetus before and immediately following its birth
A pediatrician (children's doctor) or neonatologist (newborn baby doctor) who knows and can treat special problems of babies with mothers who have diabetes
A registered dietitian who is experienced at developing meal plans as needs change throughout pregnancy
A diabetes educator who can help manage diabetes during pregnancy