Pregnancy Program
For women with diabetes, it is important to lay the groundwork for a safe pregnancy well before getting pregnant. The best chance for a healthy baby is if your blood glucose levels are as close to normal as possible before trying to conceive. This is because critical organ development occurs in the first few weeks of pregnancy—before most women even know they are pregnant.
Although the babies of women with type 1 diabetes or type 2 diabetes have a slightly higher risk of birth defects, the vast majority are born perfectly healthy nowadays. It just takes extra attention. That means more frequent blood glucose monitoring, insulin adjustments and medical visits.
Sometimes diabetes is diagnosed during the course of a pregnancy. For a healthy baby, women with “gestational diabetes” need to learn to manage blood glucose, usually through diet and exercise. Sometimes insulin is required for the remainder of the pregnancy. Blood glucose levels of women with gestational diabetes usually return to normal after delivery of the baby. Women who have had gestational diabetes are at risk for developing type 2 diabetes, however, especially if they are overweight.
A Healthy Mother and Baby
The Pregnancy Clinic is a collaborative effort of Joslin Clinic’s medical staff and the high-risk maternal-fetal medicine specialists at Beth Israel Deaconess Medical Center.
Joslin’s healthcare team—which includes physicians, nurse educators, dietitians and other diabetes specialists—provides the diabetes treatment. Maternal-fetal medicine specialists from Beth Israel Deaconess, who are skilled in high-risk pregnancies, provide the obstetrical (pregnancy and childbirth) care.
Joslin's Pregnancy Clinic staff are happy to coordinate care with your own high-risk obstetrician, if this is preferred.
The Joslin team services include:
- Instruction about home blood glucose monitoring and insulin adjustments.
- Nutrition counseling and meal planning.
- Instruction in intensive diabetes therapy.
- Information about managing diabetes when experiencing morning sickness and other difficulties.
- Eye, kidney and other tests to monitor the effects of pregnancy on organ systems related to diabetes. Referrals to specialists are made when appropriate.
- Support services, including those of a psychologist and licensed social worker.
When to Come to the Clinic
Women with diabetes should make an appointment with the Pregnancy Clinic’s nurse educator before becoming pregnant to get their diabetes under good control.
When pregnant, women come to the Pregnancy Clinic on a regular basis for diabetes care. Appointments are every one to four weeks, depending on the level of diabetes control and the presence of complications.
Usually the obstetrician sees patients about once a month during the first two trimesters (the first six months) and weekly in the third trimester (the last three months). Fetal heart monitoring is usually done once a week starting about the 30th week of pregnancy and at least twice weekly starting the 36th week.
Contact
For an appointment or more information, call 617-732-2496.
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