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Getting ready for pregnancy
The best time to start getting ready for pregnancy is as soon as you start thinking about a baby!
Getting the right information and advice before you fall pregnant can give you the best possible start for a healthy pregnancy. It’s a good idea to make an appointment with your diabetes health professionals or GP as soon as you start thinking about a baby. Talk to your health professionals about:
Using effective contraception is important until you are ready to start trying for a baby. There are a number of different options for women with diabetes, all with pros and cons. Talk to your doctor about the best contraception suited to your needs.
Pregnancy health checks
Before falling pregnant there are some general health checks that all women need. Your GP can advise you about blood tests, vaccinations and nutrient supplements needed before pregnancy.
Diabetes in pregnancy specialists
When planning a pregnancy, women with diabetes can benefit from the support of a team of health professionals, with expertise in managing diabetes in pregnancy. This includes specialist doctors and diabetes health professionals. If you’re not already seeing these health professionals, ask your GP for a referral. If you live in a regional area, ask your GP about Telehealth or shared care with a major hospital.
Your diabetes health professionals can help you with managing your diabetes to prepare for pregnancy. Make an appointment three to six months before you start trying for a baby.
Blood glucose levels
Blood glucose levels in the target range before you fall pregnant and during the early stages of pregnancy reduce the risk of health problems for mother and baby. Before you start trying for a baby aim for an HbA1c of less than 7% (53mmol/mol) if you have type 1 diabetes and 6% (42mmol/mol) or less if you have type 2 diabetes. Discuss your individual blood glucose targets with your diabetes health professionals and how you can reduce your risk of hypos.
Not all medications have been shown to be safe to use during pregnancy. Ask your doctor to check all the medications you are currently taking to see if they are safe to use.
Folic acid (folate)
Folic acid can help reduce the risk of certain birth defects. Women with diabetes are recommended to have a higher dose of folic acid than women without diabetes. Start taking high dose folic acid at least one month before falling pregnant. Your doctor will recommend you take half to one 5mg tablet, depending on other supplements you are taking.
Diabetes complications can increase the risk of other health problems during pregnancy. Before you fall pregnant, you need to have a full complications screening (eyes, kidneys, nerves) and have your blood pressure checked.
Being in the healthy weight range before pregnancy can reduce your risk of health problems during pregnancy. Eating well and being physically active can help you manage your weight. An accredited practising dietitian (APD) can help you with managing your weight to prepare for pregnancy.
Many women worry about their chances of falling pregnant and whether diabetes will have any effects on their fertility.
The good news is—if you are in good health and your diabetes is well managed, your chance of falling pregnant should not be any different from that of a woman without diabetes.
There are however other factors that affect fertility such as having polycystic ovarian syndrome (PCOS), being overweight and your age. Talk to your doctor about any concerns you have about your fertility.
To find out more about factors affecting fertility for all women go to yourfertility.org.au.
Why is my HbA1c before pregnancy so important?
The first eight weeks of pregnancy is the time when a baby’s major organs develop, and often before women even realise they are pregnant. High blood glucose levels at this time can increase the risk of miscarriage and health problems for the developing baby. For this reason it’s important for your blood glucose levels to be as close to target as possible before you fall pregnant and during the first part of your pregnancy.
Research has shown that if you manage your blood glucose levels well at this time, it will help lower these risks.