Becoming a parent can be one of the most exciting times in your life. But it can be stressful as well. When the mum-to-be has diabetes, there are additional concerns and efforts needed to prepare for pregnancy and manage diabetes during pregnancy. For any couple, a supportive relationship from the start of the pregnancy is important. Every woman’s pregnancy will be different, but there are some things that you can keep in mind to support your partner along the way and help make the pregnancy more enjoyable and less stressful for you both. The following NDSS fact sheets are available to read online, or download and print out: understanding type 1 diabetes understanding type 2 diabetes pregnancy and diabetes. Support the hard work Pregnancy with diabetes requires planning and intensive day-to-day management—which can be hard work. Keeping blood glucose levels within target range can also be more challenging during pregnancy, and this can be frustrating for your partner. Your partner will appreciate if you acknowledge and gently encourage her in all her efforts to stay healthy. Offer practical support Work out together what practical support your partner needs and how you can best help. As a couple, you may have other children to care for, as well as work, family and a social life. You can support your partner by changing the way you manage these things. She may want to drop some social events, reduce her work hours or hand over some of the regular household duties. Family and friends can also help. Attend medical appointments together where possible Women with type 1 or type 2 diabetes will have frequent medical appointments to help ensure the health of both mum and baby. These may include appointments with a number of different health professionals such as an endocrinologist, diabetes educator, dietitian, obstetrician and midwife. It might be difficult to attend all appointments, but your partner may prefer you accompany her for some of these visits. It’s a good idea to attend appointments with her in the months before conceiving, in the first three to six months during pregnancy, and more, if possible, as you get closer to birth. This will help in having a shared experience of pregnancy and provide you with the opportunity to ask any questions you may have. It can also help with remembering the information and advice provided during appointments. Talk to your partner about the appointments she would particularly like you to attend together. Attending both obstetrician and diabetes health professional appointments can be helpful. Going to prenatal classes together can help you understand what to expect during labour and birth and some of the medical procedures such as inductions and caesarean section. Finding out as much as you can about pregnancy and diabetes from seminars, recommended books and websites can also help you in supporting your partner. Listen and talk often You may find that pregnancy with diabetes puts extra pressure on your relationship. But it may also bring you closer together and is an opportunity to learn more about each other. Talk regularly about how you both are feeling—the worries as well as the excitement. Ask your partner how you can support her along the way. You may have worries and fears of your own, so make sure you also have other supports you can call on when you need a listening ear. Remember, despite the increased risks, women with diabetes can have very healthy pregnancies and babies. Take time out It is a good idea to take time out as a couple when you prepare to become parents. Spending time together doing things you both enjoy can help take the focus off the daily demands of diabetes. Some couples find that being active together is a great way to take time out, with the added benefit of being good for health and emotional wellbeing. Some couples also like to book a ‘babymoon’ or a weekend away to spend some time together before the baby’s arrival and enjoy each other’s company. Avoid nagging Nagging your partner all the time can cause more stress than support. Your partner will appreciate you being supportive and encouraging of all her efforts to stay healthy. Talk about the kind of help, if any, she would like. Be aware of the signs of diabetes ‘burnout’ Keeping blood glucose levels within target range while planning for pregnancy can be exhausting, especially if it takes some time to fall pregnant. After this, there are another 9 months of intense work ahead, followed by the arrival of the baby. Diabetes management never stops, and the constant changes in her body are challenging. Some women go through ‘diabetes distress’ whereby they may feel overwhelmed by diabetes, believe they are ‘failing’, become frustrated by how unpredictable diabetes can be and guilty when things get ‘off track’. If not managed, this may lead to ‘diabetes burnout’ or feeling emotionally exhausted by the demands of their diabetes and being tempted to give up on taking care of their diabetes. This is a very important time to have the support and reassurance of understanding family and friends. If your partner is experiencing ‘distress’ or ‘burnout’ from her diabetes, it’s recommended that she seek the help of her diabetes in pregnancy team. If she needs additional emotional support, there are counselling services available. Her doctor or diabetes team can assist her with information about services available locally. Depression and anxiety can also occur more frequently during pregnancy and after the baby is born. Be aware of the signs of depression and anxiety and help your partner seek any support that she needs. Again, signs of depression and anxiety should not be ignored. The good news is that there are treatments available. Help with hypos Women with type 1 diabetes or those with type 2 diabetes taking insulin are at risk of what’s known as a ‘hypo’ (hypoglycaemia). This is when blood glucose levels fall too low (below 4mmol/L). During pregnancy, women may experience more hypos than usual, especially in early pregnancy. Some women also notice that their early warning signs for hypos (such as feeling shaky or sweaty) change when they’re pregnant. This means that hypos can happen without much or any warning, increasing the risk of a severe hypo (when a person with diabetes can’t treat the hypo themselves and needs help from someone else). If your partner has type 1 diabetes, it may be recommended that you or other family members attend an information session with a doctor or diabetes educator to explain when and how to use a glucagon injection (GlucaGen®). Glucagon can be used to reverse hypoglycaemia in someone who has lost consciousness due to a severe hypo. It helps the body to release glucose stored in the liver and raises blood glucose levels quickly. After the baby arrives Taking home a new baby is incredibly exciting, but this can also be a stressful time. This is a time when your partner will need your support, as well as that of family and friends. This may include practical help with the care of the baby and household tasks, as well as giving her some time out for rest and recovery. At this busy time, new mums often find it very hard to put their own health first and give their diabetes the attention it demands. Ask your partner how you can help. This might include preparing regular meals and snacks, providing reminders to check glucose levels or looking out for signs of hypoglycaemia (especially after breastfeeding). Remember too that depression and anxiety can also occur more often after the arrival of a new baby. Be aware of the signs of anxiety and depression and make sure that you or your partner seek the support that you need. Future pregnancies Remember that planning for pregnancy and well-managed diabetes before pregnancy can reduce the risk of health problems for mum and baby. So if you and your partner would like to have another baby, make sure you are using reliable contraception to avoid having another pregnancy before you are both ready. If, as a couple, you decide to not have any more children, you may want to consider more permanent contraception methods such as a vasectomy (for him) or tubal ligation (for her). There are also a number of very effective long-term but reversible contraception options. Talk to your partner and doctor about available options. The following additional information and support are also available: Dadvice—web-based information developed for new dads PANDA (Perinatal Anxiety and Depression Australia) on 1300 726 306 Beyond Blue Support Service on 1300 224 636 Acknowledgement: Thank you to the women living with diabetes and their partners who kindly reviewed the content of this page and to Helen Edwards for her contribution to this page.