Years ago, women with diabetes were discouraged from becoming pregnant because there were too many risks involved. Today, however, women with type 1 diabetes or type 2 diabetes are almost as likely to have a healthy baby as women without diabetes.

Having diabetes does pose certain risks during pregnancy, such as a greater chance of miscarriage, stillbirth and birth defects. It can also worsen some diabetic complications in expectant mothers, such as high blood pressure and eye disease. However, these risks can be greatly reduced through monitoring and control of glucose (blood sugar).

Because of the risks associated with diabetes and pregnancy, women with diabetes who would like to become pregnant should first have a complete physical examination to help identify any complications that may jeopardize the health of the mother or baby. Women with diabetes should also receive preconception counseling and care to learn about the general risks of pregnancy and the specific risks associated with diabetes.

Most diabetic complications of pregnancy can be prevented by achieving and maintaining near-normal glucose levels. This can typically be achieved through:

• Proper diet
• Regular exercise
• Control of insulin (a hormone that regulates glucose)
• Watching for signs of dangerous fluctuations in glucose

Because of the level of care required for the mother and baby during and after delivery, home births are not generally recommended for women with diabetes. Diabetic women can generally deliver vaginally providing that glucose levels are normal, that there are no complications and that the baby is not oversized. Otherwise a Caesarean delivery (C-section) may become necessary. Regardless of whether the baby is delivered vaginally or through C-section, glucose is carefully monitored during labor, and most women with good glucose control during pregnancy have a healthy baby.

The relationship between the new mother and the medical team does not end with birth. Many new mothers with diabetes experience glucose swings after delivery. They may rely on their medical team for care and advice about how to predict bodily changes, especially if they are breastfeeding their infant.

Many women with diabetes can nurse successfully. However, those who take certain medications should speak with their physician before nursing because many over-the-counter and prescription drugs, including some diabetes medications, can pass into breast milk in varying quantities. It is important for nursing mothers with diabetes to continue to monitor their glucose because they may develop hypoglycemia, which can harm mother and baby.

Diabetes increases the risk that a pregnant woman will develop preeclampsia, a condition involving high blood pressure and excess protein in the urine. In addition, nondiabetic women can develop temporary pregnancy-induced diabetes, which is known as gestational diabetes.