Pregnancy and type 1 diabetes in 2020

Friday, 27 November 2020

Ashleigh, married to Hugh Riccardo since 2012, is a long-time volunteer at diabetes events, a full-time Patient Support Group Co-ordinator at the Cancer Council, and now a loving mother to Adeline Matilda, six weeks old.

“I’ve never known love like this before,” Ashleigh said. “I said to my husband, ‘I’d have to save her first,’ and that’s what I hope he feels, too.

“All the worry and concern that some things are out of your control were worth it. I can’t believe we’ve got Adeline.”

Ashleigh said the only time she has seen her husband cry in their 10 years together was when she was diagnosed with type 1 diabetes in 2012.

“I was working for an endocrinologist and I saw the list of a patient’s symptoms: Weight loss, frequent urination, thirst, tiredness. I said ‘I’ve got those symptoms!’ so I saw my GP. It was confirmed I had type 1 and I was taken to hospital to be stabilised,” Ashleigh said.

“That endo is still my specialist. She’s just a brilliant person.”

Strong management

Ashleigh has worked very hard to be on top of her condition and says she hasn’t had anything “really wrong” since diagnosis.

Maybe her determination and good health helped Hugh and Ashleigh when deciding if the time was right for a baby.

“When I turned 30 we both thought it was right, but I’d just started a new job that I loved so we decided to wait until this year,” Ashleigh said.

What a year to have a baby!

But COVID-19 seemed like nothing more than background noise during Ashleigh’s pregnancy.

“As soon as I got pregnant, I found the responsibility overwhelming. Every decision I made impacted her. If my blood glucose levels were high, I worried about her development. If they were low, I worried about her development.

“I was told over and over again horrible stories of what happened to some women with diabetes when they were pregnant. I had to stop listening.”

Factors you can control

Ashleigh, who has a maternal cousin with type 1, said she focused on the factors she could control such as her diet, BGLs – and her choice of medical attendants.

“From the time I started my antenatal appointments at the hospital, I was warned that women with diabetes had big babies but I could avoid it if I ate well and kept my BGLs under control.

“I was very good and still the scans showed she was a big baby. I felt like such a failure.

“Then, as soon as it was confirmed my baby was large, everyone changed their song sheet. It went from being something I could control to something that just happens when you have diabetes.

“What was it? The initial advice caused me a lot of upset and guilt.”

Change in endo

Ashleigh also requested a change from the first endocrinologist she was assigned at the hospital.

“She did not listen to me,” Ashleigh explained.

“She kept focussing on my low BGLs and wanting to treat them. I told her I was only having the lows because I was over-treating the highs, which were worrying me. The lows were a direct result of my intervention but that’s still all she focused on.

“After one phone call when she said I probably wasn’t doing anything she’d asked of me, (when I was doing everything she’d told me to do), I came out and said ‘I’m not seeing that endo again’.

“I needed to be listened to.”

Ashleigh was transferred to another female endocrinologist, this time one who also lives with type 1 diabetes, and finished her pregnancy with a health team she trusted and could communicate with.

Pushing for a natural birth

Ashleigh and her husband prefer not the discuss the baby’s birth weight but Adeline was born healthy at 37 weeks after an induced 36-hour labour.

“From the time I was young, I’ve always wanted to experience childbirth. It was important to me that I gave it my best shot to have a vaginal delivery.

“I prepared a detailed birth plan to maximise my chance. It included things like not being checked too often at the early stages to make sure my labour was progressing.

“Sometimes if it’s not happening as quickly as people think it should they can try to influence you to have a caesarean. It’s a vulnerable time.

“One of the women I do a podcast with had told me about her experience of that happening so I wrote it in my birth plan to minimise those checks.

“The midwife said after it was only because of my detailed birth plan that I was allowed to progress to a normal delivery.

“They don’t usually allow induced labours to last as long as mine did, but I had one hour of pushing when the time was right and she was born when she wanted to be.

“It was the most rewarding and wonderful moment of my life.”

Need for positive information

Ashleigh credits a private Facebook group called “Bump, baby and beyond” for providing interactive help and advice, and especially for featuring the many stories of healthy babies being delivered to women with type 1.

“There are always going to be confronting stories about diabetes. This group made a big difference to me in that there were lots of stories about healthy babies. You need to have some real-life positive input too.”

In the same vein, Ashleigh realised there weren’t any podcasts available for women with type 1 solely focussing on pregnancy.

Mamabetes is born too

She and two friends set up in a bedroom with a little help from our Diabetes Support Group grant, recorded it on Zoom and then used the audio for the podcast. Mamabetes was born, and is now available on most major podcast providers.

Carleigh Eastlake has two kids, Rachel Hicks has one, and Ashleigh was the pregnant woman for the Mamabetes podcasts, specifically for women with type 1 diabetes. Their first season of 30 episodes covered every conceivable (!) topic from planning pregnancy through the three trimesters.

“We just retreated into the bedroom, closed the door and hoped for the best. It worked out OK,” Ashleigh said.

Series two will focus on birth.

Ashleigh will focus on Adeline. She is not going to spend any time worrying about passing on diabetes to her daughter because the risk is so small and she has no control over it.

Now is the time for joy and accomplishment.

“I know it sounds strange but if you’ve got type 1 and you’ve had a successful pregnancy, you feel that more accomplished. I had a healthy baby AND I managed type 1 diabetes.

“I can’t believe how strong we are.”

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