Pregnancy for British women with diabetes is fraught due to lack of support

by Barbara Hewitt on October 13, 2017

Pregnancy is fraught with difficulties and concerns for women with diabetes with only a small number getting all three recommended health checks before they become pregnant.

The situation is so bad that British charity Diabetes UK is calling for an urgent, joined-up approach to drastically improve preconception, maternity and antenatal services for women living with diabetes following the publication of a new audit.

(Ivanko80/Bigstock.com

The National Pregnancy Diabetes Audit published by NHS Digital shows that stillbirth rates for diabetic women are more than twice those of general population, and neonatal deaths more than four times.

It also reveals that only one in 12 women get all three key recommended pre-pregnancy health measures and nearly half of babies born to women with type 1 diabetes, and nearly a quarter born to women with type 2 diabetes, were larger than gestational age.

Diabetes UK says that the audit, which looked at 3,356 pregnancies in 3,297 women across 172 antenatal diabetes services, shows that services are failing to provide these women with the essential support they need before and during pregnancy.

A key issue highlighted by the report was that few women living with diabetes are well prepared for pregnancy. To support a healthy pregnancy, it is recommended that women keep control of their blood sugar, aiming for a safe HbA1c level of below 48mmol/mol, take a high-dose supplement of folic acid of five milligrams a day and review any medication they’re taking to ensure it’s safe during pregnancy.

‘This audit reveals the unacceptable reality that, for too many women living with type 1 or type 2 diabetes, pregnancy remains fraught with unnecessary difficulties for both mother and baby. The clear reason for this is that women, for a number of reasons, are not getting the support they need before and during their pregnancies,’ said Douglas Twenefour, Diabetes UK’s deputy head of care.

‘Diabetes UK wants to see urgent action on this issue. The steps women can take before getting pregnant are clear, but the audit suggests there are still variations in the level of care across services and that far too many of them are simply not aware of what they can do to protect themselves and their babies,’ he pointed out.

He explained that Diabetes UK recommends that all women with diabetes receive individualised support to plan carefully for their preconception and pregnancy. ‘It is vital for all women with diabetes who discover they are pregnant to make immediate contact with an antenatal team in order to receive the best possible care. Women with unplanned pregnancies will be particularly in urgent need of this immediate care and support, as they may be taking medications that could potentially harm their unborn baby,’ he added.

The charity is calling on all services across public health, primary care, specialist diabetes and maternity to jointly take ownership of women’s health before and during pregnancy. ‘Without a joined-up approach, we will continue to see the harrowing results revealed by this audit. Things need to change, and urgently,’ said Twenefour.

One woman gave an insight into her experience. Sarah’s control of her diabetes wasn’t as good as it should’ve been when she started trying for a baby. Although she was seeing her GP for check-ups, she wasn’t fully aware of the risks and was pregnant before she realised how serious it could be.

‘I then read up on what effects diabetes can have on pregnancy and I felt quite irresponsible for not having taken better care of my sugar levels before. I wanted this baby so much but was really worried that I would have a miscarriage. My pregnancy was without doubt the hardest thing I’ve ever done, but worth every minute to have baby James safe in my arms,’ she said.


The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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