If you become pregnant and you have diabetes, you should go on to have a healthy baby. But there are some possible complications you should be aware of.
If you have type 1 or type 2 diabetes, you may be at higher risk of having:
- a large baby – which increases the risk of a difficult birth, having your labour induced or needing a caesarean section
- a miscarriage.
Your baby may be at higher risk of:
- having health problems shortly after birth, such as heart and breathing problems, and needing hospital care
- developing obesity or diabetes later in life.
There's also a slightly higher chance of your baby being born with birth defects, particularly heart and nervous system abnormalities, or being stillborn or dying soon after birth.
But managing your diabetes well, before and during your pregnancy, will help to reduce these risks.
The best way to reduce the risks to you and your baby is to ensure your diabetes is well controlled before you become pregnant. So, ideally, a pregnancy should be planned.
Before you start trying for a baby, ask your GP or diabetes specialist for advice. You should be referred to a diabetic pre-conception clinic for support.
Read more about managing your diabetes during pregnancy
If you're taking anti-epileptic drugs (AEDs) and you're planning to get pregnant, you should continue to use contraception and take your medicine until you discuss your plans with a GP or epilepsy specialist (neurologist).
This is because your doctor may want to make changes to the dose or type of medicine you are taking, which is best done before you become pregnant.
You should also be offered pre-conception counselling, which will help you understand any risks and plan for a healthy pregnancy and baby.
It's difficult to predict how pregnancy will affect epilepsy. Your epilepsy may be unaffected, or you may see an improvement in your condition.
However, as pregnancy can cause physical and emotional stress, as well as increased tiredness, your seizures may become more frequent. If this happens to you, let your doctor, midwife or neurologist know.
Risks from epilepsy medicines
Research has shown that there is an increased risk of your child not developing normally if you take some types of AED during pregnancy, including:
- sodium valproate
- valproic acid
- carbamazepine
- phenobarbital
- phenytoin
- topiramate
Find out more about managing epilepsy during your pregnancy
Being obese when you're pregnant increases the chance of some complications such as gestational diabetes. Make sure you go to all your antenatal appointments so your pregnancy team can monitor the health of you and your baby.
Being overweight increases the chance of complications for you and your baby. The higher your BMI, the higher the chance of complications. The increasing chances are in relation to:
- miscarriage
- gestational diabetes
- high blood pressure and pre-eclampsia
- blood clots
- the baby's shoulder becoming "stuck" during labour (The Royal College of Obstetricians and Gynaecologists has more information about shoulder dystocia)
- heavier bleeding than normal after the birth
You are also more likely to need an instrumental delivery (forceps or ventouse), or an emergency caesarean section.
The best way to protect you and your baby’s health is to go to all your antenatal appointments. This is so your midwife, doctor and any other health professionals can help with any problems you might face and take steps to prevent or manage them.
If you were born with a heart problem and you're planning to have a baby, talk to your cardiologist before you get pregnant.
If you were treated for congenital heart disease as a baby or a child, you may not have seen a heart specialist for many years. So getting regular checks if you're planning a pregnancy, or are pregnant, is important.
If you do not have a cardiologist, ask a GP to refer you to one.
Your doctor can talk with you about:
- any medicine you're taking and whether this may need adjusting in pregnancy
- how your heart condition might affect your pregnancy
- how pregnancy might affect your heart condition
Do not stop taking your medicine until you've talked with your doctor.
Your congenital heart disease can affect your baby. Your baby may be smaller if your heart does not pump as efficiently as it should and delivers less oxygen and nutrients to the placenta and your developing baby.
Babies may be born prematurely. You'll be offered regular scans during pregnancy to ensure that your baby is growing normally and healthily.
Depending on the type of congenital heart disease you have, there's a chance that your baby could inherit the condition. For example, if you have Marfan syndrome there's a 1 in 2 chance your baby could inherit the condition.
NHS Choices has more information about managing your heart condition during pregnancy and what it might mean for your baby.
Most women with Crohn's or Colitis will have normal pregnancies and healthy babies. However some research has linked Crohn's and Colitis with an increased risk of early (preterm) birth, babies with a low birth weight and, more rarely, miscarriages. How active your disease is may play an important part in these risks.
During pregnancy, you will receive antenatal care that will include scans and checks to make sure you and your baby are as well as possible. Your IBD team and antenatal team should work together to make sure you receive the best care.
If fibroids are present during pregnancy, it can sometimes lead to problems with the development of the baby or difficulties during labour.
Women with fibroids may experience tummy (abdominal) pain during pregnancy, and there's a risk of premature labour.
If large fibroids block the vagina, a caesarean section (where the baby is delivered through a cut in the tummy and womb) may be necessary.
In rare cases, fibroids can cause miscarriage (the loss of pregnancy during the first 23 weeks).
Your GP or midwife will be able to give you further information and advice if you have fibroids and are pregnant.
Most women with systemic lupus erythematosus (SLE) have successful pregnancies. But being pregnant with lupus means that you may be more likely to develop complications in pregnancy than the average healthy woman.
These complications are most likely if your condition is active or not well controlled when you get pregnant. This is why it’s important to get specialist help before you start trying to get pregnant. This is called pre-pregnancy counselling. By making sure your condition is under control before you get pregnant (and during your pregnancy), you can reduce the risk of complications.
Do not to stop taking medication before talking to a doctor or specialist. They will go through the safest options for you and baby with you, so you can make an informed decision about your care.
Having lupus in pregnancy can increase the risk of:
- pre-eclampsia
- thrombosis
- infections
- miscarriage
- stillbirth
- foetal growth restriction (small babies)
- your baby being born with a form of lupus.
Your healthcare team will monitor you and your baby closely throughout your pregnancy.
If you have or had a mental health problem in the past and you’re planning to have a baby, you should talk to your doctor before you become pregnant. Most women with mental health problems have healthy babies with the right treatment and care, but it is important to talk to your doctor or specialist early.
Pregnancy and having a baby can be an exciting and demanding time for women. If you have a mental health condition it brings extra challenges and you are at higher risk of relapse during this time than at others.
Tommy’s Charity has expert advice on how to manage your condition, and the support available to you.
High blood pressure, or hypertension, does not usually make you feel unwell, but it can sometimes be serious in pregnancy.
Your midwife will check your blood pressure at all your antenatal (pregnancy) appointments.
If you are pregnant and have a history of high blood pressure, you should be referred to a specialist in hypertension and pregnancy to discuss the risks and benefits of treatment.
If you develop high blood pressure for the first time in pregnancy, you will be assessed in a hospital by a healthcare professional, usually a midwife, who is trained in caring for raised blood pressure in pregnancy.
If you're already taking medicine to lower your blood pressure and want to try for a baby, talk to your GP or specialist first. They may want to switch you to a different medicine before you get pregnant.
If you find out you're already pregnant, tell your doctor immediately. They may need to change your medicine as soon as possible.
This is because some medicines that treat high blood pressure may not be safe to take when you're pregnant. They can reduce the blood flow to the placenta and your baby, or affect your baby in other ways.
Read more about managing your blood pressure and the care you will receive.
HIV is a type of virus called a retrovirus that prevents the body’s immune system from working properly and makes it hard to fight off infections. If you have the virus, this is known as being HIV positive.
The virus can be passed from one person to another through the exchange of body fluids including blood, semen, vaginal fluids and breast milk.
You can pass the virus on to your baby through the placenta while you are pregnant, during the birth and through your breast milk. The care you will receive aims to reduce the risk of passing HIV on to your baby.
You will be offered specialist care and regular health checks. You should be cared for by a team of specialists that includes:
- a doctor who specialises in HIV
- an obstetrician (a doctor who specialises in the care of pregnant women)
- a specialist midwife
- a paediatrician (a doctor who specialises in children’s health).
You and your baby will be monitored during your pregnancy, and this may include extra ultrasound scans. The amount of virus (viral load) and antibodies to HIV (CD4) in your blood will be monitored, as will drug levels if you are on treatment.
You can greatly reduce the risk of passing on HIV to your baby if you:
- have treatment with anti-retroviral drugs (see below)
- avoid breastfeeding and choose to bottle-feed your baby with formula milk
- have a caesarean section if your specialist team recommends it.
If you already know you have hepatitis b, or your antenatal blood test shows you have hepatitis B, you should be referred to a specialist doctor or midwife. They will talk to you about further tests and treatment.
You will be offered tests that check the level of hepatitis B virus in your blood. The level of hepatitis B is called the viral load. If your viral load is high, you may be offered treatment with a medication called tenofovir (Viread) to reduce the risk of passing the disease on to your baby.
Treatment may start in the third trimester of your pregnancy, depending on how high your viral load is. Treatment should continue for four weeks to 12 weeks after you give birth. If your viral load is lower, it’s likely that your doctor won’t advise you to start treatment at this time, unless you have liver disease.
There are many different medications for hepatitis B, and some are known or thought to be unsafe during pregnancy. For this reason, if you already know you have hepatitis B, it’s a good idea to talk to your doctor before trying for a baby. If you’re already having treatment when you become pregnant, make sure you tell your doctor in case they need to change your medication.
Find out more about hepatitis b and managing your symptoms
