This past Saturday marked my 23rd week of pregnancy and so far I have had too many doctors appointments to count! They are quickly becoming my new best friends. I knew that having Type 1 diabetes would mean more doctor visits than the “normal” pregnant woman but I had no idea what all it would entail.
Once I got the positive test result around week 4, I immediately called my Certified Diabetes Educator (CDE) and started working with her to get my blood sugars where they needed to be for growing a healthy baby (I knew I had been slacking a little bit leading up to the positive result). After that, I had my first appointment with my regular OB-GYN at week 7 to confirm the pregnancy. During this appointment, I had my first ultrasound (well first for baby, I’ve had several others for health reasons) and it was so amazing to hear the heartbeat. The doctor also took blood work and it included a lot of blood. I get blood work every three months for my diabetes so I am used to having blood drawn, but I was not prepared for how much they were going to take.
Following the confirmation that I was indeed pregnant, I was off to see my endocrinologist, where I learned my A1C was 6.8, a little higher than it should have been for being pregnant but my doctor seemed happy with the result. I started to upload my continuous glucose monitor (CGM) data every week and emailing my CDE to review my blood sugars. There was a lot of excitement those first few weeks but it was only a foreshadowing of what was to come.
At week 12, I saw the high risk OB-GYN or perinatologist for the first time (because of my diabetes), which included another ultrasound. This time my baby actually looked human! I had no idea that the image could be that clear or that the baby would be that human looking in just a few short weeks! One perk to going to the perinatologist is that they always give me a 4-D ultrasound picture to take home. The week 12 4-D ultrasound picture just looked kind of scary though. During this appointment, they checked the nuchal translucency, which is fluid beneath the neck, to check for Down’s syndrome. They also checked for other chromosomal issues with blood work, which consisted of a finger prick to fill five large circles on a piece of paper. I test my blood sugar at least 10 times per day so I thought this would be no big deal but they took a LOT of blood out of one finger prick; it actually made me a little faint. The trip to the high-risk OB also included a counseling session with the genetic counselor. My husband and I spent around an hour and half with her going over our complete family history. It was a very thorough evaluation.
After the high-risk visit, I saw my regular OB and everything seemed to be going okay. A week later I had another endocrinologist appointment (no blood work this time). At week 16, I saw the regular OB again and the following week was another endocrinologist appointment. These visits are fairly routine. For the regular OB, I get my urine tested and my blood pressure checked and we listen to the baby’s heartbeat and she answers any questions that I might have. At the endocrinologist visit, the doctor reviews my blood sugars and makes slight tweaks but overall my CDE has been handling my week-to-week changes. I get my A1C checked every two months, although insurance only covers every three months but I requested to have it done more. Week 16’s visit included blood work, where I learned my A1C had improved from 6.8 to 6.2. I had another OB appointment at week 20 and I also had two more endocrinologist visits, one last week where I learned my A1C was improved further to 5.5. I couldn’t believe it was that low!
The most exciting week so far was week 20 when I went back to the perinatologist. At this appointment my husband and I found out that we are having a BOY, much to my husband’s delight! We got another ultrasound done, where the doctor checked organ functions like the heart. It was really cool to see the blood flowing in and out of the baby’s heart. He also measured the amniotic fluid, the head circumference and limbs and so far everything seems okay. The 4-D ultrasound picture was much more clear this time and it was so cool to see my son’s cute little nose!
Also during these first 23 weeks, I went to the dentist and the eye doctor. Pregnancy can cause some women to become more susceptible to gum disease and with diabetes already increasing those odds, I thought it was important to make the visit. I have heard that a lot of insurance companies will allow a pregnant woman to go more than twice per year to the dentist when they are pregnant. Pregnancy, especially in diabetic women, can also cause changes to the eyes. On the advice of my endocrinologist, I scheduled my eye doctor visit before a full year had passed since my last visit. Both visits went well, no cavities and no changes to my eyes. One thing to note is that when you are pregnant, you cannot get your eyes dilated so it’s not as thorough a diabetic exam as usual (I did not know this prior to the visit).
On Friday, I have my next perinatologist appointment followed by my regular OB appointment next Wednesday. The week after I will have another endocrinologist appointment. I haven't received a ton of information on the exact tests they are running or what specifically they are looking for at each appointment, but so far every doctor has told me that everything is "fine" so hopefully that remains the case the remainder of the pregnancy.
I have asked my doctors what I can expect for the rest of my pregnancy and I’ll admit, it’s a little overwhelming. I will see the perinatologist at week 24 (Friday), week 28 and week 32 then I go to weekly appointments at week 33, 34 and so forth until I deliver. For my regular OB, I will maintain the same schedule but starting at week 32, I’ll be going twice a week for non-stress tests on the baby. Luckily, my endocrinologist is the only doctor whose schedule won’t change; I’ll keep seeing her once a month until delivery then hopefully I can go back to once every three months. I’m also still checking in every week with the CDE and I expect I will be relying on her a lot in the future weeks as my insulin resistance kicks in.
I have heard from some other Type 1 friends that are pregnant that they have had the doctor visits streamlined so instead of seeing a separate high risk OB, regular OB and endocrinologist, their high risk OB takes care of everything. I wasn’t so lucky to fall into that ship, but even though all of the doctor appointments can be overwhelming, knowing its all to make sure everything is going smoothly for my son makes it all worth it. I can’t believe I’ll get to meet him in less than 16 weeks!