Existing health conditions

Most people will have a smooth pregnancy and a healthy baby, but some health conditions need careful management to minimise the risk to you and your baby. 

If you have a long-term condition and plan on becoming pregnant, speak to your GP and/or specialist team about optimising your health BEFORE you conceive.  It is advisable you do this at least 3 months before you stop contraception.

Here at the Countess, we have a team of specialist doctors called obstetricians to support you, alongside your midwife, throughout a pregnancy. Obstetricians will work with specialist doctors, relevant to your existing health condition, in a multidisciplinary team to ensure the best outcomes for you and your baby.

Please see below to find out more about diabetes, high blood pressure, heart disease, and epilepsy in relation to planning a pregnancy

Diabetes

Although those with pre-existing diabetes can be at an increased risk during pregnancy and birth, the best way to reduce these risks is to ensure your diabetes is well controlled before you become pregnant.  It is important to remain on contraception until you and your health professional are confident that your diabetes and blood glucose levels are well controlled. Your average blood sugar level (called your Hba1c) may be measured monthly to check optimal blood sugar control whilst trying to conceive.

An Hba1c less than 43mmol/l is indicative of good control and is associated with better outcomes for both you and your baby.

An Hba1c more than 100mmol/l would indicate that it is better to wait to conceive until your levels are better controlled as a high HBa1c is associated with poorer outcomes for you and your baby.

It is advisable to have had an ophthalmic review (for retinal eye assessment) within 6 months of trying to conceive. Speak to your GP or specialist about this before trying for a baby.

It is also advisable to have had recent blood tests to check your kidney function and have had a review of your medication to ensure safety whilst trying to conceive. Your GP should also be able to prescribe you high dose folic acid 5mg for you to take prior to conception and throughout the first trimester of pregnancy.

To find out more about how to safely plan for a pregnancy with existing diabetes, click here: https://www.nhs.uk/conditions/type-1-diabetes/pregnancy-and-giving-birth/

High Blood Pressure (Hypertension)

If you have a history of high blood pressure (also called hypertension) you should seek support from your GP or specialist before getting pregnant. It is important that they have the opportunity to review you and optimise your blood pressure prior to conceiving.

If you take medication to control your blood pressure, this may need to be changed or adapted whilst trying to conceive and during your pregnancy. You should not stop taking your medication – speak to your GP who will advise you about this whilst you plan for a pregnancy. 

Those with high blood pressure problems can be at increased risk of developing other pregnancy induced conditions, such as pre-eclampsia https://www.nhs.uk/conditions/pre-eclampsia/

Heart Disease

Those with heart disease need specialist support in their pregnancy. For some, it might mean having your baby in a hospital with additional resources to care for you and keep you safe. If you have heart disease, you should visit your GP or heart specialist before stopping contraception and trying for a baby. They will be able to speak to you about:

• how your heart condition might impact on your pregnancy
• how your pregnancy might affect your heart condition
• your medication – including adapting your medication if required. Do NOT stop taking medication without speaking to your doctor. 

Epilepsy

If you are epileptic and planning a pregnancy, you should continue your contraception until you have spoken with your GP or Specialist Dr/Nurse. This is because they will help you understand and avoid any risks and plan for a healthy pregnancy and baby. There are some epileptic medications which are not safe for pregnancy so the doctors may wish to change your medication whilst you are trying to conceive. It is very important you do not stop taking your medication before you have spoken to your care provider.