UnityPoint Health - Meriter - Center for Perinatal Care

• Cardiac disease
• Chronic hypertension
• Cystic fibrosis
• Diabetes – type 1 or 2, insulin dependent GDM
• Hemolytic incompatibility
• History of or current coagulation concern
• HIV
• Hypertension
• Pulmonary disease (including active asthma)
• Renal disease
• Seizure disorder
• Sickle Cell disease
• Thyroid disorders
• Other chronic or acute condition that may affect pregnancy

• Fetal anomalies
• Multiple gestation
• Growth restriction
• Other fetal condition(s) that may affect the pregnancy

• Preeclampsia
• Pregnancy induced hypertension
• Oligohydramnios (low amniotic fluid)
• Polyhydramnios (excess amniotic fluid)
• Prior pregnancy loss
• Other condition that may affect the pregnancy

• Pre-pregnancy Counseling
• Group Prenatal Diabetes
• Gestational Diabetes

Appointments & Referrals

We are dedicated to helping you reach your goals. If you are interested in having diabetes pregnancy counseling contact your doctor for a referral.

We recommend pre-pregnancy counseling for patients with preexisting diabetes, including pre-diabetes, type 1 diabetes, type 2 diabetes and cystic fibrosis-related diabetes. Getting the facts can reduce your stress and reduce the risk of problems as you work through the demands of a high-risk pregnancy.

• During pre-pregnancy counseling you can:
• Talk with your provider about diabetes and your desire for pregnancy and contraception
• Discuss health risks for you and your baby
• Work with a team of diabetes specialists who are knowledgeable about diabetes and pregnancy care to help improve your control to a safe level for pregnancy
• Plan the best time to have a baby

Pregnancy changes the way diabetes is controlled, and it can have a significant impact on the health of both mom and baby. Group Prenatal Care for Patients with Diabetes offers you support for a successful pregnancy and birth, and healthy newborn.

During group prenatal care:

• Each group brings together 4-8 pregnant patients for prenatal care to give them tools to keep their diabetes under control.
• The group setting is ideal because it provides devoted time for education and support that would not be possible in one-on-one care. Each group meets for 10 two-hour sessions.
• At each visit, we will record your weight, blood pressure and glucose checks. Throughout each session women will be pulled aside for a one-on-one prenatal check in with a provider. This will allow your provider time to perform individualized tests and allow you to ask questions you may not feel comfortable asking the group.

Gestational diabetes is different from other forms of diabetes in that it occurs after the patient is pregnant and usually goes away after the baby is born. The Center for Perinatal Care offers care for patients with gestational diabetes in an individual setting as well as a group setting. Held weekly, the group gestational diabetes class is an easy way to receive care and meet with your entire care team in one convenient location.

• During the first part of the class you will meet with a Certified Diabetes Educator, who will provide an overview of gestational diabetes, give you a glucose meter and teach you how to use it.
• During the second part of the session you will meet with a Registered Dietitian, who will help you identify which foods will help control your blood glucose.
• A plan will be made for follow-up to determine if anything else is needed.

• I have had diabetes for many years. Why do I need to meet with a diabetes educator and/or a dietitian?
  • Diabetes management during pregnancy is much more challenging. Insulin needs may double or triple during pregnancy due to changing hormones. Certain strategies that have worked to manage your diabetes prior to pregnancy will no longer be effective. A baby needs you have normal glucose levels to prevent problems during pregnancy. Our Certified Diabetes Educator provides most of the medical management for your diabetes during pregnancy and will provide education as appropriate. The pregnant patient has access to a variety of resources and strategies that will help you achieve goals you may have never thought you could before and will need to meet for a healthy pregnancy.
• If I had gestational diabetes before, do I need to go through the class or visits with this pregnancy?
  • Each patient and pregnancy is unique. In this situation, an individual visit may be more appropriate. Our goal is to tailor the care to the patient's needs.
• What is the a1c goal for conception?
  • 6.5 or less.
• What is the a1c goal once I am pregnant?
  • 6 or less.
• What are the blood glucose goals during pregnancy?
  • Fasting or pre-meal: 70-95
  • 1 hour post-meal: 70-140
  • 2 hours post-meal: 70-120

The low threshold is not needed for anyone not on medication or insulin. The 130 at 1 hour is for women with gestational diabetes.

• Diabetes Education Services at UnityPoint Health – Meriter
• Diabetes Health Library
• Diabetes: Centers for Disease Control and Prevention
• American Diabetes Association