Pregnancy with Diabetes: Where Can I Clip My Pump?

Every night, Gary and I lie in bed and watch our baby – we call her The Girl – kick, jab and swim under my skin. My belly squirms up and down and side to side. The Girl moves the most in the late hours. She’s a night person, like her mom. Last night, after a day of blood sugar swings and insulin adjustments, I asked The Girl, “How are you feeling? Am I doing okay for you? She answered with a tumblesault. Gary said tumblesaults are a good sign. I asked him how he knows that. He said that he knows that sort of thing. It made me feel better so I said, “Okay.”

It’s the second trimester of my pregnancy with diabetes. Though not a breeze, it’s been much better than my first trimester. The nausea and severe hypoglycemia have subsided. I can leave my apartment, engage in coherent conversation, and eat. I have gone from being Miss Nausea, as in, Get That Plate of Pretzels Outta My Sight! to Miss Hungry, Hungry Hippo, as in, Whatcha Got Over There? Care to Share a Bite?

Of course, I’m not hungry for kale or carrot sticks. All I want to eat is chocolate. I dream about diving into a bowl of cookies & cream ice cream, followed by two or three Twix bars. But unlike pregnant women without diabetes, I have more to face than the number on my scale; I have to face the number on my glucose meter. That little machine packs big judgment. As a compromise between my cravings and my blood glucose, I’ve started to buy dark chocolate, the kind that declares the cacao percentage on the wrapper. I’m sticking to a minimum of 72% cacao!

Aside from discovering the wonders of dark chocolate, another fun part of the second trimester is finally telling people I’m pregnant. Most reactions are the expected ones, like “Great news!” “Mazel tov!” and, “When are you due?” I like those.

And then there are the, “Have you seen Steel Magnolias?” comments. “Isn’t that high risk?” and, “I know a diabetic who had a baby; he was born over ten pounds!”  I don’t know why my pregnancy announcement has elicited diabetes references. When a person with asthma announces she is pregnant, do people think of her asthma? I guess that some people think *DIABETIC* at the mere site of their friends and acquaintances with diabetes. They can’t shake it, no matter what the context. I blabber responses like, “Yes, this is a high risk pregnancy, but I am taking good care of myself so that my baby will be healthy.” Blah, blah, blah. And, “Not all babies born to women with diabetes are big. And I know some women without diabetes who have had ten pound babies!” And, “That film is a cliché!

Steel Magnolias doesn’t do us modern-day women any favors. It just makes people think that if their friend has diabetes and is pregnant, she will die. It’s unfair, and it’s hard to knock down stereotypes that are so deeply engrained in people’s minds.

Luckily, the insensitive remarks have been few and far between. Most people have been really nice and supportive. And if they were curious about a pregnancy with diabetes they’ve asked in a caring way.

Now, back to the second trimester changes… I’m outgrowing my regular clothing: a shopping spree! Tops are easy to replace. I’ve purchased a few basics from my local Destination Maternity. Plus, my friend from work, who is also pregnant and a few months ahead of me, has been dispensing hand-me-downs. But finding maternity pants that can accommodate an insulin pump is a big challenge. You might be surprised to learn that many maternity pants are made with faux front pockets, just a seam that’s been sewn together.

Why fashion designers believe that pregnant women don’t need pockets is a mystery to me. And why they think we’d want the appearance of pockets, without the benefit of functional pockets is an even bigger mystery.

Most women don’t mind this suspicious pocket situation, I know.  But it’s a problem for women with diabetes. We need pockets for our insulin pumps, damnit!  Many maternity pants have high elastic bands that slide all the way up the stomach, so there’s no waist band on which to attach the pump. And my bra size has already gone up significantly, making bra-wearing uncomfortable enough. Do I really want to clip my pump there every day? I accept that I’ll have to clip my pump to my bra on the days I wear leggings. Even non-maternity leggings don’t have pockets. I’m used to that. But when I’m wearing jeans or regular maternity pants to work, I want a pocket for my pump.

The most important part of the second trimester is that I’ve continued to experience good blood glucose control. And the bonus: the nagging lows I experienced in the first trimester are gone. I’ve had rough days, of course, but for the most part, blood sugar management has been easy. Easy, like an old stretched-out sweatshirt, it has been forgiving, providing me with wiggle room. A blood sugar of 80, even after a sliver of red velvet cake. I view this as nothing short of a miracle because we are talking about diabetes here. Since when was diabetes easy or forgiving?

Of course, all good things come to an end.  As I near the third trimester, insulin requirements and insulin resistance increase. I have begun to see numbers in the 160s, 170s, and even 200s. Not where you want to be when you’re hosting a baby. I worry about my baby. How does she feel when my blood sugar is high? Wasn’t it just a few weeks ago that I was lowering my basal rates and fighting hypoglycemia all day? A 30 carb breakfast that was once covered by 2.5 units of insulin is now covered by 6!

I readjust my basal rates and insulin to carb ratios. I try. And try. And try.  I’ve even taken some time off work so I can stalk my blood sugar, because it’s not just about me anymore. High numbers are harmful to my baby, and I have an obligation to fix them. Maybe for some that’s an easy feat. But not for me. I am not good at multitasking. I am good at doing one thing at a time. Pregnancy with diabetes is probably the biggest challenge I’ll ever go through.  It’s a full-time job. I’m doing the best I can, but I fear that my best isn’t good enough, that an A1C of 5.5 is not as good as an A1C of 4.9.  That being exhausted isn’t a good excuse for skipping the gym again. That the square of 86% cacao dark chocolate I ate was selfish.  I don’t worry about getting fat. I don’t worry about stretch marks, swollen ankles, or the pain of childbirth. (Okay, maybe I worry about those things a little.) I worry about maintaining normal blood sugars for the sake of the little baby who’s depending on me.  In the meantime, as I wait and work, I keep feeling for those tumblesaults.

Jennifer Jacobs

Jennifer Jacobs grew up in Long Island, New York. She was diagnosed with type 1 diabetes at age twelve. The challenges of living with diabetes have inspired Jen to be creative. She makes “diabetes art,” which can be viewed on her website, www.diabetesart.com. Work from Jen’s Diabetes Revealed series has been exhibited at various events in the NY-metro area. She also writes about diabetes and is putting together an essay collection.

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