Childbirth is almost like rebirth to women. This is especially so for those who do not have good health. Pregnant women with problems like diabetes, hypertension, thyroid or heart problems etc. run a greater risk. These women should first take treatment for their problems before they plan conception, says gynecologist, Dr. Jeyarani Kamaraj, who is running a modern clinic for those who have fertility problems.

She answers our queries on pregnancy and childbirth:

Q: They say that women with heart problems will have difficulties during the period of pregnancy and delivery …

A: Some are born with heart problems. Some might be having rheumatic heart. Some might have blocks in arteries. We advise women with congenital heart problems against conception if their condition warrants it. The heart will have more tension during pregnancy. A weak heart cannot withstand this additional strain. It might even lead to the death of the woman. Women with rheumatic heart do have children. But it is better to consult the doctor before conceiving. In the case of some women, they would have undergone heart surgery in their younger days. They would have been taking anti-blood clotting medicines after the surgery. These medicines might affect conception. So, it is always better to consult a heart specialist. Proper diet and maintaining weight and keeping everything under control would reduce the problems in conception.

Q: Those with thyroid problem will not have regular periods. In that case, can they conceive?

A: Thyroid problem carries only 2 % risk in conception. But the rate of abortion is much more. Excess secretion by thyroid gland will have adverse effects like rapid pulse, palpitation and shortness of breath. These might lead to abortion or delirium or miscarriage. Insufficient secretion of thyroid will result in infertility. Even if one conceives, abortion will occur. So, it is better to take treatment for any kind of thyroid problem as a preventive step.

Q: Diabetic women are not able to conceive? Why?

A: The eggs are not able to mature due to the problem of diabetes. For conception, matured eggs are necessary. Also, the medicines they take for sugar control will affect the growth of the eggs and the breaking up of the chromosomes. Even if they conceive, abortion will take place. Also, there’s the risk of the baby being born with defects. Possibility of premature delivery, stunted or abnormal baby or still-born baby are also there. During the period of pregnancy, the level of the fluid in the uterus might also come down, leading to premature delivery. The babies born to diabetics will have deficiency of calcium, glucose and magnesium, which might lead to attacks of fits.

Q: Will diabetes appear during the period of pregnancy?

A: Hereditary or some other factors can cause diabetes. There are two types – those who are already diabetic, those who get diabetes during pregnancy. Those who are already diabetic usually belong to the middle age group. But both the types affect pregnancy in the same way. They have greater risk of getting hypertension. But diabetes manifested during pregnancy will disappear on its own after delivery. Those who are already diabetic have the risk of their kidneys and heart being affected. Their weight will increase during pregnancy. They might become anemic and weak.

Q: What kind of diet diabetic pregnant women should take?

A: They must be very strict in their diet. Also, they should keep their blood pressure under control. Light exercises and walking will be good. They can take insulin injections daily on the advice of the doctor. This will protect the fetus. Those who are already diabetic should bring their sugar level under control three months before conception. Only then, they should plan conception. Also, they should start taking folic acid tablets (5 mg) three months before conception. In the third and fourth months of pregnancy, the limbs are formed. If the sugar is not controlled, it will affect the formation. Diabetic pregnant women should take greater care to keep all their clinical health parameters under control if they want to get a healthy baby.