Antenatal appointments

At your antenatal appointments you should get extra care because of your diabetes as well as the normal antenatal care that all pregnant women get. Your care team should check on you and your baby. At each appointment you should be offered information and advice, and have the chance to ask questions and to talk with your midwife or doctor about any concerns you might have.

You should have contact with your care team every 1 to 2 weeks to talk about your blood glucose control.

You may also find the NICE information for the public on antenatal care useful (see other NICE guidance).

If you already had diabetes before getting pregnant

An appointment with a joint diabetes and antenatal care team should be arranged for you straight away when you first get pregnant.

The table below gives a guide to the extra care that you should receive at your antenatal appointments.

Appointment

The extra antenatal care that your care team should offer

Booking appointment – ideally by 10 weeks of pregnancy

  • Information, advice and support about your blood glucose levels and about how diabetes will affect pregnancy, birth and early care of the baby

  • Ask about your diabetes, current medications and general health

  • Eye examination (unless you have had one in the last 3 months)

  • Kidney test if you have not had one in the last 3 months.

  • HbA1c test

  • At 7–9 weeks, check how far along your pregnancy is

  • Advise you to take 75 mg of aspirin daily from 12 weeks until the birth of the baby, to reduce the risk of pre‑eclampsia (high blood pressure in pregnancy)

16 weeks

20 weeks

  • Ultrasound scan to confirm that your baby is developing normally, including checks on your baby's heart

28 weeks

  • Ultrasound scan to check your baby's growth

  • Eye examination

32 weeks

  • Ultrasound scan

  • If this is your first baby, routine antenatal care that would be given at 31 weeks

36 weeks

  • Ultrasound scan

  • Information and advice about:

    • planning the birth, including timing and types of birth, pain relief, and changes to your medications

    • changes to your treatments for diabetes during and straight after the birth

    • looking after your baby, including starting breastfeeding and the effects of breastfeeding on your blood glucose

    • follow-up care and contraception

  • Advise you to have your labour induced, or a caesarean section if this is the best option, before 37 weeks if there are complications

37 weeks

  • Advise you to have your labour induced, or a caesarean section if this is the best option, during week 37 or week 38 if there are no complications

38 weeks (and every week thereafter)

  • Tests to check your baby's wellbeing if he or she has not been born yet

Treatments for eye and kidney problems

If eye screening shows that you have diabetic retinopathy, this shouldn't affect treatment to improve your blood glucose levels in early pregnancy if this is needed. It also doesn't mean that you can't have a 'normal' (vaginal) birth.

If a kidney test shows that you have diabetic nephropathy, you should be offered treatment and you may be referred to a kidney specialist.

It is possible that you might need extra scans and more detailed checks on your baby's growth and development if you have circulatory or kidney problems.

If you are at risk of or have gestational diabetes

The table below gives a guide to the testing and extra care that you should receive at your antenatal appointments. You should start having extra antenatal care as soon as gestational diabetes is diagnosed.

Appointment

The extra antenatal care that your care team should offer

Booking appointment – ideally by 10 weeks of pregnancy

  • Test for gestational diabetes if you have had it before and are booking in the first 13 weeks

  • Advice, information, support and treatment if you are diagnosed

16 weeks

  • Test for gestational diabetes if you have had it before and are booking after 13 weeks

  • Advice, information, support and treatment if you are diagnosed

20 weeks

  • Ultrasound scan to confirm that your baby is developing normally, including checks on your baby's heart

24–28 weeks

  • Test for gestational diabetes if you haven't had it before but are at high risk of getting it

  • Advice, information, support and treatment if you are diagnosed

28 weeks

  • Ultrasound scan to check your baby's growth

32 weeks

  • Ultrasound scan

  • If this is your first baby, routine antenatal care that would be given at 31 weeks

36 weeks

  • Ultrasound scan

  • Information and advice about:

    • planning the birth, including timing and types of birth, pain relief, and changes to your medications

    • changes to your treatments for diabetes during and straight after the birth

    • looking after your baby, including starting breastfeeding and the effects of breastfeeding on your blood glucose

    • follow-up care and contraception

38 weeks

  • Tests to check your baby's wellbeing

  • Advise you to have your labour induced, or a caesarean section if this is the best option, before 40 weeks if there are complications

39 weeks

  • Tests to check your baby's wellbeing

  • Advise you have to have your labour induced, or a caesarean section if this is the best option, before 41 weeks if you haven't had your baby by then

Questions you might like to ask your care team about care during pregnancy

  • How soon should I contact my diabetes care team once I find that I'm pregnant?

  • Will pregnancy affect my diabetes and my general health?

  • Why do I need to have more scans and antenatal appointments than women without diabetes?

  • When should I test my blood glucose? What are my target levels?

  • How might my medication change during pregnancy?

  • Why do I need more or different insulin during pregnancy?

  • Where should I have my baby? What care might my baby need after birth?

  • Information Standard