Centering on diabetes in pregnancy

Obstetrician Unzila Nayeri, MD of Upstate's Regional Perinatal Center (center) talks with patients at a recent Centering Pregnancy class.

Obstetrician Unzila Nayeri, MD of Upstate’s Regional Perinatal Center (center) talks with patients at a recent Centering Pregnancy class. Photo by Susan Kahn.

Pregnant women, some with their partners, gather in a circle with their obstetrician, midwife, a nurse and nutritionist. A chime sounds. The Centering Pregnancy group begins. 

Centering Pregnancy is a program offered in a variety of medical practices throughout the country, bringing together women with similar due dates for group visits. The Regional Perinatal Center at Upstate used grant money from the March of Dimes to launch Centering Pregnancy specifically for pregnant women with diabetes.

“This is a time for us to help women with diabetes meet the challenges of pregnancy and possibly  make some big changes in their lives,” certified nurse midwife Kathleen Dermady says, this includes mothers living with with diabetes and those diagnosed during pregnancy. Diabetes increases the risk in pregnancy, requiring frequent medical visits and close monitoring. Pregnancy hormones decrease the body’s sensitivity to insulin, the hormone  that helps the body process glucose, so that even women who have experience living with diabetes can become frustrated in pregnancy.  

Listen to interview

The moms-to-be who choose to participate attend 10 two-hour Centering sessions before their babies are born. Blood work, sonograms and other tests are scheduled before or after each session. “Moms tell us they learn so much more than they would in an office visit,” Dermady says. The support they feel from other women is important, too.

The sessions include bursts of laugher, some education and warm cups of tea.

Unzila Nayeri, MD talks about the A1C blood test. Because glucose leaves its mark on the red blood cells, this test reveals the average glucose in the last three months. She reminds the women, still in the early months of pregnancy, of the importance of stability. Dermady explains it this way: A car that drives down a bug-infested highway may arrive at its destination — but the imprint of all those bugs will remain on its windshield.

Women with diabetes are at high risk of having difficult labors and deliveries, partly because they are liable to have large babies. This may mean they require a Cesarean section or other interventions. “If we do a good job taking care of sugar levels, we can really reduce these risks,” Nayeri says.

Registered dietitian, Julie Mellen speaks about proper portion sizes and weight gain, saying that the desirable pregnancy weight gain is based on a woman’s pre-pregnancy weight. “What if you are gaining 1 to 2 pounds per week?” she asks before answering: “Your baby is getting too big, too fast.”

Centering leaves time for questions, too, an efficient way of addressing common issues, Dermady says. “Many of the questions they have are questions that all the moms have.” Learn more about Centering Pregnancy by contacting the Regional Perinatal Center Program Coordinator Karen Davis at 315-464-5702.

Listen to an interview with Kathleen Dermady on HealthLink on Air

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