Fierce diabetic mom-to-be refuses to let the 'betes keep her down

October 19 | Guest post by Elka Karl
Elka the adventurer.
Elka the adventurer.
My perinatologist runs a diabetes clinic every Monday at his office. For me, this means a lot of time spent reading old New Yorker articles while waiting for his overbooked office to get to me.

When they do, they will take my insulin pump off of my body, make charts and graphs of my bloodsugars from the past two weeks, and quiz me on my carb grams to insulin ratio. Has it changed? What about my basal rate? Any ketones in your urine?

In the meantime, I wait and I observe my fellow diabetic pregnants in the waiting room. Overall, there are so many overweight, unhealthy women here. And I have nothing to say to them. Not a one has a tattoo. No one chats to anyone about yoga or hiking. I can virtually guarantee that none is working with a doula. They have become passive passengers in their pregnancies, and they scare me.

I’ve gone through online parenting forums, magazines like Mothering, and word-of-mouth looking for like-minded diabetic pregnant women, and I’ve come up pretty empty-handed. I need comrades, but I don’t know where to turn.

I am not a shy, vulnerable, brittle diabetic. I am fierce, and I am looking for my fellow fierce, pancreatic-challenged tribe.

Here’s the deal: I backpack. I take yoga and pilates classes. I have a lot of sex with my husband. I am already planning my post-birth (sixth) tattoo. And yes, I’m a diabetic.

I have been for 20 years now. I kind of hate it, but I hate a lot of things more, like the stigma related to my disease. And the amount of fear I’ve gone through thus far in the conception and gestation of my baby (and I’m only at four and a half months!).

I have no choice about a homebirth or not: I must be in a hospital. I have very little choice about whether or not I am getting an induction (though I am going to fight hard on this count if I’m still doing well come the month before my due date).

But I do have other choices. I can choose to exercise every day. I can choose to find the most capable, hospital-friendly, kick-ass doula in Berkeley. I can decide to not let my life be limited by expectations of what a high-risk pregnancy looks like.

For me, that means challenging myself to backpacking trips, road trips, camping excursions, concerts out on a week night, raising a puppy while I’m knocked up, and working on a book.

We can't wait to meet him.
Adventurer in the making!
I had an amnio last week, and it was pretty stressful — as everyone will tell you, not the procedure itself, but the anticipation thereof, and the anxiety of waiting for results afterwards. The best part of the procedure was seeing my baby.

His heart beat strongly and perfectly. His little brain was wonderfully developed. He kicked and floated happily, scratching his nose, coyly keeping his legs crossed for nearly the entire ultrasound. I can’t wait to meet him.

Insert baby here :)
Insert baby here 🙂
When I do, we will be thankful for whatever way he came into this world. I have a birth plan, I have my desires (natural, unmedicated, and vaginal being the operative words here), but most of all, I have trust in myself, my medical team, and my doula, who are going to get us healthfully and safely from first push to birth.

We plan on taking baby backpacking soon after I’ve recovered. After all, my husband and I bonded on a trek to the bottom of the Grand Canyon, and honeymooned along the Kalalau Trail. We can’t wait to bring our little boy into the world of nature, too.

So when my doctor asks me if I have any questions, he's no longer surprised when I ask, “Can I do a hut-to-hut snowshoeing trip at 7 ½ months? Can I backpack in the third trimester? Can I take a yoga class the day after the amnio?”

I may be high risk. I may be a 20-year survivor of a chronic pandemic, but I am an adventurer, too. And this is perhaps my greatest adventure yet.

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  1. I had no idea that being diabetic was considered a high-risk "thing," pregnant or otherwise. I always thought it was a manageable disease, so I learned a lesson today! Too bad my friend Rob is not a woman– you could bond with him over being a diabetic outdoors-y person. We did a 4 day backcountry hiking trip on the Wonderland Trail a few years ago… there must be more female versions of Rob, and you, out there somewhere!
    Looking forward to reading about baby's adventures on the trail!

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  2. Good for you for not being passive about your pregnancy. I hate it when women are so free to "do what they are told" by doctors. Thank you for spreading the word! And congrats on Baby!

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  3. You go girl! I am a fellow preggo diabetic who hates the stigma and tries to present another more positive representation of our disease. No wah! it's hard! here either! Just going day to day, gettin that exercise and pumpin that insulin – it's just life. Thank you for your story, it's very inspiring for us other tattooed, kickass diabetic mama's!!!
    Maryann in the NW

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  4. Hi Maryann! Aw, I'm excited to hear from another kick-ass diabetic mama-to-be. Glad you're fighting the good fight, too!

  5. From you I would expect nothing less than kickin ass. Congrats Elka. I'm sure you'll be a wonderful mother.

  6. Hi Elka, were neighbors! I live right over by your beloved thrift town. I love your post, but I do want to gently point out that one can be overweight AND healthy. When I had my 9 pound daughter, everyone assumed I had Gestational Diabetes even though I was never diagnosed, and only gained 17 pounds during pregnancy. Ive lost all my baby weight, but Im still "fat", yet not unwell. It is possible.

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  7. Hi Hunnydu, Absolutely . . . it just gets more complicated when you had Type 1 diabetes to the mix. One of my BFFs is a very large and healthy and luscious lady, and she exercises regularly, works out, etc.

    Being overweight with Type 1, while on insulin, just causes a lot more complications, especially during pregnancy. I absolutely agree that you can be overweight and healthy, but it's much harder to do so when you're also a diabetic.

    My mom was thought to have gestational diabetes for all of her kids. I was 10 lbs, my sis 10 1/2, my bro the smallest at 9 1/2, and the twins were induced a few weeks before their due date because they were good to go, and already 5 1/2 and 6 1/2 pounds!

    Maybe I'll see you at Thrift Town one of these days. 😉

  8. "They have become passive passengers in their pregnancies, and they scare me."

    That is some beautiful writing. I'm sure you will be as brave and courageous with parenting as you are with your pregnancy. Best of luck to you, and thanks for sharing your story!

  9. Elka, can you expand on your pandemic comment? I completely understand why one would say this in reference to Type 2 diabetes, but don't understand it from your perspective as someone with Type 1.

    I also wanted to throw this out there for any gestational diabetics: I have a healthy diet, am not considered "overweight", and have always been active and athletic. I still ended up with gestational diabetes. Sometimes it's just the (bad) luck of the draw.

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    • Beth, Type 1 has become much more common in people of all ages, and has increased fivefold in children over the past 20 years. It's pretty scary. My little brother, who is 7, was diagnosed at the age of 4, and has been on an insulin pump for 2 years. There was no family history of diabetes in our family before this, and both Forrest and I were diagnosed after an auto-immune issue. I'm really hoping that the possibility of a public health option will disincentivize diabetes as a money maker (okay, I'm a bit of a conspiracy theorist on this one, but it's not too much of a stretch) and encourage a cure through islet cell transplants or other measures.

      Oh, and as far as gestational goes, I just found out that a very fit, vegetarian, healthy friend of mine has gestational. It is indeed a bad luck of the draw.

      • My partner's mom got gestational diabetes with her second daughter… and if anything, I'd guess she's probably UNDERweight. (She was also older, which I think is a risk factor, but still.)

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    • I love Soren, but one of our good friends has claimed it as his (if he ever gets a lady knocked up).

  10. hi elka – i love this post. i did not (while pregnant) nor do i day to day have diabetes issues, but i did exercise and stay fit during my pregnancy. i feel like the 'passive passenger of pregnancy' is SUCH a common theme many pregnant women, and I wish it wasn't. Look forward to learning more about you.

  11. hey elka, loved this and am passing it on to two friends w type 1 diabetes who may be inspired one day to be mom's. Passive passengers come in all walks of life; it is extra scary when they're repsonsible for another. Doctors ran some really nasty choices by me when I was preggo and after Isa was born. I went home and read my medical dictionary and was blown away that I might have listened w/o doing my homework.
    Trusting yourself as you do will take you through your pregnancy and motherhood fine!! It is the biggest adventure ever, and So worth it!!!
    That's one lucky boy!!

    • Hi Maggie,

      Please feel free to pass my blog on to them as well. It's one of the reasons I started it — to encourage other type 1s to to take control and enjoy their pregnancies! I feel like I was so scared by doctors and medical professionals that I spent most of the first trimester worrying that I had somehow compromised my baby by having my disease. No more of that, though. I'm going to enjoy this pregnancy for the next 18 to 20 weeks!

  12. Heynow Elka, my friend Maggie passed your blog along to me. Thanks for all you wrote. I have a good story that I think you would appreciate. I have a beautiful 14 year old daughter living with type 1 diabetes who, after living 8 years of living with da 'betes, stands at the brink of womanhood. As sure as the sun moves through the sky, our conversations have deepened about what the future holds as she lives on into adulthood with diabetes. Pregnancy and motherhood are rolled into the conversations, if even they are young ideas at this point. But I feel nothing but confidence in the young woman she will become. She's the sort who, at a tough young age of 9, conquered 11,000ft passes in Sequoia Kings Canyon, wearing her pump and hauling an extra 15 pounds on her back full of low supplies, extra water, meters, 1st aid kits and her insulin. She was afraid to get separated by accident from us and not be carrying her own supplies. (I sure wasn't planning on losing her, but you've got to admire this in a kid!)

    As she crested the ridge to Eagle Lake in Mineral King, which is rugged-as-hell territory, she suddenly yelled "Take that, diabetes!" which echoed across the lake off the solid granite beyond. Blew us all away as a family, and we stood with our arms around each other, quiet and still, as the echos faded into the wind and trees and we all were empowered by this little kid who had faced her demons and won.

    And you know, after that she's no longer let her diabetes control her; she very much controls it instead. Like you, she stares the diabetes beast down and lays it flat on its you-know-where when it tries to raise its gnarly claws at her. As she says, she also loves her diabetes because its an honest adversary that has shown her the stuff she's made of. Just gotta love our children in this world. You don't have to love diabetes, but it sure does command respect and provide perspective in life.

    So, more power to you, girl, to grow your young little fella the way you see fit. If anything, while living to the fullest with type 1 diabetes in tow, you'll teach your little boy that challenges arise and challenges are met- and in the process we find ourselves.

    • Hi Gev,

      Wow, what a great way to start my day! Tell your daughter she rocks. 🙂 Now I'm off for the morning after-breakfast hike with the dogs.

  13. Elka,

    First off, congratulations on your pregnancy. It does seem like a wonderful adventure for you, and I wish you many happy days along the trail with your family. Your attitude toward your diabetes is wonderful.

    However, I just wanted to point out something, hopefully in a non-drama sort of way. I know that you've had your own experiences with diabetes and how your health is perceived, so I'm trying to keep that in mind. This is just meant to be food for thought. I felt that your comment about the other mothers in the diabetes clinic was rather unfair. Fatness, though our common knowledge often tells us other wise, is not always unhealthy. There are fat women who are healthy, and thin women who are unhealthy, and vice versa. Given that you were observing a diabetes clinic, this may seem like a silly argument, but maybe not everyone is that clinic was unhealthy or a "passive passenger in their pregnancy." I, for one, am not diabetic, nor do I have children. But I am fat, and I do have polycistic ovarian syndrome (which is why I'm fat, and why I'm considered pre-diabetic), so my blood sugar and I are constantly doing battle. Fat people are constantly bombarded with negative comments – as I'm sure you've dealt with in relation to your diabetes. But as you know, you are an active person, which means that perceptions about what certain diseases or conditions look like are not always true. Personally, my condition, which causes me to gain weight, is not something that I have personal control over. I can make choices about how to live, such as eating healthfully and being active, which I am. But that's not going to change my hormone levels to such a degree that I will ever be thin. But this doesn't mean that I can't be healthy. What it does mean is that people look at me and assume the worst. I absolutely encourage and celebrate your healthfulness and awareness and determination in regards to raising a child while having such a challenging condition. But your being healthy doesn't mean they're not. It just might look different. Thanks for reading, and congratulations again.

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    • Hi Kristen,

      I definitely understand and agree (see my comment from a prior post about my experience with this). For me, a lot of the other women I saw just looked unhealthy, no matter what their weight was; they had sallow skin, awful posture, no muscle tone, and also, just really beat-down attitudes. I have lots of sassy, healthy, large and beautiful lady friends who are strong, positive, and carry themselves with pride and love. This is not what I observed at my doctor's office, and it was not what I heard in their conversations. I wish that they were fighting the good fight, as it were, but a lot of them seemed resigned to getting things over with, scheduling a c-section, and squeaking by with minimum effort.

      As a diabetic mom-to-be, you are often terrorized by the medical community, told that your baby will have heart problems, spina bifida, problems developing in the womb, high birth weights, the potential of coma upon birth, etc. And you are told that you may experience extreme lack of circulation, neuropathy, retinopathy, etc., thanks to your decision to get knocked up. It's hard to come out of that conversation swinging, but that's what I'm trying to do. And for me, one of the main ways I can counter that negativity is to be an active person.

      I'm no skinny mini either. I'm really strong and muscley, but I'm a D cup (now DD, oy) and a size 10-12 when I'm not pregnant. I will never be a skinny girl (I have too much boobage and hips for that), but I will always try to be an active, healthy one. We all try to do what we can!

      • Dear Elka,
        Congratulations on your strong spirit and pregnancy! As a diabetic myself ( I have diabetes II, though – like you, I have always been a healthy weight) I found your adventuring inspiring!

        However,
        I, too, felt deeply uncomfortable about your comments regarding the other women in the room, though not necessarily about the weight issue.
        Is judging the other women really necessary? You haven't walked in their shoes. You can't possibly begin to assume that they are "along for the ride" or – if they are – is it SO terrible? As you stated yourself, doctors CAN scare you and intimidate you. So what if some acquiesce? Or simply have a different view? They're at a doctor's office for pete's sake , so they're not exactly neglectful parents. Perhaps the pregnancy wasn't planned. Perhaps they have little family support. Perhaps – just perhaps- you DON'T KNOW THEM.
        Your comments saddened me for many reasons. You can't relate to these women because they don't have tattoos and don't go outdoors? just how small is your world? Do you only surround yourself with people who have similar interests and views? I work with underpriveleged (mostly) minority families in literacy and ESL programs. At first glance, I have very little in common with some of them. But i always try to find a commonality. I try (not always successfully) to seek a way to connect, rather than to to assume my superiority.You are about to welcome your baby into a big, broad world. Instead of dividing the world into the "right path" and "wrong path" that so many liberal-leaning mothers (including myself) are prone to doing, perhaps seek a way to expand your compassion to include people not like yourself.

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  14. I am the daughter of a kick-ass Type 1 diabetic who used to bike 26 miles a day and plays tennis 4 days a week. Many people told my mom she should not have kids. Twenty-five years later I am the one yelling at her to listen to her doctors and she still refuses! Thank goodness!

  15. P.S. Both myself and my sister (23) are and have been perfectly healthy (thank God). I was born 3 weeks early and spent some time in an incubator. We were both delivered by C-section. Other than my early birth, (mom was unconscious too) none of us have had any complications because my mom decided she wanted to live and breed like a normal, healthy woman.

  16. I think Hrothgar is a good name for a boy. Or Wiglaf. Those are from Beowulf, but I'm sure you already knew that. 🙂 Good luck with everything!

  17. Firs to fall, this is a great post and I applaud you for your positive, kick-ass attitude.

    But the fat phobic part of it really bothered me.

    How do you know those other women in the waiting room are unhealthy just because they're overweight? and how do you know they're not just as kick ass as you are? I have seven tattoos and most of them aren't visible if I'm wearing long sleeves. I'm overweight but I'm healthy. I go to yoga once a week. But you can't tell those things about me from just looking. I'd hate to think someone would judge me as scary and unhealthy just because they thought I was too overweight to be cool.

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  18. I'll probably be part of the unhealthy looking mom. Some ppl get lucky and bloom during pregnancy. Some just feel crappy and don't really care who knows/sees it.

    I've been struggling with my self image pretty much as soon as the baby established itself on my womb. I get oily face and hair. My belly grew faster then other ppl's experience. Non stop painful pimply face. I usually feel like crap.

    Nothing like a total stranger taking once glance at me and judging me to get my back up. It's awesome that you feel so kickass. Wish I could feel it too.

    But making comments about "so many overweight, unhealthy women here" just makes your article sound petty and judgemental.

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  19. I'd like to echo some comments about the petty and judgemental tone of this article. Being overweight and diabetic is not because I am passive in my pregnancy or my life. Type I and Type II are two different diseases that are lumped into one canopy known as the all encompassing diabetes. I'm glad you can go out and snow shoe at 7.5 months. I would love to, but I have realistic expectations of my pregnancy and my condition and I know that I'm not a failure because I can't do that. I eat healthy, I test my glucose levels regularly. I keep my fastings under 90 and my post meals under 110. I'm fat, I'm type II, I'm not an adventurer, and I'm making a healthy baby girl.

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  20. I know I'm commenting on a rather old post here, but I just want to thank you very belatedly for this. I've been type 1 diabetic since my childhood and now, in my mid-20s, I'm surrounded by friends getting pregnant and settling down, I've been talking about all that serious stuff with my boyfriend … and what with all the extra risks that diabetes and pregnancy carry, I am absolutely terrified. Pretty long term plan, but still. I'm going to be bookmarking your blog linked in this, as it's very reassuring to read others' positive experiences – your drive is fantastic!

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