# Pre conception clinic



## fallfromgrace

My partner and I are now at a stage where we are planning another pregnancy. Our past attempts resulted in two miscarriages and my son born asleep and have always been told that my first two pregnancies failing was due to poor diabetic control (them being over 5 years ago now) and my son due to fluctuating management pre-conception. So after my HBA1C being great for the past 6 months and enjoying now having an insulin pump, we have decided to do everything properly and go to the pre conception clinic for diabetics on the advise of the nurse I see each week. I just wondered if anybody else on here had been to one similar and if so, what was your experience like?


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## KateR

I don't have that experience but I just wanted to wish you all the best of luck for a happy outcome this time. x


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## fallfromgrace

Thank you, very kind of you


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## trophywench

Hi Grace

Do you go to St Cross?


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## Redkite

Sorry to hear about your previous pregnancies and sad losses.  I'm not type 1 myself, but from what some of the ladies on here have posted, the pre-conception clinics sound very supportive and have helped people achieve ideal levels before conceiving.  Hopefully some of the Mums who have recently given birth might see your message and reply in more detail than I can.  Good luck anyway, and hope it all works out well this time around


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## Bloden

Good luck fallfromgrace. Keep us posted!


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## trophywench

I'm gobsmacked no-one has replied yet!  still, they are probably busy with little babies ......

Briefly, the consensus is, they are great.  They want you to go for a few months with a stable lower HbA1c before you TTC but when you do, from there it's then a smooth transition to the diabetes obstetrician and midwives. 

All the extra tests and scans will then be arranged in timely fashion, which you will want to happen not least because of your previous experiences.

Once you are ready to TTC the very first thing is to get to the GP and get the higher dose (5mg I think it is?) folic acid capsules prescribed, cos that's an important foundation stone in every 'diabetic' pregnancy.  I think some of them also want you to get Vit D prescribed.

I wish you both all the very best in your forthcoming journey and look forward to reading next year ,that you've safely delivered a beautiful bundle!


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## tabbicles

Hi there 

I am on my 2nd pregnancy and both were planned. I have also had 2 m/c within 12 weeks but to this day will never know exactly what caused them. 

When planned I have always had a hba1c circa 7.6 when I started trying which was apparently fine and had folic acid for months before. At my hospital they were great and saw me every 3 months (sooner if needed) and then every 2 weeks once pregnant so my control has got tighter.  So sorry to hear about your losses as well as the late one  

Hopefully now you sound more controlled and with good control throughout you will get your happy outcome! X


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## fallfromgrace

trophywench said:


> I'm gobsmacked no-one has replied yet!  still, they are probably busy with little babies ......
> 
> Briefly, the consensus is, they are great.  They want you to go for a few months with a stable lower HbA1c before you TTC but when you do, from there it's then a smooth transition to the diabetes obstetrician and midwives.
> 
> All the extra tests and scans will then be arranged in timely fashion, which you will want to happen not least because of your previous experiences.
> 
> Once you are ready to TTC the very first thing is to get to the GP and get the higher dose (5mg I think it is?) folic acid capsules prescribed, cos that's an important foundation stone in every 'diabetic' pregnancy.  I think some of them also want you to get Vit D prescribed.
> 
> I wish you both all the very best in your forthcoming journey and look forward to reading next year ,that you've safely delivered a beautiful bundle!


Its comforting to hear how supportive they are, Im waiting for the appointment to come through for the pre con clinic at walsgrave, but I go to St Cross weekly and see Kim (who has been a total star). Do you go there too?


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## fallfromgrace

Redkite said:


> Sorry to hear about your previous pregnancies and sad losses.  I'm not type 1 myself, but from what some of the ladies on here have posted, the pre-conception clinics sound very supportive and have helped people achieve ideal levels before conceiving.  Hopefully some of the Mums who have recently given birth might see your message and reply in more detail than I can.  Good luck anyway, and hope it all works out well this time around


Thank you for replying, I appreciate such a kind message. Fingers crossed some of the newer mums will have some pointers for me


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## fallfromgrace

Bloden said:


> Good luck fallfromgrace. Keep us posted!



Thank you very much, I will do, be nice to share pregnancy experiences this time around. I don't really know many diabetics, certainly ones who have experienced pregnancy so will be a blessing being able to discuss it on here


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## fallfromgrace

tabbicles said:


> Hi there
> 
> I am on my 2nd pregnancy and both were planned. I have also had 2 m/c within 12 weeks but to this day will never know exactly what caused them.
> 
> When planned I have always had a hba1c circa 7.6 when I started trying which was apparently fine and had folic acid for months before. At my hospital they were great and saw me every 3 months (sooner if needed) and then every 2 weeks once pregnant so my control has got tighter.  So sorry to hear about your losses as well as the late one
> 
> Hopefully now you sound more controlled and with good control throughout you will get your happy outcome! X


Thank you for sharing your experience with me, really nice to hear some success stories, as I don't know many diabetic parents its sometimes easy to feel like we are doomed. Im off to see the consultant next week and am waiting for the pre con appointment to come through to give us the green light. My HBA1C has been 7.1 for 3 months and 7.8 for 3 months before that so fingers crossed!


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## tabbicles

Ah that sounds ideal then, are you on folic acid? I bet you get the green light now! 
I had no problems, my daughter came 3 weeks earlier naturally so a week before they would induce. She was 7lb 8 so perfect size but I guess if it was full term she would have been big. 
I love this forum, so nice speaking to people who understand! X


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## Cleo

Hello fallfromgrace,
I'm one of the new mums who should have replied sooner  
My son was born on 29th March so he's now 3 months (crickey how time flies!).  

- Basically, as soon as I told my consultant that my husband and I wanted to start a family she referred me to the dietician so I could learn how to carb count (this was in Nov 2012). I was asked to go back to clinic every 2 months so they could test my hba1c.  There was also a Dafne course scheduled in March '13 which I went on.  I also had various tests to make sure everything was in working condition (eyes,kidneys etc).  By June I had managed to maintain a hba1c below 7 for the 6 preceding months so my consultant was happy to prescribe 5mg dose of Folic acid (very important), and gave me the green light to start TTC.  

- as soon as I found out I was pregnant I had a booking appointment with the midwife (at 5weeks) and then had my first antenatal appointment at 6 weeks with the endocrinologist and obstetrician.  I saw these people every 2 weeks throughout the pregnancy.  I also had my eyes tested in each trimester and after baby was born.  In terms of scans : I had the standard ones at the hosp at 12, 28, 36 weeks plus I think 2 extra scans in the 3rd trimester.  

- throughout the pregnancy I had access to the DSN an and the dietician (by email) 

- It was a very intense and tiresome journey but I did feel incredibly supported by these people which made all the difference.

I hope this has answered your question ? Otherwise please feel free to PM me ! 
Wishing you all the very best and hope everything goes well - planning is key  xxx


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## fallfromgrace

tabbicles said:


> Ah that sounds ideal then, are you on folic acid? I bet you get the green light now!
> I had no problems, my daughter came 3 weeks earlier naturally so a week before they would induce. She was 7lb 8 so perfect size but I guess if it was full term she would have been big.
> I love this forum, so nice speaking to people who understand! X


Its lovely isn't it? so refreshing to speak to people that don't pull a 'your being melodramatic' face when talking about these issues. wow, must have been such a beautiful experience your daughter being born and such a perfect weight too! Im not on folic acid at the moment as the diabetes nurse I see every week said she wasn't sure if I would need to so to wait until I go to pre con, but Im pretty sure I should be on it now from what others have said. Did you get yours through the doctor/hospital or buy it in a pharmacy?


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## Cleo

Ps : in terms of hba1c results : I have never quite understood this as I don't think there is a specific result that they expect EVERYONE to achieve before TTC. Ie some women get the green light at 6.5, some at 7.0 and some at 7.5.  Think it's very much done on a case by case basis . Xx


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## tabbicles

My diabetes nurses always stressed that I should start taking folic acid as soon as possible, ideally for several months before falling pregnant! I got a prescription from my Gp then on repeat. I'm amazed your nurse didn't think it was not important yet when it was drilled into me! 
I never got an official go ahead but I knew what my hba1c needed to be from number 1.
 X


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## Northerner

I've heard that the over the counter folic acid isn't the right strength, so needs to be on prescription


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## trophywench

You're right Alan - it does need to be the higher dose for diabetic mums to be.

Yes Grace - but I see Lynda, and Dr Sankar.  I was at Walsgrave but after doing the CARBS 4 1 course at St Cross I decided I'd much rather go there -  and they said I could - it's just an extra Junction on the M6 (we're close to Jct 3, so Walsgrave is Jct 2 anyway, and Rugby is of course the next one), it's in the countryside, you don't have to queue for half a mile for the carpark and can always find a space, the carpark is cheaper, you don't have to plough your way through well - yobs - outside the main entrance on the way to the diabetes centre (the Wisden Centre entrance is to the right of the main entrance) so from the carpark you need to walk past them or through them if the Clinic you want is accessed from the main body - unless it's actually in the Maternity Block, which isn't where I said at all, but accessed from the roadway down the other side of the main carpark.  In which case Whoo Hoo - no ne'er do wells !

But I'm awfully sorry, actually going IN there is not what I'd call a really enjoyable experience, though once you get where you're going, they are (almost) all lovely anyway.  Do please allow yourself another 15 or so minutes to get parked up and sorted out.  You take a ticket to lift the carpark barrier to get in, keep it with you, don't leave it in the car - then when you come out you stick it in a machine and give it your money, it gives you the ticket back, find your car and drive back to the Out barrier, feed your ticket in the thing that side, and the arm lifts to let you out.  

Whereas, I actually enjoy my visits to St X !


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## fallfromgrace

Cleo said:


> Hello fallfromgrace,
> I'm one of the new mums who should have replied sooner
> My son was born on 29th March so he's now 3 months (crickey how time flies!).
> 
> - Basically, as soon as I told my consultant that my husband and I wanted to start a family she referred me to the dietician so I could learn how to carb count (this was in Nov 2012). I was asked to go back to clinic every 2 months so they could test my hba1c.  There was also a Dafne course scheduled in March '13 which I went on.  I also had various tests to make sure everything was in working condition (eyes,kidneys etc).  By June I had managed to maintain a hba1c below 7 for the 6 preceding months so my consultant was happy to prescribe 5mg dose of Folic acid (very important), and gave me the green light to start TTC.
> 
> - as soon as I found out I was pregnant I had a booking appointment with the midwife (at 5weeks) and then had my first antenatal appointment at 6 weeks with the endocrinologist and obstetrician.  I saw these people every 2 weeks throughout the pregnancy.  I also had my eyes tested in each trimester and after baby was born.  In terms of scans : I had the standard ones at the hosp at 12, 28, 36 weeks plus I think 2 extra scans in the 3rd trimester.
> 
> - throughout the pregnancy I had access to the DSN an and the dietician (by email)
> 
> - It was a very intense and tiresome journey but I did feel incredibly supported by these people which made all the difference.
> 
> I hope this has answered your question ? Otherwise please feel free to PM me !
> Wishing you all the very best and hope everything goes well - planning is key  xxx



Thank you for replying, lovely to hear your story turned out so well  Im sure going through the pre con clinic is the right way to go and will be all worth it in the end


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## fallfromgrace

tabbicles said:


> My diabetes nurses always stressed that I should start taking folic acid as soon as possible, ideally for several months before falling pregnant! I got a prescription from my Gp then on repeat. I'm amazed your nurse didn't think it was not important yet when it was drilled into me!
> I never got an official go ahead but I knew what my hba1c needed to be from number 1.
> X


I now find it strange that it hasnt been drilled into me after seeing everybodies responses. Ive taken it into my own hands now though and got put on folic acid today through the GP


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## fallfromgrace

Northerner said:


> I've heard that the over the counter folic acid isn't the right strength, so needs to be on prescription



I guessed as much but went to get some from the GP today (on repeat) thankfully


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## fallfromgrace

trophywench said:


> You're right Alan - it does need to be the higher dose for diabetic mums to be.
> 
> Yes Grace - but I see Lynda, and Dr Sankar.  I was at Walsgrave but after doing the CARBS 4 1 course at St Cross I decided I'd much rather go there -  and they said I could - it's just an extra Junction on the M6 (we're close to Jct 3, so Walsgrave is Jct 2 anyway, and Rugby is of course the next one), it's in the countryside, you don't have to queue for half a mile for the carpark and can always find a space, the carpark is cheaper, you don't have to plough your way through well - yobs - outside the main entrance on the way to the diabetes centre (the Wisden Centre entrance is to the right of the main entrance) so from the carpark you need to walk past them or through them if the Clinic you want is accessed from the main body - unless it's actually in the Maternity Block, which isn't where I said at all, but accessed from the roadway down the other side of the main carpark.  In which case Whoo Hoo - no ne'er do wells !
> 
> But I'm awfully sorry, actually going IN there is not what I'd call a really enjoyable experience, though once you get where you're going, they are (almost) all lovely anyway.  Do please allow yourself another 15 or so minutes to get parked up and sorted out.  You take a ticket to lift the carpark barrier to get in, keep it with you, don't leave it in the car - then when you come out you stick it in a machine and give it your money, it gives you the ticket back, find your car and drive back to the Out barrier, feed your ticket in the thing that side, and the arm lifts to let you out.
> 
> Whereas, I actually enjoy my visits to St X !


I always enjoy going to st cross too now, mainly because after seeing kim for years I feel I can really trust her and she knows me really well, been a total star. I do know lynda as well through the CARBS41 course and seeing Dr Sankar this wednesday coming.Small world eh?


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## trophywench

He tried to get me pumping in 2007 the very first time I saw him but as I was actually having a nervous breakdown at the time, I didn't take it any further.  He got his way though over 3 years ago (well, I well and truly wanted one, but just before I was about to ask him, he asked me !  When I said Yes, he said Oh - we'd better see if Lynda thinks it's a good idea !  She did, LOL)

Poor woman.  She always greets me with 'Hallo, Trouble!'

Nice.


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## fallfromgrace

hehe she is lovely isn't she? I bet we have bumped into each other there at some point. I tend to end up chatting to whoever is waiting there as well. Im glad you have had the pump for such a long time and still loving it, very reassuring


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