Courtesy of E!

Courtesy of E!

Dear Hallie:

You don’t know me but 6 years ago, I sent you a copy of my prenatal book, The Smart Mother’s Guide to a Better Pregnancy and your agent sent it back with a rude note attached. No worries. I don’t hold grudges.

Congratulations on your pregnancy at the blessed age of 46 but with your advanced age, I’m sure you’re aware of the potential risks. I would have sent this message via video but my 11 and 12 year old camera men (aka my sons) are still in school.

Women with advanced maternal age have to be extremely careful for a multitude of reasons and you, especially because you are a Class C Diabetic, meaning you have been a diabetic for over 20 years. In fact, you might want to read a blog I wrote entitled Pregnancy After Age 45 is a High-Risk Dilemma when you have a moment. Unfortunately you’ve joined a very unpopular sisterhood of celebrity women who had pregnancy complications that almost cost them their life. Don’t believe me?

  • Salma Hayek had Gestational Diabetes
  • Mariah Carey had pre-eclampsia and Gestational Diabetes with twins
  • Tori Spelling had a Complete Placenta Previa that required her to be hospitalized for 10 weeks
  • Jane Seymour had pre-eclampsia and an emergency cesarean section
  • Brook Shields had post-partum depression

Hopefully, you are under the care of a maternal-medicine fetal specialist (high risk pregnancy doctor) who will closely monitor your diabetes. In fact, it might not be a bad idea to seek out an endocrinologist as well. Because of your age and high risk condition, you should:

  • Have a 1st trimester blood test for possible genetic disorders including Down syndrome and Spina Bifida
  • Have monthly ultrasounds to document fetal growth because of your diabetes
  • Have weekly Nonstress tests beginning at 32 weeks
  • Not fly in a plane (even a private one) after 32 weeks to reduce your chances of breaking your water based on the difference in barometric pressure at 32,000 feet above land
  • Pay attention to fetal movement because of the increased risk of stillbirth with older women and especially those who have diabetes
  • Plan on being delivered by 38 weeks because of your diabetes

I wish you a healthy and wonderful pregnancy but remember: a healthy pregnancy doesn’t just happen. It takes a smart mother who knows what to do.