February 25, 2004
Family Planning
Question from Pau, Pyren�es-Atlantiques, France:
I have had diabetes since age five. I have been told by my doctors that, if I wish to have children, I should do so before age 30, although he didn’t explain why. Also, last year, I was refused a repeat prescription of birth control pills, by a different doctor, who told me it was dangerous to take the combined pill if you have had diabetes for more that 10 years. My questions are:
Why is the combined pill dangerous? To what degree is the risk? I have tried the DepoProvera injection and the mini-pill, neither of which agreed with me. Personally, if the health risks associated with the pill are small, I would rather take that chance than risk an unwanted pregnancy.
Why is 30 a cut-off age for having children? I am a recent graduate and I am just beginning my career. I know I will not be ready to have children by that age. Diabetes-wise, what risks does a mother older than 30 face?
If I decided to adopt children rather than go through a dangerous pregnancy, could I be turned down due to my diabetes?
Answer:
In a woman with well controlled diabetes and no vascular disease, birth control pills are a reasonable option. The concern is increased risk of clot formation. However, the risks of complications from pregnancy are probably greater than those of the oral contraceptives. I am not sure where the age 30 cut-off comes from, other than with long standing diabetes there is a great likelihood of secondary complications, such as kidney and eye disease. Once again, if you are well controlled and these other conditions are not present, then your risk should not be significantly increased.
I am not sure if you would be turned down for adoption. You probably should call an agency and test the waters.
OWJ
