Having a home birth with type 1 diabetes is totally possible and safe. But there are a few things you need to know to see if it’s the right choice for you.

It also doesn’t mean you need to take a daily baby aspirin 🙃 (see why, and what I did instead here).

My first birth was a C-section at 39w 4d due to low fluid. VERY low fluid. It was a score of 1 when it should have been around a 10. Thank the Lord for BPP’s being able to catch problems!

Fast forward 6 years later from that csection and I was able to convince my husband to FINALLY have another baby! Baby #2! I knew I wanted a VBAC (vaginal birth after c-section) and I wanted to do it at home - but was that even safe? or possible?

I was thinking:

• Can you have a home birth with Type 1 Diabetes?
• Is home birth safe with T1D?
• What are the risks of home birth for women with diabetes?
• How to plan a home birth with Type 1 Diabetes?
• What do midwives say about T1D and home birth?
• Can midwives take on clients with T1D?

I had so many questions, and I bet you do too. So let’s get into it!

The short answer is YES.

Now of course, it goes without saying, but I'll say it anyway, there are some scenarios where a home birth isn't for every woman, diabetes or not.

If you are a healthy, well-controlled T1D woman, with no complications (even if, like me, you've had a cesarean before), you can absolutely have a home birth with type 1 diabetes.

Having type one diabetes is not a risk factor in itself.

I’ll talk in a bit about what some of the risk factors are and what might risk you out of home birth, but get it out of your head that just because you have diabetes makes you “high risk”.

Yes. And in fact, I felt safer birthing at home than in a hospital.

Hospitals don’t have great safety stats when it comes to birth:

• C-SECTION RATE: The national average is currently 32.3% and rising (as of 2024, according to the CDC)! That’s 1 out of every 3 women!
• INTERVENTIONS: The NIH estimates that around 70% of women get an epidural. Most of which lead to needing Pitocin and IV antibiotics - which then leads to a higher likelihood of needing a c-section.
• RISK OF TEARING: Hospitals, epidurals, and coached pushing lead to a higher risk of tearing.
• RISK OF INFECTION/HOSPITAL GERMS: Hospitals are nasty, dirty places.

So what about birthing with a midwife?

Most of the midwives that I interviewed had a 1-3% transfer rate. And most of those transfers are due to the mother feeling exhausted and wanting pain relief that the midwife doesn't have, like an epidural.

Laboring & birthing at home, for me, was safer. And when you feel safe, your labor tends to go a lot smoother too.

As obstetrician Dr. Stu (from the Birthing Instincts Podcast) says,

“A woman with T1D labors the same as a woman without T1D”.

So if a woman with T1D labors the same as a woman without T1D, then the next question is what about AFTER the birth… are there any risks T1D women have to look out for?

Surprisingly there is only ONE… but i’ve included two because the second one we hear a lot even tho it's not entirely true.

First up…

LOW BG IN BABY: this only happens when moms blood sugar is high before birth. This is because Baby is making his own insulin based on the sugar level in his environment - your uterus. So if your blood sugar is 200+ and baby’s pancreas gives him insulin for that but then 💥BAM he’s born and not exposed to the 200+ blood sugar then his blood sugar is going to drop.

It’s like when you’re sick and give yourself insulin for a meal, but then puke it up… you’re going to go low because that insulin has no carbs to go up against.

☝️ the solution: nursing so that the baby gets colostrum is a great solution for this. But if baby needs more than colostrum, then you could use donor milk. Some midwives will carry IV sugar for Baby or a sugar gel to rub on Baby's gums. I also had maple syrup on hand to rub on Baby’s gums if needed.

SECOND IS: "BIG BABY"

BUT.... most👏T1D's👏don't👏birth👏big👏babies👏 !!!

If you’re told that your baby is “BIG” know that growth scans are notorious for being off. Which is why most midwives don’t use them.

With my first baby, my OB/MFM told me he’d be over 10 pounds — and I’m sure if I had gotten growth scans for baby #2, they would’ve said the same thing. But guess what? Both my babies were 7½ pounds and born at full term:
→ My son was born at 39w4d, 7 lbs 8 oz.
→ My daughter was born at 40w0d, 7 lbs 7 oz.

BUT there is some validity to the claim that diabetics can have big babies:

Insulin is a growth hormone. So if you’re taking more than your body actually needs (causing lots of lows), or if you’re slamming back tons of carbs — and believe me, some (most) T1D nutritionists will actually tell you to eat 70–100g of carbs per meal 🤯 — then yes, that can lead to a bigger baby.

But if you’re not having a lot of lows, and you’re not consuming a ridiculous amount of carbs, your baby will very likely be a normal, healthy size. ✨

There are two things, related to routinely HIGH BLOOD SUGAR, that might risk you out of home birth:

BABY BORN WITH HEART, BRAIN, OR SPINAL DEFECTS: There is a higher risk of birth defects if your blood sugar isn’t well controlled. Most defects would likely be caught at the 20-week anatomy scan or during weekly BPPs (biophysical profiles) later in pregnancy.

Birth defects themselves typically wouldn’t affect how you labor or give birth — but if a defect were present, a home birth probably wouldn’t be the best option, since Baby might need medical care right after birth.

INAPPROPRIATE FLUID LEVELS: Depending on how high or low fluid levels are (for women with diabetes it’s usually high fluid - known as polyhydramnios) it means there is a problem in your baby's environment, and you’ll likely need a medical intervention to kick start labor.

In studies, diabetic women have about an 8% chance of polyhydramnios ⁽¹⁾  compared to 2% in non-diabetic women. But, it’s worth noting that the study that claims an 8% risk was looking at women with any kind of diabetes - meaning type 2 and gestational. The studies were not done on a group of well controlled type 1 diabetic mothers.

Here are the steps that I took to plan my successful homebirth with T1D:

✅ Find a midwife that’s comfortable with you having T1D

✅ Find a doula

✅ Think about what hospital you’d go to incase of transfer… how far away is it?

✅ Prioritize Strict BG Control

✅ 20 week anatomy scan to look for birth defects

✅ Weekly BPPs starting at 38 weeks, every 3 days if you’re past 40 weeks

✅ Get educated on physiological birth. Birthing Instincts podcast and IG account (@birthinginstincts) is EXCELLENT for this! He’s an OB and his co-host, Blyss, is a midwife.

✅ Watch positive birth videos. IG is filled with these. My favorite was @christianhypnobirthing

✅ Have a plan for low BG in baby

✅ Ward off pre-eclampsia with brewers diet (see why HERE)

✅ Consider changing diet for better BG control and better health outcomes for Baby (I personally follow a high protein animal based diet with seasonal fruits & veggies from local farmers)

✅ Get a good prenatal: The best prenatal in my opinion is organ meats; liver in particular. Vitamins & minerals from animals are more bioavailable than if they’re plant-blased. My favortie companies to use are Heart & Soil or Paleo Valley’s Beef Organ Complex because their cows are pasture raised, 100% grass fed, and not given mRNA vaccines or antibiotics.

And also Folate - NOT FOLIC ACID - helps women with diabetes ward off infant spinal defects. I take Thorne's 5-MTHF Folate.

✅ Red Raspberry leaf tea?: on the fence for this. I’ve heard anecdotal evidence from several of my mom friends who have had more than one kid, that RRL tea made them have longer pregnancies (going past 40 weeks). When they didn’t have RRL tea they delivered on or right before their due dates. With my second pregnancy I didn’t drink RRL tea and had my baby at 40w0d. So I’m up in the air on this one. If I were to get pregnant again I would not be drinking RRL tea; at least not religiously like i did with my first.

✅ Walk and move to help get baby in a good birthing position. But if Baby is breach have no fear! Home birth breach is an option! Breach doesnt = Csection. Find a midwife who is trained in breach delivery HERE.

Blood sugar will usually go up during labor because of a spike in cortisol. I noticed this a bit, but it wasn’t a spike, more like a steady rise and was easily managed with a bolus.

FIASP is a great insulin to have on hand during labor because it works faster than humalog & novolog to bring down blood sugar. And remember, the more we can stay in range, the less likely Baby is to have low blood sugar.

I had both low carb and high carb snacks on hand for either scenario - but honestly, I never needed them because I had ZERO appetite during labor.

If having a home birth is something you really want for both you and baby, it can totally happen. With tight blood sugar control, a healthy diet, and a good birth team, you can absolutely do it! My HBAC (home birth after csection) was a long, intentional journey that was worth every minute.

Resources Mentioned:

My article on Baby Aspirin & Brewer's Diet

Birthing Instincts Podcast with Dr. Stu & Blyss: Listen on Apple  Listen on Spotify

Breech providers

My article on What to Expect at Your BPP Appointment

Prenatals:

• Heart & Soil Liver
• Paleo Valley Beef Organ Complex
• Thorne 5-MTHF Folate

Natural Births for Type 1 Diabetics FB Group

Fiasp

IG Accounts:

• @birthinginstincts.
• @christianhypnobirthing

Did You Have a home birth? Do you want a home birth? Whats holding you back? Share it in the comments!