Diabetes control in pregnancy: who takes responsibility for what?

At our diabetes team meetings in Peterborough, which included a psychotherapist, the issues involved in who takes responsibility for the birth of a healthy baby from a diabetic mother were explored. Traditional prescriptive approaches were compared with the empowerment model in the specific instance of pregnancy, when the needs of the fetus have to be considered as well as those of the mother. Clinical examples are given to illustrate the dilemmas over who takes responsibility with different models, and questions are raised for debate. The empowerment model of diabetes care may not be entirely applicable to the pregnant diabetic woman. Copyright © 2003 John Wiley & Sons, Ltd.