Twenty years ago, medical opinion was against women with diabetic kidney disease (nephropathy) proceeding with pregnancy. With new technology and increasing experience, the outcome for these women and their children has improved substantially. Over the last decade, there has been a substantial decline in the number of women with diabetic nephropathy who die during pregnancy, childbirth and early maternity. Successful pregnancies with fetal survival rates of up to 95% are now achievable in women with diabetes who suffer kidney damage.