I am almost 31 weeks pregnant, and it's going well so far. The baby was about 3 lbs according to the last ultrasound check 6 days ago.
My OB talked about the delivery process and mentioned that she would schedule the induction (just in case) on the 38th week. Isn't it too early for a diabetic who doesn't have any complications or issues with pregnancy so far?! I am very concerned about the whole situation, since I don't think my OB had dealt with too many women with type 1 diabetes (mostly gestational diabetes), which makes me a bit nervous.
I went to my endo today and shared my concerns with her. She (being type 1 herself and having two healthy kids) said that there is no reason for me to have induction if there are no issues (baby size or anything else) closer to the due date, and that induction at 38 weeks could be just too early. She said that I need to push back and be able to stand my ground.
Another concern I have is 'who will be controlling my blood sugar levels during the labor'? If it's just a nurse, would she know enough about diabetes in general? Sometimes I get the feeling that nurses at the OB office have no idea what type 1 diabetes is. At one of the appointments one nurse even asked me to do the glucose test by giving me a bottle with sugar water... and even after I told her that I have type 1 diabetes, she was not too concerned...
Unfortunately, I can't just go to a different doctor, since this is the provider covered by my insurance.
Did you have any similar experience with your OB? Do you have any advise on how to deal with such a situation and when to say 'no' to certain procedures?
Sarah-- my doctors had the same concern, but they agreed to closer monitoring and keeping the little one inside as long as possible. The non-stress tests and the ultrasounds will show if the baby is in stress. I was going every other day, then every day in the last week and we were able to complete week 38.
That said, I was SOOO focused on making it to week 40 because I thought of that as "success" (and because my mother had her babies in week 42!). When we had our c-section one day after completing week 38, our little guy was completely ready to come out! He had meconium in the amniotic fluid, no vernix left on his skin, and seemed ready for the big world!
Sometimes I also feel that there is really no one to support me except my husband. I do have a great endocrinologist though who is very supportive, and every time I have an appointment with her, it's very encouraging. I also talk with my previous OB [I moved away and no longer visit her, but can always give her a call :)] and she said that diabetes itself is not considered a complication, and there is no reason to use any medical procedures if everything is going well. She also mentioned that it's very important to let your body do what it needs to do if there is no harm to the mother or baby of course.
During my last OB visit I expressed my concern again about the induction at 38th week, and my doctor seemed to be more understanding and is willing to wait and cooperate as long as everything stays within the norm. It was a huge relief. I am just very scared of any unnecessary procedures since they may lead to further procedures and even a C-section (which can be avoided). My husband and I are now thinking about getting a doula who has experience with diabetic mothers.
Also, I heard from many women that wearing a pump during labor is very helpful (as LAK mentioned as well), and I think, no one should discourage or prevent wearing a pump during labor.
It sounds like, between your husband, your endo, and your former OB, you actually have a pretty good support system! I am definitely of the mindset that, if it ain't broke, don't fix it! Unless your doctors see some reason to intervene (low fluid levels, pre-eclampsia, evidence of placenta breakdown, etc...) then there is no reason to do anything. Your body will, in all likelihood, do exactly what it was designed to do. Also, for what it's worth, we had a doula, and she was fantastic!! A huge support and advocate. Oh, and wearing a pump during labor/delivery is a no-brainer (unless of course you don't want to wear it, which is totally fine too.) If you want to wear it, then do! No one knows your diabetes like you do, and you are really the best person to manage those blood sugars at that critical time.It was very easy to wear. I stressed about how exactly I would wear it in the hospital (in an arm band? In some kind of pocket?) Turns out I ended up just staying connected and setting it next to me on the hospital bed. No problem at all.
My OB allowed me to self monitor and I typed up a plan in case of c-section where I wasn't able to self monitor on what to do. We knew ahead of time there might be a chance of a crash c-section so he let me decide what I wanted to do. My daughter was born at 36 weeks due to water breaking early. She was 4.5 lbs. My Ob didn't even bother to schedule a c-section he was willing to let me go until she was ready to come out. He didn't feel there was no need to do an early induction or a c-section since I was under tight control already. He even allowed me to tell him what I wanted on hand iv wise concerning diabetes and told me that my diabetes care was totally in my hands.
I had my little girl in July of 2010, and I was told by my obgyn that they were going to induce me right at the 38 week mark. I too wanted to wait and hoped that I would deliver naturally as I really didn't want to be induced. The reason they wanted to do it at 38 weeks is because they say a diabetics placenta can dry up. However, I don;t wuite get that if you are in stable condition, I had nothing wrong with me, no high blood pressure, no high sugars, no low sugars, in fact pregnancy only made my diabetes better and I'm not sure if it's because I was extra cautious or what???? I did not feel like a diabetic when I was pregnant, and i really wanted to be treated like a woman without a condition! The had had my induction date set for July 30th and I went to get checked out on the 26th just to see if I had dialated. The OB had ensured me that I would not be delivering anytime soon and that I would be getting induced on the 30th....well boy was she wrong! My water ended up breaking 12 hours later, but unfortunately the way I was positioned to help relieve the labour pains, I was causing stress on my little girl and was told I should have a c-section. I was ok with it because I was in pain and at that point I just wanted to get her out! During the c-section, I kept my insulin pump on and monitored it myself...they never even checked my sugars the entire 4 days I was there which I thought was kind of weird but at the same time I liked it that way! In the end, I had a little girl who was born at 37 1/2 weeks! She nursed and took the bottle immediately which was a bonus for me, and she is now a healthy almost 2 year old!
I say go with your gut because it's always right and don't do anything you don't want to do!!! You could even try natural ways of going into labour so you dont end up getting induced.
Good luck and please make sure to let me know how everything goes...if you have any other questions, please ask :)
Thank you for sharing your experience. It's very helpful to know other peoples' stories. It's strange though that they never even checked your blood sugars. Was it something you talked about with your doctor before?
I'm 31 1/2 weeks and the baby is measuring about 5lbs now so we are keeping an eye on it. My BG's are great and my A 1C is 5.5 so we shall see....
Do you see a high risk OB? Mine is wonderful and very helpful!
You will have to ask the hospital you are birthing at about who will be controlling your BG's.They will keep an eye on it of course but sometimes they will let you keep your pump on and other times you have to be put on an insulin drip. You can always check your own BG's though.
It's your body and your bbay and you can say no to anything you don't feel comfortable with.Ask lots of questions and write a birth plan.
Congrats by the way!!!
Thank you Angela!
I'm not sure if my OB is considered a high risk OB or not, but she does act like one :) My endo is the most helpful person. She said she would look into the hospital protocol and let me know about what their strategy for controlling BS is, and then will help me with birth plan as well.
I am not on the pump. I just did not like it. I used Omnipod for 6 months when I was thinking about trying to get pregnant, but it just did not work out, which pushed my trying to conceive further. I got back to my injections, brought my A1C down again, and felt much better about not using a pump.
So here we are :)
Got my A1C checked this week, and it's 5.1. The lowest I've ever had!
During the last ultrasound, they said that my baby is measuring just according to a textbook (neither smaller or bigger), which is a good thing, I believe :)
Congratulations to you to!
Please keep us posted how everything goes.
Sounds like you are doing perfectly and congrats on your super A1C.
My baby was also pretty much text book growth the whole time and my A1Cs ranged from 4.9 to 5.4.
This pretty much means that you would be considered non-diabetic in terms of risk to your baby.
Just read your comment in birth stories post. Thank you for all the info!
Well we got home from the hospital last night with our Rachel. She was born via c-section (due to beinging breech) June 7th. She was 6 lbs 11 oz and 19 inches long. So not the typical huge diabetic baby. My A1c ranged from 5.8 at conception to a 5.3.
Rachel's blood sugars were 53 at birth (normal for an infant) and did dip to 38 at one point. They allowed me to breast feed her in recovery, although hospital policy (if suagrs are below 40) is that she had to go to the floor nursery for observsations. Once she had 2 normal suagrs spread 1 hour apar they would move her back to the room. Her enxt sugar was a 61 and the one after that she was a 65. From there on she got to stay in my room.
I wore both my pump and CGM during the delivery as well as throughout my recovery. My husband was allowed to bring my meter, and dexcom receiver into the OR and he could also work my pump if needed. My blood sugars ranged between 84-115 during the surgery. My endo gave me temporary settings for delivery day and suggested setting for post delivery with the expectation that I would likely need to tweak them.
I had to set my basals to 60%. I was weird and my basals consitently dropped throughout my pregnancy although my carb ratios and sensitivity did get "worse." so they could not just go back to my prepregnancy settings as I would be taking MORE insulin.
Hope the info helps.