So I am a couple days past the 31 week mark and, to be honest, this first pregnancy has been pretty good. I had the usual crazy lows up to about 24 weeks. Then the expected insulin resistance started around 26 weeks and has been steadily increasing. It feels like a whole new ball game since then. My DP has disappeared and now I have real trouble in the afternoon, evening and overnight. I have highs that won't respond to corrections. I feel like a complete rookie at all of this!
I saw my endo 2 weeks ago and she was alarmed that my A1C had increased from 5.3 to 6.2 in about 6 weeks. We now meet every 2 weeks to perfect the I:C and basal rates. I am working harder than ever and she knows it. I really like my endo and know that she has the best in mind for both me and the baby.
But she dropped a big one on me today. This morning she said that I should be prepared for the baby to be induced at 37 weeks after an amnio to determine lung function. She said that I may not even make it that far. She told me to prepare for him to be in the NICU for hypoglycemia after birth. This is the exact scenario that I've been trying to avoid.
I know that this is all is in the realm of possibility and may or may not come true. I guess the weight of diabetes is resting heavily on my shoulders after that news. I spent the first months feeling in control and telling myself that I could have as good of a pregnancy as a non-D woman. Today I feel as if diabetes is stealing the health of my child. And I feel powerless to stop it.
What was she basing that on? Since hypoglycemia at birth is based on your blood sugar around the time of birth, this is by no means a sure thing. I had a complete BS crash before I gave birth (at 35 weeks) because the placenta started shutting down in preparation for the baby's birth (I didn't know this at the time, only was told in retrospect) and so my blood sugars were NUTS before I gave birth. My baby was not hypo though when he was born, as my BS was managed very tightly in the 12 hours preceding delivery while I was in the hospital.
As for the diabetes baby guilt --- you do the best you can and accept that the rest is beyond your control. The most important thing is that first trimester, and given your good a1cs the problems associated with imperfect control in the 3rd trimester feel much scarier when you are pregnant than they do in retrospect. I cried when I found out my baby was measuring in the 98th percentile at week 33 because I felt like I had failed him, despite how hard I was working. Looking back, I did the best I can and being a big baby was probably worse for me than it was for him and he is a totally normal level of chub now at six months.
Anyway, try not to worry if you can manage it. Pregnancy hormones_+ first pregnancy + diabetes guilt are not a nice combination and things can feel much more serious in the moment than they will later.
It sounds to me like you endo is just preparing you for the worst case scenario. My daughter was born at 34 weeks. I was told her lungs would be immature and she would be a nicu baby as well for more than just the possible of blood sugar issues. The human body is resilent just as the baby's body is as well. My blood sugars were under tight control during her delivery. She did go straight to nicu, but she did fine. No blood sugar issues and lungs were mature. She spend 6 days there due to low birth weight (which is odd for a diabetic) and issues with maintaining body temp. She is now 2 years old and there is no way to tell she was premature or small.
My son was in the NICU for a week following his birth. It was upsetting and scary but it was mostly precautions for him to ensure he would be leaving the hospital a healthy boy. I'm sure she's just preparing you for the worst case scenario since there is no way to predict what will happen.
I am confident you and your baby will be just fine.
I'm 29 weeks and have just entered that realm of craziness too with overnights that I just can't quite fathom yet - grrr. Take heart that you are at 31 weeks and that your ob is talking 37 weeks when babies are term - not 32 when organs are starting to mature :) My daughter was born at 34 week as the placenta was starting to shut down and spent 12 days in the NICU - lungs were fine but she was delivered in a hurry during steroid treatment and probably didn't get the best foot forward because of that. At 27 months she's the size of a 3.5 year old and is bright as a button - what I'm getting at is without knowing the intimate details of your pregnancy, and not being a medical professional, to this third time preggers T1 it sounds like you're doing a mighty fine job and have a team of docs on hand to help you get the result you've worked so hard for... I'd also take heart that you're seeing your endo every 2 weeks still and aren't sitting in a hospital bed - it's all sounding super positive!!!
Wow, third T1 pregnancy! Do they get easier? :-D
Yes :) You become more patient about all the doctor visits!
Thanks everyone - I appreciate the words of encouragement. I am feeling much more settled (for lack of a better word). I think it was the shock of the news. Perhaps it is because it's getting down to the home stretch, but it just seems so much more real now. The time is coming when all the "maybe's" and "could be's" will be :)
My A1c was between 6.0 and 6.5 the entire pregnancy and I had a c-section after 38 weeks and no hypoglycemia at birth. I had a big boy (9lb 5 oz), but he is perfectly healthy and seems unaffected by my diabetes now :) Many of us do end up having our babies before 40 weeks. I really wanted to go to 40 weeks, but my doctor felt that it was time after completing the 38th week and as it turns out our little guy was really ready to come out!! Keep your chin up you are doing great and you aren't far from holding that precious little baby in your arms!!!
I was told this could happen to me as well. I had my baby at 38 weeks and his bg crashed but they tube fed him formula right in the delivery room and got it back up and I was able to nurse within an hour after my c-section. They tube fed (inserted a tube into his stomach through his throat) him because it was the easiest delivery method without giving him a bottle because I wanted to nurse him. They were great with adhering to my wishes. I am hoping my next delivery in May is as easy but I'm having more trouble with my bg in this preg. than the last.