Replies to This Discussion

Permalink Reply by lizzistardust on February 2, 2011 at 8:29am

Sandra, CONGRATULATIONS!!!

I'm almost 12 weeks and I was really worried about the "high risk" label, too. But when I had my first prenatal visit, I was convinced that my OB and her staff will treat me and my baby, instead of my diagnosis. They don't have across-the-board policies for diabetic patients, and so they only recommend interventions based on what's going on in an individual pregnancy or delivery. They rarely even induce their diabetic mothers early, which I had read was a common policy and it was one of my biggest fears. I think I was just really lucky to already have an OB/gyn who had that kind of attitude.

That said, one of the smartest things I did was contact a midwife who also serves as a doula to women who have hospital births. Since she has a very strong bias toward natural birth (being a midwife and all!) but has also attended at most of the local hospitals, she was able to recommend which hospital was most natural-friendly. She even recommended her favorite doctor at that hospital, though said that any of them would be great. (I should note that it was not my hospital she recommended, but I felt good enough about my OB that I've decided not to switch.)

Also, simply having a doula would be a great choice. One of the many, many benefits is that they can help you try natural alternatives before accepting some interventions. She can explain choices to you if the doctor glosses over them, and she can help express your wishes. Women who have a doula have a lower rate of interventions than those without.

Permalink Reply by Sandra F on February 2, 2011 at 4:40pm

Thanks for the great advice -- and congratulations on your pregnancy!!! I've investigated using a doula and I think a doula will definitely be part of my "birth team." I really like the idea of one-on-one continuous support throughout the labor process since from what I understand the nurses can be awesome -- or not so much -- and you never know in advance who you will have. Plus, at many hospitals I know nurses are just really overworked which means that you're basically alone for much of the labor (besides my husband and probably my mom, who are both wonderful, but not very experienced -- at least not within the last few decades in the case of my mom!). Especially with a first pregnancy, I'm sure a doula's presence will be extremely reassuring.

It sounds like you have a great OB. That's exactly the kind of attitude I'm hoping to find in my care provider. I had a pretty negative experience with the doc who has been my GYN for years at my first prenatal visit. I always saw the midwife in his practice for my routine gyn stuff in the past and had only met him once. When I first found out I was pregnant I didn't put a lot of thought into choosing an OB and blissfully scheduled my first prenatal apt. with him without really thinking about it. Then as I asked questions about what exactly the "high risk" label meant, he outlined all the problems diabetics can sometimes have. When I pressed him I found out most of these are associated with poor control and I have extremely tight control -- a distinction he didn't really seem to acknowledge. Then he started talking about routine induction at 38 weeks and seemed very dismissive of my concerns about this -- so I knew I needed to switch. I'm shopping around now and am hoping to be co-managed by an all-midwife practice and a maternal fetal medicine doc at Yale who is a diabetes specialist. The midwife practice has told me I need to get the green light from the maternal fetal medicine doc before they will accept me as patient and my first apt. with him is next week, so we'll see how it goes. Fortunately where I live I have quite a few choices. If I were in a rural area that may not be the case. I'm also really lucky to have a very close friend who is a midwife so she has been able to give me the "inside scoop" on a lot of things. Some of them I wasn't necessarily psyched to hear (like it will be tough to find a provider who would let me go past 40 weeks), but she's been great about giving to me straight. In fact, I wanted her to be my doula, but because of her work schedule she can't commit to being available.

Anyway, thanks again for your reply. I hope things continue to go smoothly for your pregnancy. Keep us posted!

Permalink Reply by MelissaBL on February 2, 2011 at 10:29am

Welcome to TuDiabetes and the Oh Baby group! I just celebrated my daughter's first birthday this week. Looking to TTC #2 some time this year.

My OB's practice was one that had mandatory 38 week induction or c-section (I chose the c/s), but you'll find that OBs out there can vary GREATLY. So keep searching for one who will work with you. I've met a lot of women in the positive diabetic pregnancies yahoo group who progressed to 39 or 40 weeks and were able to do natural births.

I was perfectly happy with the care I received and my baby was born without any hypoglycemia. My husband had his hands on her within seconds of her birth and I was able to breastfeed her very soon after she was delivered. She lay on my chest as they moved me to my recovery room. The only thing about her birth experience I would have changed was that I would've liked more lactation assistance in the first couple of days.

Best of luck to you and keep us posted!!!

Permalink Reply by Gina on February 2, 2011 at 1:22pm

Melissa, you say you chose the C section, and you still were able to breastfeed her soon after delivery? How soon? I have friends I work with whom have had C-sections (they aren't diabetic) but couldn't see the baby for hours after the surgery? Just curious?? Thanks for any info!

Permalink Reply by MelissaBL on February 2, 2011 at 1:35pm

The c-section takes only 45 minutes - about 15 to remove Baby and about 30 to stitch you up. I couldn't hold her during those 30 minutes for obvious reasons. They took her out, performed the Apgar tests and weight and such (with my husband over there with his hand on her), swaddled her and put a little hat on her, and then handed her over to my husband. He held her for a bit near my head while they finished stitching me up, they laid her on my chest, and wheeled us in my bed to the elevator where we rode up to the recovery room. From there, my memory is a little hazy. I know I wasn't holding her while the nurses lifted me/rolled me into the bed, but it was shortly after that that I got into position for the first feeding. They might have taken her to the nursery briefly, but I think I nursed her within about an hour of delivery.

Permalink Reply by Sandra F on February 2, 2011 at 4:43pm

Melissa,
It's fabulous to hear a really positive c-section birth experience. So happy for you and your daughter and your husband! Thanks for sharing. :)

Permalink Reply by Marps on February 8, 2011 at 10:56am

Thanks for doing this discussion. And congrats on your pregnancy!

I'm type 1 for 12 years and 15 weeks pregnant with our first baby. People around here don't know much about type 1, so it's been difficult for me to find answers to my questions. I, too, would like a natural labor for my baby, but am worried about having low blood glucose, or high blood glucose levels while trying to deliver.

Also, I've read in many places that type 1s who go full term have high risk of stillbirth- which scares the crap out of me, so I am researching early delivery- possibly 2 weeks early to be sure my baby survives in the best conditions.

I haven't even considered prenatal yoga classes, so thanks for mentioning that! I've been doing mild elliptical runs for an hour a day since my energy level has gone nearly to normal. The first trimester was very tiring and I could barely get myself out of bed to go to work those first 3 months! Finally beginning to feel like myself again.

Is your belly "showing" at all? I'm starting to show now, and am a little concerned it's too soon for me to show? I was pretty toned and thin when we conceived, so I suppose I'll show relatively soon because my stomach was flat before.

Congrats again! And thanks again!

Permalink Reply by Kristin on February 8, 2011 at 1:46pm

I'm 20 weeks pregnant now with our first baby.

I think that your best bet is to find an OB-GYN who considers your level of control. My A1c is not nearly as low as yours, but my OB-GYN sees that I have pretty tight control and treats me according. I do, however, like having the "high risk" label for the extra attention and exams. If there is any problem, I feel that I can trust my OB-GYN will be aware of it and then we can proceed accordingly. I know that my OB-GYN has let a woman with type 1 go to 41 weeks (she was hospitalized and monitored carefully due to pre-eclampsia in the last weeks), but it was also important to me to be only induced or have a scheduled c-section if we can see a reason to do so.

I'm interested in introducing some aspects of natural labor into our birth experience, but I'm trying to keep my mind open at this point and will make the decisions as we get closer to the date based on how our baby seems to be doing. I know that if the baby has a low blood sugar at birth, I want that taken care of before cuddling! Of course, I would like contact with the baby and to be able to breastfeed as soon as possible, but I want to be sure that our baby has a normal blood sugar as soon as possible. I'm hoping it will be perfect.

Like Melissa said, the advice that I got is to have your partner stay with the baby. Even if they have to take the baby away for some reason, my husband is planning to follow right along and be able to hold the baby whenever possible.

Permalink Reply by Angela on February 9, 2011 at 7:10am

Thank you for this post Sandra! I've been type 1 for 16 years and PLANNING on pregnancy (hopefully soon).
I love my OB. one of the 1st things that came out of her mouth was "we always try for vaginal birth 1st".That was a relief! Usually they look at you and say "oh,diabetic=automatic C section" It's pretty sad!
I wish you lots of luck and also Congrat's!!