Nd advice! C-sec 2morrow!

Ok, so after 9 months of an average a1c of about 5.9/6, I'm still having a giant baby! They're estimating at least 10 pounds... So, to be safe, I'm having a c-sec tomorrow (1 day shy of 40 wks)

I'm a first time mommy and obviously very excited and terrified... I'm not sure what to expect with my blood sugar. The hospital is letting me and my husband manage my numbers and keep my pump on, but it sounds like everyones insulin requirements post-labor is different. My pancreas produces absolutely no insulin... and so I guess I'm just needing some advice...

What was your experience post c-section with insulin? With baby's blood sugar? Did you need to drink any clear juice before the procedure because of a low blood sugar? Anything you wish you would've known before hand? I hate the unknown!!

Thanks so much!!

I was told my baby weighed over 10 pounds on the ultrasound.  When he was born he was 8.9 and was tall and not fat, exactly like my husband.  So don't stress you're having a giant baby.  You may or may not.

Your blood sugars should be pretty good because you won't eat pre-surgery.  I doubt they'll let you drink anything before the c-seciton.  Glucose tablets are probably the best way to treat a low if you need to.

You'll be awake for the first part of the c-section and it doesn't hurt, you mostly feel odd pressure.  Kind of like having dental work done, where it feels weird, but isn't painful.  Then your baby is born and you'll be seeing this amazing new person!  Your pregnancy will seem like nothing and you'll realize THIS is where it really begins!  

After that your husband will probably take your baby to be bathed and evaluated and then you will get full anesthesia while they finish the rest of the procedure and close the incision.  You might want to clarify with your doctor if your pump will be connected the whole time.  For my c-section, the pump was removed and they had me on an insulin drip until I came out of anesthesia a few hours later.  

Bring your meter, extra stips, pump supplies, syringes, and snacks.  Insist on getting back on your pump as soon as you are able to manage your blood sugars. Sometimes doctors don't include everything in your chart, or a doctor who doesn't know you gives directions to the nurses.  Hospital staff is not used to a savvy type 1 mom, so you may have to be insistent about making your own insulin decisions.  I had to refuse what was charted a couple times, but the nurses felt better when they saw my blood sugars were consistently good and the doctor finally made accurate notes on my chart.  With a c-section you'll be in the hospital a few days.  Sometimes the surgery can delay your milk coming in, so your baby may need to have formula until you are able to breast feed.  

Make sure to bring a cute outfit for the baby becasue the hospital will take his/her picture and have a cute, loose outfit for you to wear home.  Most new moms have puffy stomachs for a few weeks or months, especially with a c-section.  

I'd had diabetes for 28 years when my son was born and my c-peptide tests show that I don't make insulin, but once I started breastfeeding I took no insulin at all for a couple weeks.  In addition to the breastfeeding, think my blood sugars were low because of the post pregnancy hormones and lack of sleep.  Eventually my insulin dose went back to normal.  Make sure to drink juice or eat something when you breastfeed because it lowers blood sugar.

It took probably 6 weeks to fully recover from the c-section.  The toughest part was not being able to drive.  My incision wasn't painful after the first few weeks, but taking pain pills until the prescription ran out helped me not be so tired.  

Let your husband, family and friends handle housework and help with the baby.  It will help you recover more quickly.  Also, even though I breastfed my husband did the 10pm feeding every night by bottle.  I went to to sleep around 8pm and had almost 4 hours before baby needed to be fed again.  That helped a lot.  

You will find what works for you too.  I am so happy for you and this wonderful new time that is beginning in your life.  Congratulations to you and your husband!

My perinatologist was thinking my youngest daughter was 'big'.  Measured in/near 9lbs.  She was born at 6lbs 13oz.     Some women just have big babies.  Sounds like your A1C was good during pregnancy and you've done everything you can.  

Try not to worry too much.  Sorry, I haven't been through a c-section so have no advice there.    Good luck & congrats on your Valentine's baby!

Oh Jenna, thank you so much! I've been T1 for 19 years, and it blows my mind to think I won't need any insulin (since I'll be breastfeeding), but I'll watch and expect that. Thanks again!

It doesn't happen for every diabetic mom, but I've seen others post with the same experience.

You'd think it would have been wonderful to be insulin-free but it was so unexpected, it made me feel kind of crazy.  I kept thinking, did having a baby cure my diabetes?  Unfortunately it didn't. =)  

Fortunately, motherhood is so wonderful that having diabetes didn't seem like such a big deal anymore.

I'll be praying for you tomorrow.  I love that Katie caught you're having a Valentine baby!  That's a wonderful day to be born.  

First, let me say how exciting it is for your baby to almost be here! I felt just like you - I had a scheduled C-section for my "giant" baby (they were estimating him at almost 11 lbs!) and when we went in the night before, I was super nervous. I am a planner and that unknown - I DID not like that. But things went fine - I ended up having to be put completely under, so I can't attest to the feelings of the C-section, but it all went fine, and in the end, like Jenna, I had a 9 lb baby, who lost a little more weight before we left the hospital.

Also like Jenna, I also needed almost no insulin while b-feeding. The plus side of that is that I was able to stockpile my supplies a bit, but it also felt very strange to be taking so little insulin but eating so much more than normal, too! And it was a bit of an adjustment and trial and error period after I stopped b-feeding to figure out what my new post-baby diabetic body needed. My doctor was very good, saw me often enough to make changes as needed and I got back to "normal" pretty quickly.

The only other thing I can say is this - I read a lot of books beforehand which all told me the same thing - trust your instincts. you know your body and your reaction to insulin better than anyone else, and if yuo don't understand why they want you to do something, or it seems strange, ASK. Better to be clear about things, then wondering why something was done the way that it was.

Enjoy that new baby - it's so much fun! Congratulations, and good luck!

When I had my last ultrasound before my daughter was born by c-section, the ultrasound said she'd be anywhere between 8 and 9 pounds. My doctor put her hands on my belly and estimated 8 lbs 9 oz...and she was only off by an ounce! My blood sugars were very well-controlled, from 5.5 to 5.9 throughout, so it is possible to have a large baby even if you're in ideal ranges.

The c-section for me was a breeze. I didn't eat anything after midnight the night before, and when I had one low blood sugar in the early morning hours, I drank 8 carbs of apple juice. When I arrived at the hospital, the plan was to have an insulin drip, but somehow wires were crossed, and no one had the drip numbers at hand. So my endo approved me to stay on the pump during the c-section and control everything myself. It was kind of wonderful and scary at the same time.

When I was wheeled into the OR, I suspended my pump. The doctors got started with everything, and it was only half an hour before the incision was made. 50 minutes later, my baby came out with the healthiest set of lungs the nurses had ever heard. She was shown to me for a moment (gorgeous!), then she was whisked away for the testing. My husband stayed with her the entire time to make sure they never gave her formula.

Her blood sugar was on the verge of low when she was born, and it ended up dropping to the high end of low -- to the point that they needed to correct. I was insistent that they not give her formula, so the hospital treated her low with donor milk (my milk took a few days to come in because of the c-section).

As for my blood sugars, they were perfect at 100 mg/dl during the c-section (I got to keep my CGM on as well). Once I was closed up, I was wheeled back to the room, and I immediately began my pump again at my pre-pregnancy numbers (provided by my endo). I never had a point where I did not need any insulin.  

I had to drink juice every time I nursed, and I experienced some lows, so I adjusted my basal down over the next few weeks. It took a while to find the perfect ratios, and as the months went by, once I thought I found them, they kept changing -- my body got more efficient at producing milk.

What I wish I had known:

Your baby may need a correction for BG even if your A1c was ideal. I knew that the correction may be necessary, but I didn't stress it to my husband because I thought she wouldn't need any supplementation. He was a little scared that she was in the NICU.

Babies born to type 1s can have large shoulders. Something to do with holding the elevated sugars in the shoulder area, I was told. My daughter looked like a linebacker...but the shoulders fade over time.

C-sections tend to bring on jaundice. I was not expecting jaundice at all and did not know that it's common, even among natural births. It's an annoyance (lots of trips to the doctor, lots of time in a bilirubin blanket), but is easily fixed by a bilirubin blanket or time in a light box.

Your blood sugars will most likely be fine in that short window of time during the c-section. Focus on the baby. I wish now that I hadn't worried so much about my BGs and had focused on the miracle of birth.

Congratulations on your little miracle! Enjoy the birth and every single moment with your brand new baby!!

Let us know how you and your little one are doing!! Best wishes~