Questions about delivery

Hi all, I've reading for a few weeks now and wondering, do all of us t1's have to have c-sections or be induced, or have there actually been some natural births?  I know they induce and do the c-sections for certain complications (pre-eclampsia), but do they just do it as well because we're diabetic, or is it only in certain cases?

Talk to your doctor openly about what he or she expects will happen and be willing to make your own informed decisions.

C-sections are common now for all moms because OB-GYNs are extra cautious to avoid lawsuits.  For a diabetic mom it's almost guaranteed your doctor will try to talk you into an induction.  If the induction doesn't work, then you have a cesarean.  Diabetics are considered a high risk pregnancy, no matter how good your control.  

When I took childbirth classes the nurses teaching said that I'd want to pay special attention to the c-section info because as a diabetic mom that's likely how my baby would be born.  Thought they were crazy... I had a 5.1 A1c, healthy baby and completely healthy pregnancy. But one of the teachers said in 20 years as a labor and delivery nurse she'd never had a diabetic mom give birth naturally.  

At 38 weeks my doctor insisted that he induce, since statistically I was at risk of having a high birth weight baby.  The sonographer said it looked like my baby weighed almost 10 pounds at that point!  I was shocked because I'd worked to hard to not have high blood sugars, but trusted what they said.  My body wasn't ready to give birth at that point, so the induction didn't work.  In my case, induction meant I went into the hospital on a Monday night at 6pm.  They did a suppository right away to help initiate labor and I was not allowed to get out of bed from that point on.  At 6am they started giving me Pitocin, which is a drug that helps induce labor.  Unfortunately it also makes contractions EXTREMELY painful.  My cervix was not dialating, I had been having brutal contractions for over 12 hours, and my water still hadn't broken.  A nurse said she'd do an exam and broke my water (learned later she was trying to help me by hastening my body to deliver or ensure I'd have a cesarean since hospital policy is that a baby had to be born within 24 hours of water breaking).  So after being bed bound for over 30 hours and in painful labor for more than 20, I finally had a cesarean on Wednesday morning.

I had to recover from both labor and a cesarean and was in the hospital for extra days because of exhaustion.  Before delivery, I was active and worked a busy job up until the end and took maternity yoga and water aerobics until the week my son was born.  I'm not a weak or wimpy person, but my labor experience was a terrible way to start motherhood.  Because of the c-section my breast milk took a while to come in too, and in hindsight I wish I had also ignored the lactation consultants and allowed him to drink formula until I was able to breast feed.  The lactation experts say that once you start a bottle the baby will refuse a breast; frankly, my son was hungry from the start and easily switched between both through his first year.  

??Despite the sonographer and my doctor's concerns, my son was born at a normal birth weight (8.9 lb) and had normal blood sugars.  He's 5 now and no sign of diabetes.    I've since learned that my experience having a baby is not uncommon.  I don't think doctors are trying to be difficult, but diabetes treatment has changed drastically in the last few decades and diabetic moms can have much healthier pregnancies than they may have been able to in the past.  Hospitall practices haven't quite caught up with that yet and as a first-time mom it's difficult to know what is right.

I am so thankful I had my children in a simpler time.  That meaning, they (the medical profession) didn't know about all the complications.  All I knew is that my babies would be larger.  (ended up being 8-3 and 8-11).   I was induced both times.  Started the pitocin about 8:00 am for both and the hard labor didn't start until about 5 or 5:50.  They were born (NOT TWINS) 7:35 and 7:38.  The water was broken for me and there was about three different people helping to push the baby out.  Perhaps the births being in Kahalui, Maui made a difference.  Not really the most advanced medical location.  The births were in 1978 and 1980.  I have no idea how my blood sugars were.  

and you are type 1?  Wow....that is impressive...

Nicole - home BG meters weren't available until the mid-80s and then they were $1000+ out of pocket, strips were $1 each and each BG test took 1 minute.  Also, when you did get blood glucose readings, you didn't do anything with them... you had two insulins NPH & Regular.    There were no carb ratios, no insulin sensitivity, no basal rates or bolus rates.  It was two shots a day and that was what you did.  

Heather,

Please start talking to your doctor about this ASAP. Unless something else is going on, besides your normal diabetes, you don't have to have a c-section and no one should tell you you absolutely have to do something just because you are diabetic.

I had a little girl in 2009 via a normal delivery. I was very careful and did everything I could think of to keep the best control I could. I still had some highs and lows, but for the most part things were very smooth. As you know we are all classified as high risk and some medical professionals will try to tell you horror stories and make you feel like you are doomed for failure. It simply is not true. If you are willing to do your best, keep an open mind and find a doctor to work with you a delivery without c-section may be possible.

In my case the doctor ordered contraction stress tests every week starting at week 34 to make sure the baby was doing ok and could handle the stress of delivery. I had to agree that if she looked like she was not going to do well that we would do the section.

At each test she did fine and when we reached 38 weeks he was going to do one more test and then determine if induction was necessary. We didn't quite make it that far because the night before we were scheduled for the last round of tests my water broke on its own. We went to the hospital in the wee hours of the morning, got me hooked up to the epidural and about 12.5 hours after admission had a healthy little girl of 7 lbs 7ounces.

I guess that is the other thing to keep in mind. Not all babies of diabetic mommies are over 9lbs and most times the ultrasound tech is wrong when they estimate weight.

Good luck to you and please let me know if you have any other questions.