my name is Nicole and I'm 29weeks pregnant with my second child, a boy :) I have had diabetes for 15 years and I have no complications I'm physically active and in truely great health. My first pregnancy went fine and until it came time to be induced the doctor induced me 2.5 weeks early because he said the baby was too big for me to deliver vaginally...she weighed 7lb 12oz, nevermind the fact that he was leaving town the following week I'm sure that had nothing to do with it! Well my daughter ended up in the NICU for a week struggling with lung function problems, Jaundice, and a bacterial infection. I beleive this was all related to her being born before she was truely ready. She is now 6 years old and healthy little girl. I however don't want this experience again. I have my endocrinologist on board with my plan and after firing 3 doctors I finally found one willing to work with my endocrinologist to help me make it to 40 weeks without induction or C-section. My last A1C was 5.6 I have the continous glucose monitor, have a dietition working with me and I'm excersizing daily. I know the reasons for induction, heavy baby, preclampsia and pre-aging placenta. I will not ignore medical advise but I also will not tolerate being told that just because I'm diabetic I "have" to be induced.
My question is am I really alone in this has anyone else refused induction??
I am not, nor have I been pregnant (yet), but I've heard a lot of women have problems with dictating what they want for their child's birth, and it's not limited to diabetics. Obviously if your a1c was 5.6, you have a cgm, you're working with a dietitian, and exercising, you know what you are doing. I personally wouldn't take no for an answer. The doctors are supposed to want what's best for their patients, but I think often they assume that because we are not doctors, we are not smart enough to handle making our own decisions, and they just advise us to do what is recommended for everyone, even if that may not be the right thing for us as individuals.
I haven't seen it, but I have heard wonderful things about "The Business of Being Born." It's a documentary about childbirth in the United States, and how it's become a business and seen as more of a medical emergency than a natural occurrence. You may want to look into it.
No problem! :) I understand that doctors want to help us, but ultimately, this should be your decision. Your pregnancy, your child, your birth. Period. If your ob doesn't want to work with you, find a doula or a midwife who will help you achieve the birth you want. My only personal concern for when it's my turn is that I need to be in a hospital with a good NICU, juuuust in case. We are high risk because of the diabetes, regardless of how tight our control is, and I would never forgive myself if something happened to my baby because I wasn't near a NICU.
I have had 3 planned c-sections and I have 3 healthy kids, I'm a Type I diabetic. My endo wanted me to have the baby at 38 weeks. 38-40 is considered full gestation. My last baby was 7lb 13oz, my smallest. The reason my endo wanted the baby born at 38 weeks is because research shows that the odds of having a healthy baby are having that baby at 38 weeks (for diabetes), he actually put it like this, "the mortality rate for babies born to diabetics drops significantly when the baby is born at 38 weeks." My gyno was willing to do whatever my endo suggested. If the endo hadn't stepped in, I was considering a natural vaginal birth--even though my other two were scheduled c-sections. I think you should get all of the facts you can, and talk to both your endo and your gyno, and the baby's daddy and get all of the input you can and try to make the best decision for you.
I think, statistically you're making a pretty safe decision. I think with careful monitoring, your chances of placental failure are pretty low even if slightly higher than for a woman w/o T1. I don't know how you feel about the twice-weekly BPP's/NST's (I know of some T1 women who are starting to refuse them for similar reasons -- unnecessarily invasive, etc for the amount of risk). But, personally, if it was me and I was going to 40 weeks, I'd make sure to be getting them as often as possible... I think it's also important to remember that most babies born at 38 weeks don't end up in the nicu, so while waiting very likely would have helped your 1st child, there's unfortunately an element of bad luck in there.
It's interesting that in the last 5-10 years, the timeframe for inducing T1 Moms seems to be moving later and later because of better control & outcomes. When I first started researching (2005?), it was generally 37-38 weeks. When I had my son in 2008, it was generally 38-39 weeks. Last year, I met with another MFM (to see if we wanted to have another) and he was adamant that he wouldn't induce (or for me, 2nd C-sec) earlier than 39 weeks if everything else looked ok. So, if you go naturally at 39 weeks (more likely for a 2nd baby), you'll be right in that timeframe!
If we have a 2nd, I'm personally planning on making the decision for 39 weeks, rather than 38 or 40.
P.S., This is obvious, but I'm not a doctor... This is just my personal opinion / educated guess. (:
I'm not T1D, (my oldest, my 5 yr old is). I delivered both my kids naturally but was early ~37.5 weeks with both but neither had any complications due to being born early, and technically my OB said that 37 wks is considered full term. That said, I TOTALLY agree that induction unless it is clearly needed (for the reasons you listed among some others) is not in the best interest of the baby or the mother. I believe I read that the actual process of going into labor prepares the baby for life outside the womb and inducing labor can screw up that preparation in the baby. I think if you feel you finally have your endo and your OB working as a team that induction should not be neccessary. You can refuse any medical treatment, so stick to your guns unless you are presented with compelling evidence why induction should be considered.
Don't do the induction if you don't feel it's right. The pregnancy statistics for diabetics are based on research studies done before tight control was possible (thanks to insulin pumps and CGM) and also include diabetics who had TERRIBLE control.
I too had a healthy pregnancy (5.1 A1c with no severe lows) but was told it was important for the health of my baby to induce. My body was nowhere near ready to give birth, so the induction was unsuccessful and after 27 hours in labor I had a c-section. Because of the cesarean and early delivery, my milk didn't come in for almost a week.
Wish I had trusted my instincts and waited until my son was full-term.
I fully support your decision! Glad to hear it! I am only 15 weeks today but this is something I have been thinking about a lot after I read that induction is more common now days, especially for "high risk" pregnancies. I hope all goes well & that you carry your child until he is ready! Congrats btw.