Trapped!

Pregnancy
1

Just had my 6 week ultrasound and good news is that my blood sugars are great and the baby is perfectly healthy!

Bad News...  My doctor informed me that at 39 weeks I will be forced to induce.  My doctor informed me that I will be forced to be on a insulin/glucose drip.  My doctor also informed me that I will not be able to eat or drink at all during labor.  He said that I will most likely have a c-section due to being induced.

I feel very trapped.  I take really good care of my blood sugars and have a healthy baby.  The doctor kept saying that my risks are the same as a normal pregnant woman as long as my blood sugars are normal.  I don't understand why they will induce me at 39 weeks and put me on the glucose/insulin drip. 

 

PLEASE... What have your experiences been?  Is this just the way it is for all of us Type 1 Diabetics?  Do I have choices? 

2

I was also induced at 39 weeks. I was told the reasoning is that with diabetes they do not want any surprises, If labor goes for too long or there are delivery complications they have no choice but to do a c section. That is the same for diabetic and non diabetic women. Some diabetics have an increased chance for c section if they have a very large baby. It doesnt seem that that would be the case if you have very good control. It does get harder to control blood sugars as the weeks go on. I had to work very hard and test myself 8 times a day to keep good control but it was worth it.   I asked early on if I would have to get a c section and my doctor said that they would only do that if it was absolutely required for my own safety. I also had to be on an insulin drip and luckily for me I was because i had a bad reaction to a medication and i was vomiting. the sugar drip kept my blood sugar stable. the reason that you ( and all women in labor) cannot is is because if you or the baby goes to the bathroom during the process it can be dangerous to you and the baby,   I was in labor for 21 hours and had my son with out the c section.He was 6lbs 4oz and 19 and a 1/2 inches long. i think that maybe your doctor dint do a great job at explaining the reasoning for what may or may not happen. I hope that I help ease some of your concerns and maybe gave you a lottle bit of insight as to why your doctor may be considering some of those option. Rose.

3

I'd think about finding a new doctor, honestly.  

I was induced with both of my daughters at 38 weeks and was told by my perinatologist that normally, a person with type 1 will need to be induced but that we'd know when we got to the end of the pregnancy.    For my first daughter, I had low placental fluid (not due to type 1) so I had to be induced.  With my 2nd daughter, I had signs of placental failure (extremely low blood sugars) and I was basically demanding to be induced (I was exhausted with a 20 month old at home, taking care of diabetes (it's a LOT of work) and all the lows).  

I had both of my daughters vaginally... ended up asking for epidural about 16 hours into both inductions (both were 24 hour labors).  At the time, I don't recall having a choice of insulin drip or not, but you'll read out here plenty of women who managed their blood sugars and insulin via pump on their own throughout pregnancy.    

Good luck.  Keep those A1Cs down.  Do what you can to keep yourself and baby healthy and go back into your doctor (if you don't change) with stats and stories on women with type 1 who were successful delivering.  My daughters were 6lbs 9oz and 6lbs 13oz.  

4

What they are telling you is their “standard” that they tell all diabetics. I was told that most diabetics don't take care of their selves so when they get someone that does they are willing to look at other options. Ask more questions and make your concerns know. I had my first baby just over two months ago. I was also told the same things you were but once I started asking questions and making other suggestions I got exactly what I wanted. I was told that they preferred putting me on their IV insulin drip but I had been on it before and it did not work for me so I talked to the doctors and they agreed to let me keep my pump and continuous glucose monitor on during labor. There are some people who prefer the IV insulin drip so ask more questions to see what works best for you. I was told I could eat ice chips and popsicles during labor but not food in case I needed an emergency c-section, which turned out I did need :(

I had an emergency c-section at 33 weeks due to no amniotic fluid.  I choose to remove my continuous glucose monitor during surgery because of the uncertainly of the components of it, they were using some cloterizing tool and said that having any metal on would be dangerous and being the emergency we did not have time to find out exactly what material it was made of so I choose to remove it but kept my insulin pump on.

Btw, its gross but your baby drinks and pees all the time, that is actually what makes up the amniotic fluid so even if you don’t eat or drink during labor your baby will still pee. They don’t want you eating anything because the medication they give you for a c-section makes your nauseous.  

5

Your doctor is actually being cool to give you a realistic expectation of what will happen.  It doesn't matter how well controlled your diabetes is or how healthy you and your baby are... a type 1 pregnancy is high risk and your doctor will want to induce early.  Cesareans are so common now for all pregnancies (over 30% in the US) because it protects OBGYNs from malpractice lawsuits.  

This French study is has a small survey group, but the info is interesting.  It says 71% of type 1 moms have cesareans and that being overweight before or during pregnancy can contribute to the likelihood.  

www.medpagetoday.com/.../19701

A few things to think about:

- At week 39 ask your doctor for an honest assessment of an induction being successful.  If your cervix isn't dialating and you don't have other symptoms that you're ready, considering skipping induction and just scheduling the cesarean.

- If you decide induction is right for you, ask to use your pump through labor.  Because you can't eat it's pretty easy to have perfect blood sugars with a pump.   If you have a cesarean you'll have to go on the insulin/glucose drip because you'll be put unconscious after your baby is born, while they finish removing the after birth and stitching you.

- Ask your doctor to write on your chart that you will resume the pump as soon as you are conscious and able to monitor your blood sugar.  You should be ready about a day after delivery.  (Note: After pregnancy and especially after you start breastfeeding, your insulin needs will be extremely low.  I'd had type 1 for 28 years when I became a mom and took NO INSULIN for a couple weeks after my son was born.)    

- Induction and cesarean can delay your breast milk coming in.  Make sure your child is given formula until your milk is ready.  You'll know it's there because when the breast is squeezed droplets of milk will appear on the nipple.  Some people are afraid bottle feeding will inhibit breast feeding.  My son had no problem switching between, but if you're really worried you can give the baby formula from a cup.

I had your same frustrations when I was pregnant.  I worked so hard to be healthy and had a non-diabetic A1c with no lows.  Felt great and my baby was completely healthy.  But it didn't matter when it came to deliverying my son.  My body was no where near ready to give birth at 39 weeks.  I went in on a Monday night at 6pm to begin the induction, they started pitocin the next morning at 6am, and I labored until my son was born by cesarean at 3am on Wednesday.  Worst part about it was that I couldn't get out of bed or eat from 6pm Monday on!  I felt so weak and my recovery from the long labor (pitocin makes contractions more painful) and surgery took longer than it should have.  

Trust your instincts, but know that your doctors will want to be more cautious than you would have chosen.  At the end of the day it won't really matter how you baby is born.  You'll deal with whatever happens.  If your baby is due a week earlier than you think best, it isn't a big deal in the grand scheme of things.  

6

I was not put completely out during the c-section. I was awake, not groggy or sleepy at all just numb of course. I was awake talking to the doctors and nurses and was able to control my own insulin the whole time.  Not sure if that is the same for everyone or not?  

7

I'm am 22 weeks and my OB/GYN has not said anything about induction, C-section, etc. We are just keeping close tabs on things and special ultrasounds, etc. I always get nervous when I read posts like this because it makes me wonder if they are "saving telling me the bad news" until the time gets closer so I don't worry about it. They keep telling me that my baby is measuring right on (he's actually 4 days too small) and that he is so healthy and my BG's have been nice and low also. The only thing that she has mentioned recently is that when I hit 30 weeks I will come in every week to do tests (ultrasound with monitors)--she said it was called "BBC" or "BB--something". But that is all. I think I will ask at my next appointment about her perspectives on T1's with delivery. She knows I am T1 and gives me special care, but she treats me as much as a "regular pregnant woman" as she can, also. I will have to ask about it.