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Stroupie

Natural Childbirth?

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Stroupie

This is my first post on here. I am a Type 1 for almost 10 years, pumping for 8. My Hba1c are around 6.6 to 7 but I feel I could control better. My husband and I are preparing to start trying this summer for a baby. We almost started trying before, however I freaked out about the Diabetes and so we waited.

I have two questions:

 

First, how often did you have to go to the Dr during the pregnancy? Both endo and obgyn?

 

Second, is it at all possible for me to have a natural birth? I don't want to be induced or have a C-section without it being ABSOLUTLY necessary. It seems that it is almost accepted without question in the case of a diabetic. For those who have achieved it how were you able to advocate with your Dr to get what you wanted. I hope someone can let me know that it is at least possible. I understand that sometimes circumstances are difficult and procedures are necessary.

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Funnygrl

With diabetes, it's not standard to induce or do a c-section these days. Those are avoidable if your labor progresses normally.

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Keezheekoni

It depends on where you live, Funnygrl. It is standard practice to induce around 38-39 weeks here in WA. They are too scared to let T1s go beyond 39 weeks. I got lucky and found a perinatologist who will *let* me go to 40 weeks before forcing induction. In the end, I'm getting prenatal care through an OB but am having an unassisted childbirth at home.

 

There are ways to naturally induce labor, as long as your cervix is ready... if it's closed up tight, then none of those ways will work.

 

As for routine sections, those are not the norm here in WA, as long as you don't grow a big baby. I have a "proven" pelvis, so they'll let me birth vaginally, but for a first time mom they'll want to do ultrasound estimates of the baby and your pelvis to make sure they think you can fit the baby through. If they think the baby is too big, then they'll try and force you into a section...however, remember that you can refuse anything. They may not like it, but you can refuse it.

 

The whole reason that they are wanting to induce at 38-39 weeks is because in diabetics the placenta tends to degrade or *age* more quickly than in a normal mom. If you keep your A1c below 6 then you won't have that problem. :) You also probably won't grow a big baby with that A1c.

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panda1076

regarding the first question about how often are the appts, I go to a special pregnancy and diabetes clinic through Joslin, so my appts are always scheduled together. It makes for longer appts there, but at least i am not going there every week! Everytime I go to the OB, I also see either my Endo or my CDE.

 

From the beginning, I have gone every 3 weeks to the OB. I think the Endo normally sees people more frequently, but because my A1C is good and I have very good control, she said 3 weeks was fine. My A1C during pregnancy has been 4.9, 5.4, 5.2 so far.

 

Here's the general outline they laid out for me personally:

 

every 3 weeks up until week 28

every 2 weeks up until week 32

Then I go once a week until week 36

Then it looks like I go 2x a week in the end till the baby comes

 

I had the usual 9 week and 17 week ultrasounds (and I opted for the 12 week ultrasound for downs syndrome testing). Then I have an ultrasound at weeks 24, 28, 32, 36 for measuring the baby to keep an eye on his growth. And in between those visits I get an ultrasound in the "antepartum testing unit" to monitor movement, kicking, heartbeat, etc. I also got a fetal echo cardiogram at week 22 which was a 1.5 hr long ultrasound to look strictly at the heart to make sure it was developing properly.

 

I don't know if this is the normal path in all clinics. But I go to Joslin and they have me following the standard diabetes patient regime, even though my BGs are good and I should not have any complications because of diabetes. I do spend a lot of time at the doctor's office, but thankfully i have a flexible and understanding work environment.

 

I too was scared to get pregnant because of dealing with my diabetes. But i found that in the beginning, keeping lowe BGs was not as hard as it was while I was practicing keeping low BGs beforehand! The changes your body goes through initially make you more insulin sensitive. So the transition is not bad. However, around week 20-23 or so, your body becomes more insulin resistant. This is when non-diabetics take the glucose tolerance test. It has to do with horomones at this point in your pregnancy. So it has been very frustrating and challenging these past few weeks to adjust my pump settings. But it's not so bad.

 

If you keep good BGs and your baby is not too big, I don't think there's a reason why you couldn't have a natrual delivery. No one has mentioned inducing by a certain number of weeks for me. But if they see the baby is getting too big, they may suggest it. Also, if the baby is over a certain weight, they will give me the option of choosing c-section initially.

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Keezheekoni

Heh. I totally ignored the first question...

 

Here's my schedule:

 

First appt. was at 8 weeks with my regular OB. I did consult a perinatologist at 12, 16 and 20 weeks. At each of those, I got u/s done. I also saw my OB the week after those appointments.

 

I'm 22 weeks now and will see my OB again at 25 weeks. Every four weeks until 33 weeks then ever 2 weeks until 37 weeks. Weekly after that, with NSTs at those appointments also.

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Fraida

How about non stress tests? im now about 24 weeks and everything is thank G-d in good control and on target but my ob said she has all her type ones do non stress tests two times each weeks starting at week 30. is this typical?

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genie86333

Fraida,

 

With my youngest (when I had gestational D) they did non-stress tests 1 to 2 times each week starting at about 30 weeks because of the diabetes - then did a c-section at 38 weeks (I'd had 2 previous c-sections due to complications so they just scheduled the last one!)

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Keezheekoni

My NSTs are now scheduled weekly from week 33 until I have the baby. I will also see my OB on those days, right after the NSTs are done.

 

I was wrong above. I saw my OB monthly until week 28. The schedule is now every 2 weeks until week 32, then weekly until the baby is born. You shouldn't need NSTs twice a week unless your placenta or the baby is showing signs of distress. The more NSTs you get, the more likely you are to have medical interventions, which tend to lead to C-sections like crazy. If you really want a natural childbirth, fight to not have so many things done to you.

 

I'm also having a fetal echocardiogram done on week 32. Apparently in children of diabetics, their hearts can get thick walls, so you have to take a medication to clear that up if it happens. My 20 week check was fine, they just want to confirm in week 32.

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e||ement

I wasn't diabetic during my pregnancy with my son but sooooooo wanted a natural childbirth. I had placenta previa and the possibility of a c-section looming over me until week 37 when my placenta FINALLY moved up. I was sooooo happy!!

Then, after my water broke at 40w3d and labour was not progressing after a day and a half, I was induced. When the baby went into distress and I wouldn't dilate past 3cm after several hours of labour, it was time for a c-section. I was very dismayed. I felt I had failed as a "woman". Until... I met my son, and at that point did not care how he got there, just that he was there and healthy.

 

The moral: prepare for all situations...(diabetic or not) and really what counts is a healthy baby and mom in the end.

 

Good luck!

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mell1682

Ditto What e||ement said. And as for how often, I think all pregnancies are different. With my 1st, I went every 1-2 weeks from the beginning all the way til the end and at the end, I was going 2x a week!!! My peri regularly schedules all his patients for induction at 36 wks after an amniocentesis is done to prove lung maturity. He does this to all his diabetic patients no matter what. With my 2nd daughter, I went to a completely different practice and I was only seen every 4-6 weeks at the beginning and increased throughout. I was allowed to carry as far as 38 wks 2 days before my MFM induced. I really think it varies from doctor to doctor. GOOD LUCK!!! I'm part of a mommies with diabetes "group" and I've heard several women allowed to carry til, or sometimes even after, their due date. :)

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Fraida

My doctor is very clear that she plans for me to have a natural childbirth and had no intention of doing a c-section. i asked her at my last appointment how increased my chances of c-section are as compared to a non diabetes pregnancy and she said none. the only reasons she would do it is if baby is in distress, etc. hopefully i will have my natural birth. im now in my 24th week, so still have a ways to go!

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millieanmolly
This is my first post on here. I am a Type 1 for almost 10 years, pumping for 8. My Hba1c are around 6.6 to 7 but I feel I could control better. My husband and I are preparing to start trying this summer for a baby. We almost started trying before, however I freaked out about the Diabetes and so we waited.

I have two questions:

 

First, how often did you have to go to the Dr during the pregnancy? Both endo and obgyn?

 

Second, is it at all possible for me to have a natural birth? I don't want to be induced or have a C-section without it being ABSOLUTLY necessary. It seems that it is almost accepted without question in the case of a diabetic. For those who have achieved it how were you able to advocate with your Dr to get what you wanted. I hope someone can let me know that it is at least possible. I understand that sometimes circumstances are difficult and procedures are necessary.

hi, well am a type 1 and i have had 6 children through normal delivery after my first he was 12.1b13oz i had to be induced about 5 weeks early but they all came out at 10.1b range but were all healthy an are fine my first is 23 now and are all healthy hope this helps jackie.

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Mom of one

I am new to Diabetic Forum, and am finding it very useful!

I am just wondering if anyone knows of any midwives in Eastern Ontario that (Greater Toronto Area) is interested in or is practicing with Diabetics and home births?

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mmora

Well I remember going to the Dr often, my son is 6 now and non diabetics see the Dr once a month in the beginning but I would go like 3x a month for the 1st 3 months, then in my 2nd and 3rd trimester, I went weekly, I had the non stress test once a wk beginning at like 30 wks. I saw a perinatologist throughout the whole pregnancy and they wanted me to try to deliver vaginally which I tried but the baby was too high up, wouldn't drop, so I pushed for 2 hrs and nothing. I ended up having a c-section but diabetics do see the Dr more than a non diabetic. My scar healed quickly but my hba1c was like 5.5! Better than EVER...I wanted my son so badly that I was extra carefull with the diabetes when pregnant.

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jenngwenn

Hi Stroupie, this is my first post as well. I am type 1, have been for 14 years. I have 2 children, had the second in feb completely naturally! As everyone else has already said, A1C control is crucial for making sure baby stays small if you really want a chance at even vaginal delivery. However, from my experience w. doctors...especially maternal-fetal specialists (those who typically care for T1's) most are not at all knowledgeable or comfortable with natural deliveries. I really wanted it with my first, and was so disappointed and depressed when it didn't happen because the hospital I went to and doctors I had were not experienced with natural birth.

 

For baby # two, we continued to go to the maternal-fetal specialist for the diabetes management, however he agreed to co-treat me with another OB who was very experienced in natural childbirth. I worked especially hard to control the sugar...A1C's from 5.2-5.9 and to make sure baby came earlier rather than later(natural induction methods). Baby came at 37 weeks to the day, no drugs, great labor, 7lbs 10oz.

 

And, my best friend who is also a T1 for 16 yrs, had a baby 2 weeks ago with the same dr completely naturally! this was her first baby, came at 41 weeks and was 8lbs 3oz

 

happy to talk more if you have ?'s

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