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Katrinka85

Type one diabetic and delivery question....

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Katrinka85

Hi Everyone... so, I haven't been posting for a while but I read everyone posts and keeping up. :)

I wanted to ask you gals some questions about your delivery...what was your experience?

 

I am 20 weeks preg and starting to think about delivery options...some pople say that the Dr. will give me an option to deliver early or wait till 40 weeks...do a Csection or vaginal...

however at my last OB appt my Doc said that they do not let their patients go to 40 weeks and that if I don't go into labor by week 39 I will be induced.

 

So, then my dilema now is...should I do A Csection or vaginal?? i read about both a lot on the interned for regular deliveries but since I am type 1 Dabetic I wanted to know if there is any difference??

Is it safer/ better/ less pain to do a Csection with type one than a vaginal or there is really  no difference and I should make my decision just like any other soon to be mom????

 

any advice or shared story is a big plus!!!! Thanks in advance!!!!!

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Lady Imp

Consider yourself lucky. My OB's policy is to have Type 1 diabetic mothers induced at 36 weeks. This is due to a 1-2% chance of stillbirths in diabetic mothers. I went with it for my first pregnancy, did the induction...and labour never progressed. My blood pressure ended up bottoming out and my son went into fetal distress. I ended up having an emergency C-section and my son spent the first 8 days of his life in the NICU. I went home without him, and it KILLED me.

 

With my second child, I put my foot down about allowing me to carry to 38 weeks. I will be honest in admitting that 38 weeks was a prime time for us to have the baby, since Lord Imp would be able to be there for the birth without missing much school. But I had to fight like you wouldn't believe. I have never seen a doctor more afraid of a malpractice lawsuit than the main OB on my case. So, at about 20 weeks, I went digging through the American Journal of Obstetrics and Gynecology as well as several diabetes journals, and discovered that in the studies a majority of those stillbirths occurred in women whose A1c's were over 7.0 in the third trimester. I haven't had an A1c over 7 since I was in my teens, and I was confident that I could keep it well below that during the pregnancy (thanks to going low-carb, the highest one I had ended up being a 6.4). So, I went into my OB's office and made her a deal: if I could keep the A1c's below 7 from here on out, I got to deliver at 38 weeks. Which she hesitatingly agreed to - after making a very long note in my chart about being counselled over the risks of keeping a pregnancy beyond 36 weeks for "liability reasons." A repeat induction was off the table, so I went for a repeat C-section - and after my last induction experience, I was in no hurry to try that again. Admittedly, I was disappointed in being unable to have the traditional "honey, it's time!" moment and driving to the hospital and having a normal delivery.

 

Until I started having contractions 5 hours before I was scheduled to arrive at the hospital. And decided that I so have neither the patience nor the pain tolerance to do it naturally. Fortunately, the contractions stopped a couple hours later (another indication that going vaginal was not a good idea), and we got to the hospital without incident, and Baby Imp was born healthy and screaming. The added bonus was that it made it really easy for the tubal ligation I had ordered done as well - they just did it after delivering the baby. But she spent no time in the NICU, she was in the room with me and came home with me.

 

C-sections for a diabetic should only be done as a last resort though. Diabetics don't heal as well as normal people. My first C-section was a medical necessity, the second was done because the OB group's policy was to not allow a VBAC in my case. Regardless of the diabetes, it is a major surgery and there is the possibility of being a wreck afterwards. After the first C-section, I was up and going 3 days later - although I ended up with my incision getting infected and ended up with a 103 degree fever and a prescription for antibiotics. To this day I'm still a little surprised I wasn't hospitalized for it. I still have a scar from the abscess along the incision line - it was of a pretty epic size. After the second, I spent a week on Percocet unable to function, I was either in pain or high. I then spent another week afterwards finding it impossible to poop, since Percocet makes you constipated like you would not believe. 

 

In the end, no one can make the decision for you. Personally, I would recommend getting induced if you go to 39 weeks - your body will be far more ready to expel the baby than mine was and you likely won't have the trouble I did (this is disregarding the fact that my mother ended up having similar problems with an induced delivery when I was born, so my issues could very well have been genetic for all we know). You will also have to consider what your insurance will cover - many won't cover elective surgeries, and that may include an elective C-section. And if you do elect to do it and find out that it isn't covered, you will be stuck with a bill that will make college loan debt look like sofa change.

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Katrinka85

Consider yourself lucky. My OB's policy is to have Type 1 diabetic mothers induced at 36 weeks. This is due to a 1-2% chance of stillbirths in diabetic mothers. I went with it for my first pregnancy, did the induction...and labour never progressed. My blood pressure ended up bottoming out and my son went into fetal distress. I ended up having an emergency C-section and my son spent the first 8 days of his life in the NICU. I went home without him, and it KILLED me.

 

With my second child, I put my foot down about allowing me to carry to 38 weeks. I will be honest in admitting that 38 weeks was a prime time for us to have the baby, since Lord Imp would be able to be there for the birth without missing much school. But I had to fight like you wouldn't believe. I have never seen a doctor more afraid of a malpractice lawsuit than the main OB on my case. So, at about 20 weeks, I went digging through the American Journal of Obstetrics and Gynecology as well as several diabetes journals, and discovered that in the studies a majority of those stillbirths occurred in women whose A1c's were over 7.0 in the third trimester. I haven't had an A1c over 7 since I was in my teens, and I was confident that I could keep it well below that during the pregnancy (thanks to going low-carb, the highest one I had ended up being a 6.4). So, I went into my OB's office and made her a deal: if I could keep the A1c's below 7 from here on out, I got to deliver at 38 weeks. Which she hesitatingly agreed to - after making a very long note in my chart about being counselled over the risks of keeping a pregnancy beyond 36 weeks for "liability reasons." A repeat induction was off the table, so I went for a repeat C-section - and after my last induction experience, I was in no hurry to try that again. Admittedly, I was disappointed in being unable to have the traditional "honey, it's time!" moment and driving to the hospital and having a normal delivery.

 

Until I started having contractions 5 hours before I was scheduled to arrive at the hospital. And decided that I so have neither the patience nor the pain tolerance to do it naturally. Fortunately, the contractions stopped a couple hours later (another indication that going vaginal was not a good idea), and we got to the hospital without incident, and Baby Imp was born healthy and screaming. The added bonus was that it made it really easy for the tubal ligation I had ordered done as well - they just did it after delivering the baby. But she spent no time in the NICU, she was in the room with me and came home with me.

 

C-sections for a diabetic should only be done as a last resort though. Diabetics don't heal as well as normal people. My first C-section was a medical necessity, the second was done because the OB group's policy was to not allow a VBAC in my case. Regardless of the diabetes, it is a major surgery and there is the possibility of being a wreck afterwards. After the first C-section, I was up and going 3 days later - although I ended up with my incision getting infected and ended up with a 103 degree fever and a prescription for antibiotics. To this day I'm still a little surprised I wasn't hospitalized for it. I still have a scar from the abscess along the incision line - it was of a pretty epic size. After the second, I spent a week on Percocet unable to function, I was either in pain or high. I then spent another week afterwards finding it impossible to poop, since Percocet makes you constipated like you would not believe. 

 

In the end, no one can make the decision for you. Personally, I would recommend getting induced if you go to 39 weeks - your body will be far more ready to expel the baby than mine was and you likely won't have the trouble I did (this is disregarding the fact that my mother ended up having similar problems with an induced delivery when I was born, so my issues could very well have been genetic for all we know). You will also have to consider what your insurance will cover - many won't cover elective surgeries, and that may include an elective C-section. And if you do elect to do it and find out that it isn't covered, you will be stuck with a bill that will make college loan debt look like sofa change.

Thank you!!! this is very helpfull

I will definitely call my insurance and find out what they cover....

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Kathryn10

This is a personal decision but if you're looking for opinions then I'd definitley opt for the vaginal delivery if possible.  C-sections are so much more difficult to recover from and your baby will be missing out on the beneficial bacteria in the birth canal that he/she can only get from a vaginal delivery.  A C-section is major surgery.  I don't understand why any women opt for that when a vaginal delivery is a viable option.  With my two pregnancies I waited as long as the doctors would let me and then was induced at 38 and 39 weeks.  I now have two healthy, happy beautiful girls.

 

Good luck!!!

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Tanikit

At 20 weeks there is no way to know what will happen in a pregnancy and that is why your doctor will probably NOT talk about birthing options til much later even though you will think them through all the time.

 

I have had two pregnancies - I was induced with the first at 38 weeks and she was born 12.5 hours after the induction. She weighed 8 pounds 6 ounces and they did need to do a large episiotomy. Labour was very painful because they had used stuff to make me contract and it has been a bit too strong - the gynae had had to ask them to turn it down as she said I would never be able to push the baby out with so many contractions coming so thick and fast. I had used gas and air til 7cm dilated and then finally got an epidural. It took 1.5 hours of pushing to get her out. She went to NICU for a haematoma on her head from using a vacuum to extract her. I was lucky - many first inductions do land up as an emergency Caesar simply because the mother does not dilate fast enough. I had lost my plug the night before induction so my baby was on its way if slowly before I even was induced.

 

My second child I had to beg for an induction. The doctor liked C-sections and the only reason he was prepared to do an induction was that I had successfully birth my first child despite her size (8 pounds 6 ounces is not that big, but doctors here think it is enormous) A second induction can be faster and mine was exceptionally fast - starting within minutes of induction (the first had taken a few hours). I got an epidural earlier this time, but by 8cm dilated my baby's heart rate was diving with every contraction and they decided to do a C-section.

 

It is much, much, much, much easier to recover from a vaginal delivery. If you get the chance it is definitely better as it is easier to care for the baby, get up and move around. However, regardless try not to set your heart on anything - set your heart on a healthy baby and a mother who can care for it. Baby could be breech, or there could be other issues that mean you need a C-section and that is fine too. I know women who have gone straight to a C-section - that is their choice (not a choice often given in many countries, but where I live it is an option often taken) It is not one I would advise although I have spoken to many who did that and they know no difference so it does not bother them and also having chosen they feel more in control than someone who chooses the opposite and then has to have an emergency C-section. Planned C-sections are better than emergency ones.

 

Again - healthy baby, healthy Mom. 

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Katrinka85

Thanks to everyone for replies. I did talk to my doctor at my last ob appt and she said that there is no reason to do a Csection...so I will be scheduled to be induced at 39 weeks for a vaginal delivery and if something goes wrong then they will do a Csection.

 

hope all goes well.....

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Annakate17

Just wanted to give you my experience. I chose to have a c-section as I decided if I was being induced there was a high chance it could lead to that. I couldn't have been happier with my decision. I went into theatre with my husband by my side the entire time, I was able to monitor my sugar levels myself and the whole process took 22 minutes and I had my beautiful little girl placed in my arms. My little girl was delivered at 3pm and by 3:20 we were back in the comfort of our own room. My recovery went very well. My scar healed quickly and I was up and out if bed and into the shower the following morning. My scar was tender for the first week, however I had no issues moving around and tending to my daughter. A fortnight later it was as if it had never happened. From my understanding the healing process should be no different to anyone else if you are in good control. I'm now 16 weeks pregnant with my second and I am already scheduled for a c-section 1 week before my due date.

Good luck with your decision. And remember to do what you and your doctor feel comfortable with. It's about what's best for you and your baby.

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mdwinter

I would do a c-section a million times over.  I have done both vaginal and a c-section, and I feel the c-section was by far easier, and allowed me to do things a lot quicker!

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