I decided on Monday morning I think to do a little research into how labour is different for diabetic women, and therefore what the diabetes consultant may say to me. I am under no illusions that I will have a hospital birth strongly recommended (lol) to me, but also I have read about other things.
Some background (just to hopefully make things a little easier to understand). Blood sugar levels can be affected not only by what you eat, but also how much exercise you do, as the more exercise, the more your body burns the easily accessible sugar for fuel. Given that labour is an intense form of exercise, blood glucose levels should be monitored carefully throughout labour to ensure that not only do they get too high, but also that they don't get too low, as that can cause faintness, dizziness, and other problems.
For this reason most diabetic women are put on a drip throughout labour to monitor their sugar levels and to administer insulin/glucose as necessary. Of course if you go on the drip you need to be in hospital.
However it is possible to do without the drip, by making sure that blood sugar levels are tested regularly throughout labour and measures taken to even it out. Fast acting insulin in the case of too high sugar levels, or a glass of orange juice to quickly raise sugar levels.
Having not seen the consultant yet, my initial thoughts are that I want to avoid the drip... I have read that it can in some cases give the incorrect doses out and unnecessarily raise glucose levels too much meaning that your baby when it's born does in fact have elevated blood sugar levels which can lead to a crash when the cord is cut. I have been thinking a lot about things, and as if you have been reading my blog for a while will probably appreciate that this decision hasn't come lightly, but I am thinking that I will more likely than not have a hospital birth this time. With the extra risks that come to the baby from me having diabetes, the chance of needing special care is higher than if I didn't. While I do think that it must be lovely having a home birth where everything goes right, and you get to curl up in your own bed afterwards, have a bath in your own home, be in comfortable and familiar surroundings, eat whatever you want as your next meal after the baby's born... the thought of that being reality is so far away for me. I thought I'd get it with Robert, and I didn't. The fact that I am diabetic this time and the higher likelihood for treatment and complications is making me doubt that home is the right place this time round. For me, I think that if anything did mean that my baby needs special care, it will be less traumatic if I was already in hospital, than what happened with Robert.
Over the weekend I will be compiling a list of questions to ask the consultant. I am confident that this one will be a lot more useful than the previous one with the general consultant I saw a few weeks back. I will also be jotting down ideas for my birth plan as I'm fairly certain that it will be handy to get my wishes straight in my own head, but this may well be something to think about after my appointment on Wednesday.
Something else I will be doing with regards to the birth, is pre-expressing milk for the baby. I have read that with diabetic mothers, if the baby does not feed well after the birth, they are pushed into giving the baby formula, something I do also want to avoid this time round. I probably won't be expressing any until at least 35 weeks, and I probably will wait til 37 weeks to be sure the milk is as appropriate as possible. I don't know how well that will go, I had a great deal of trouble expressing milk for Robert when he was born, I managed barely 2ml of changing milk let alone colostrum, so I'm hoping that pre-expressing will go ok.
I do wonder if I will be offered an early induction. I suspect this will only be the case if I am scanned and baby is measuring big, and maybe not even then as I have given birth to a 10lb baby so we will see. But I am wondering if I would accept an early induction. That's a bridge to cross when/if I come to it I guess.
Anyway, I took a new belly photo yesterday. Here it is, along with comparison with Robert's same gestation picture!
Squidge
Robert
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