Gestational diabetes - been told to expect constant monitoring - any thoughts?

[toomanyshoes]

I am 33+5 with my 2nd baby and have been diagnosed with Gestational Diabetes. Growth scan shows the baby is not large for dates, had a great natural and fast (3 hours 20 mins) birth with DD and am currently controlling my blood sugars fairly well with diet.
However, the diabetes midwife has been pressuring me to have insulin. I am reticent to agree as once I am insulin dependant they will want to induce me early, much higher risk of intervention, constant monitoring etc. Have refused and asked to see consultant who has agreed no insulin required at the mo. However, he has said that as i have GD they will monitor me constantly throughout labour irrelevant of insulin. I hate the thought of being strapped down and on my back during labour. I know that technically I can refuse but wondered if aybody had any experience of doing this or any experiences of labour in a GD pregnancy? Feel that the more I know the better equipped I am when it comes to the inevitable bullying (not good experiences with this hospital so far!!)

[toomanyshoes]

bump

[ILikeToMoveItMoveIt]

I had GD with DS which I controlled by diet alone.

It didn't directly cause a problem with the labour as I just sipped water throughout, as the thought of food turned by stomach. Also bf the lo helps stabilise their blood sugar levels.

Things in your favour: the baby is not believed to be big, you had a great labour last time, and you are controlling your sugar levels by diet alone. So to be fair, I don't see they have any concrete reasons to constantly monitor you.

Think about what compromises are acceptable to you regarding monitoring ie you would agree to be monitored for 10 mins every hour etc. This gives the message that you are aware of the perceived 'dangers' and that you are making an informed choice to how you choose to be monitored.

[hunkermunker]

Can you ask them why you will need constant monitoring?

I had diet-controlled GD and the consultant said no to a pool birth, but I questioned his logic and he went and found out what the protocol was. He then said that as long as I didn't need intravenous insulin, I could have a waterbirth - as it happened, DS2 had other ideas and arrived before the pool was filled, but never mind!

I was monitored several times, but not continuously and even with the belt on, I stood up, swayed, walked around and bounced on a birthing ball.

[hunkermunker]

Also, how are you planning to feed your baby?

[MrsBadger]

Not GD but I was threatened by a junior doctor with continuous monitoring due to a clotting disorder.
I managed to make my consultant (who was much nicer) write on my notes that no intervention (including CM) should be performed unless clinically indicated. This meant that they could do anything that needed doing but weren't to get pre-emptive.

It worked a treat - had a water birth with intermittent Sonicaid monitoring only and no intervention at all - because the MWs were able to use the consultant's signature to fend off the obstetricians who wanted me flat on my back on a bed for no good reason than 'just in case'.

[toomanyshoes]

Thanks for taking the time to reply. I have asked about the reasoning behind monitoring and was told (by diabetes midwife) that is because I have a 5% increased risk of stillbirth. When I asked what the risk was in a normal pg she couldn't tell me so did some research and found out that it is 0.5% in a normal pregnancy so risk in a GD pg still less than 1%. She also didn't know if that statistic was for all GD pregnancies, those that are insulin dependant, those that are uncontrolled and whether an other lifestyle factors were taken into account (age/ante natal care/weight etc). When I explained that my concerns were about having a very medicalised delivery and that I felt the risks of that were a concern to me she said 'better for you to have an induction or a c-section than come in with a dead baby' Was v v angry and told her she was scaremongering as she could not back up any of the figures she was quoting and that i felt using emotive language like 'dead baby' was totally innapropriate.
Consultant was nicer but rushed appointment and I know I have been discussed and marked down as trouble (was made v obvious at next clinic appoinment when dr said 'i understand you have had some issues...' with a raised eyebrow
I am planning to mixed feed as had breast reduction 13 years ago and did not produce enough milk to solely bresatfeed (am missing some milk ducts!). Worked v well with DD so hope to do the same again. Will try and avoid formula for as long as poss in hospital to get BF established but not too worried if he had to have some formula to stabilise sugars.
Gosh, that was a long post!

[ILikeToMoveItMoveIt]

You are obviously asking the right questions, but are up against the usual NHS establishment. I would carry on with your current stance as you obviously put thought behind your comments and decisions.

God that emotive scaremongering annoys me, if only they realised the upset it really causes. Have they not read about stress and its effects in pregnancy? gggrrrrr

Breastmilk will stabilise the baby's sugars better than formula.

[toomanyshoes]

thanks, i actually feel angry on behalf of other women who might not feel able to question these stupid sweeping statements and decisions. The hospital i'm at is in an area where a huge number of the women do not have english as a first language and god knows what they push them into without being questioned.
Thanks for the experiences, feel more confident about specifying how much monitoring i am willing to have now!

[MrsBadger]

toomanyshoes, that scaremongering was exactly what I got from my junior doc (re placental abruption and stillbirth), and the 'you're trouble' look was exactly what I got from the consultant - he marked us down as a pair of hippies who'd want whale music / incense / to give birth in a field .

But after all that I had exactly the birth I wanted - it is possible.

Writing a brief, concise and realistic birthplan in bullet points will help your delivery mws too.

And as a last resort, if they do hook you up to a monitor, you can always ask to go to the loo so they'll take it off...