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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

Original poster

To ask for my baby to be delivered at 33 weeks?

127 replies

Givinguph0pe · 15/12/2015 10:27

I'm a type 1 diabetic and I'm 32+5 weeks pregnant.
Over the last four days my insulin requirements have fallen by 50%. This is absolutely not the norm. Usually the hormones kicked out by the placenta inhibit insulin and levels increase - which they had done until last Friday.
I've had a scan and baby has grown and apparently blood flow to and from the baby was normal. This means that the consultants are saying that there's probably no imminent danger and that they will keep monitoring me.

However I am extremely concerned that this rapid drop in insulin requirements means the placenta is going to stop doing its job in the very near future. I am not happy to wait any longer than it will take for me to have the steroids for the baby's lungs to be honest. I want her delivered. No one can give me any other suggestions as to why this fall in insulin levels has happened. I am now taking the same amount of insulin as I was before I got pregnant. If I did not have an insulin pump I would be having some fairly severe hypos by this point.
Personally I cannot see what other reason there could be for this - despite what the scan showed - and I'm not sure how much time I have to be honest.

I'm going back to the hospital this afternoon and I'm going to push for them to deliver her. What's the chances they'll agree?!

OP posts:
BishopBrennansArse · 15/12/2015 10:55

I'd insist in being admitted for constant monitoring, try to get to 34-35 if possible. Plus I'd ask your diabetes consultant to directly liaise with your obstetrician.

Good luck, you must be very worried x

TheTravellingLemon · 15/12/2015 10:55

A sudden improvement in your condition is associated with placental failure. I would be asking for daily monitoring at the very least. I found that the diabetes team were not always the best informed about diabetes in pregnancy so you need to advocate for yourself.

shinynewusername · 15/12/2015 11:01

Honestly, no one on here has a clue whether YABU. I'm a GP who has done a lot of perinatal care, and I don't know. It has to be an individual risk assessment as there are so many factors to balance around the safety of both mother and baby.

YANBU to be anxious. Like most diabetics, you clearly understand your DM very well and are understandably concerned when your insulin requirements change dramatically. YAdefinitelyNBU to question your obstetrician and ask if s/he will reconsider. However, you are BVU to expect a bunch of strangers on the internet to be able to offer you useful advice.

GiddyOnZackHunt · 15/12/2015 11:05

I think you should be admitted and monitored closely and given the steroids. A crash section could be done immediately if the placenta starts to fail. Keeping the baby put until 35 weeks would be good if the placenta holds up.

TaliZorah · 15/12/2015 11:13

Push for it.

I knew something was up at 37 weeks with DS, they wouldn't move my cesarean and scans said he was normal. When he was born at 38 weeks, because I kicked off and refused to wait until 39 he was blue and had got distressed and needed ventilation, antibiotics and was in NICU. If I'd have waited longer he may have died.

Trust your instincts

WhyCantIuseTheNameIWant · 15/12/2015 11:16

I had gestational diabetes (along with some other painful issues) and had to fight for my induction at 38 weeks! Monster was nearly 9lbs by then.

I would ask for a meeting between you, the senior midwife and the diabetes consultant.

And I wish you and your little one all the best!

emsyj · 15/12/2015 11:17

If you don't feel the medical staff you are dealing with are sufficiently informed about diabetes in pregnancy then push and push and push to be seen by specialists until someone arrives who can actually give you the right care and advice. Make a huge fuss and don't hold back. You don't need the internet's permission to stand up and do what you feel is right to protect yourself and your baby. And even if you're wrong and the baby is fine and all the fuss was unnecessary - so what? It doesn't matter. Don't take the risk of keeping quiet if you feel instinctively that something is wrong.

ZylaB · 15/12/2015 11:20

I had this, I was 32 weeks when I had such a bad hypo during the night I was admitted. My insulin requirements dropped to less than I needed before I was pregnant. I knew this could be a sign of placental failure and kept asking, but everyone seemed happy. I was released, but then re admitted a couple of days later due to pre eclampsia. If anything, this reassured me, she was monitored at least 3 times a day, if not more..so I knew she was ok. I had the steroids and was induced at 36 weeks (due to the pre eclemapsia) and the midwife said my placenta looked ok, but had started to go a bit grainy, which can be a sign it's starting to fail.

What I'm trying to say, my drop in insulin at 32 weeks was scary, but she was fine until 36 weeks (I wasnt, but she was!).

I think I'd insist they admit your for full time monitoring if it was me, for reassurance!

Didiusfalco · 15/12/2015 11:25

Insist on being admitted. I was monitored in hospital due to placental bleeding. The monitoring was very frequent (far more than daily) and I knew if I bled heavily they could have acted very quickly. It was reassuring to be checked so often and sounds highly desirable in your case . This might allow you to get a few weeks further along.

ZylaB · 15/12/2015 11:26

Sorry, saying 'everyone was happy' I meant.. 'My consultant who is an expert in pregnancy in diabetics and who lectures on preeclampsia in diabetics and other issues, was happy!' It was more reassuring than what I first wrote.

The midwives on the ward didn't know too much about it, but as long as my sugars were ok I didn't mind because I knew my consultant and her team were on the case!

My daughter was absolutely fine when born, she didn't want to be born, but she was fine!

NeedsAsockamnesty · 15/12/2015 11:28

Can you push to see a specialist instead of pushing for delivery?

They may be far more receptive to that.

A 34 weeker is not always a walk in the park

Original poster
Givinguph0pe · 15/12/2015 11:31

Zyla did they ever give any explanation for the decline in insulin requirements? Did they stay low until you delivered?

OP posts:
Original poster
Givinguph0pe · 15/12/2015 11:31

Glad your dd was ok. It's all very worrying isn't it?

OP posts:
VimFuego101 · 15/12/2015 11:32

I would certainly be pushing to see a specialist since it doesn't sound like your midwife team really understand diabetes.

ZylaB · 15/12/2015 11:37

giving no, they never gave a reason. When I said it could be a sign of placental failure and expressed my worries, my consultant agreed that it could be a sign, but reassured me that my baby was fine, because I was being monitored so much and that at the first sign of problems they'd do something...that's why I think monitoring is needed for you!

It did stay low for the rest of the pregnancy, yes.

crabbiearses · 15/12/2015 11:37

I work with Diabetics lots in my job and i say you sound like you know your body inside out and id go with your instincts. Such a big change in a short period of time suggests something is afoot, i also know health professionals won't intervene without solid evidence something is going on so id push and try find someone sensible who is experienced in obstetrics and Diabetes to see you, Comparing a type 1 pregnant diabetic and gestational diabetes isn't a fair comparison .
when it comes to pregnancy id always go with my instincts my daughter was a undiagnosed breech and they never confirmed till delivery despite me saying i felt something was wrong i wish id pushed for more intervention.

minipie · 15/12/2015 11:39

Push to see a specialist and push for steroids, daily scans and blood flow monitoring (admittance if necessary).

If you say to a non specialist that you want to be induced I doubt they will listen. You need to get to see someone who knows about this.

You may go into labour naturally - I had GD with DD2 and my readings improved a lot at 36 weeks, gave birth a few days later. Pack your bag....

minipie · 15/12/2015 11:42

PS please don't underestimate the effects of being born at 32-34 weeks - new evidence keeps emerging about the more subtle problems these babies can have as they grow up (DD1 was born 34 weeks so I have read a lot on this). Of course prem is better than stillbirth but there would have to be a strong risk of stillbirth to make it worth the risks of prematurity iyswim.

Original poster
Givinguph0pe · 15/12/2015 11:54

I know it's not ideal... But it is infinitely better than the baby just suddenly dying in utero which is what I'm worried about.

OP posts:
Knottyknitter · 15/12/2015 12:04

Could it not be in part that the baby's pancreas is working on the excess glucose getting through the placenta, so you're effectively making some insulin?

unimaginativename13 · 15/12/2015 12:07

Are you not in contact with your diabetes team? Surely you should be able to call them anytime and discuss your concerns?

WaitrosePigeon · 15/12/2015 12:10

They won't do it.

Diamondsmiles · 15/12/2015 12:14

Please do push to see the consultant. How horribly scary for you.

Kaytee1987 · 15/12/2015 12:22

How scary for you, I would absolutely ask to see a specialist now and don't leave the hospital until you have an appointment or have seen one. You have the right to a second opinion they can't deny you that. You know more about your diabetes than your midwife so you need a specialist who knows more than you do. You feel that this could be a medical emergency so I think going to hospital is very reasonable. I don't know if they will deliver this early but can you ask for steroids just in case?
Prem babies can have many problems however I know a 32 year old that was born at 30 weeks he's fine, 12 year old 27 weeks slight problem with her leg, 1 year old born at 24 weeks, had a cleft, was on oxygen for a while but no known problems now. I realise that doesn't always happen however I would prefer a Prem baby than the risk of no baby.

ricketytickety · 15/12/2015 12:25

Keep asking to see a consultant. Ring up your hos[ital if the midwives refuse to refer you. Speak to your gp. Basically bypass the midwives if they are ignoring you.