Diabeties and natral birth is there such a thing?

[Laners1975]

I am in my secound pregnancy only 9 wks and am already getting worried about the birthing experiance.

Im insulin dependent and have had resnable control. With my first child who is now 2 & a half, healthy and full of beans I had a terrible birth experiance.

I was induced at 38wks for no reason that I can find, (my babys weight on all scans was fine - not to big born at 7lbs 11oz). After a terrible night at the hosital being made to sleep in my own broken waters - the nurses didn't clean it up simply put a small cloth on top to sleep on. I was then put on a drip and made to contract after 11 hrs only dilated 4.5cm they decided a C - section was for the best.

I was devisated it was the last thing I wanted, I cried all the way to theater.

This time I am more detumined to have what I want - oviously my unborn childs health & mine come first. But I am really intreated to find out if there are any other diabetic mums out there who have been able to go full tearm or have a "more natrual birth"? It would be so encoraging to hear your experiances

Please don't worry. It can be fine. I've got type 1 diabetes too.

I've got 2 dcs. DS was born 3 years ago and my experience was quite horrible, although I think the care I recieved in hospital was better than yours.

Anyway, DD was born in June, and her birth was great. Lasted 2.5 hours and I know it sounds mad, but I actually enjoyed it (a bit).

The first thing you need to do is speak to your consultant (or maybe diabetes nurse if you find them easier to talk to). Explain that you are feeling really anxious. Don't let them fob you off with 'this is how it has to be'. Ask lots of questions.

I think it is probably unlikely that you'll be able to go full term. As far as I know, this is because back in the day, before diabetic mothers recieved special treatment, there used to be a high instance of still-births. They now tend to induce at 38-39 weeks, irrespective of the baby's weight.

Although, as this is your second, you might naturally go into labour a bit earlier this time. The induction is also likely to work a lot more quickly.

I can completely understand that after your last experience you are feeling a bit apprehensive- but I think now you've done it once, you'll feel more assertive about it and it will feel more in control.

I did most of my labour with dd sitting on a birthing ball, and then I was in a kneeling position when she was actually born. Get some advice from your midwife about positions you can use to help things progress, bearing in mind you will be on a drip.

Sorry, this has turned into a really long post - but I just wanted you to know that although you wont get a completely 'natural' birth, it doesn't have to be awful.

Hello,

I had gestational diabetes with my 2nd child, my first child i was fine.

I also had a terrible exsperience with my 2nd labour because of the diabetes, i was induced at 38 weeks aswell, but i also was induce with my 1st child and it was perfect.

i found it hard as i wasn't aloud to move and had to lay on my back with numerous wires and it didnt help thta my baby was back to back!!

I would also like to hear from anyone who had a good exsperience as we ttc our 3rd baby which im terribly worried about.

I do know though Laners1975 that i was told i had to have the drip and i refussed it saying i wanted to wait .. obviously if me or baby would of been in any danger i woudnt of, but it is always an option.

x

Remember now- the reason they induce at 38/39 wks, even if the baby weight is normal, is that the placenta can stop working properly towards the end of pg in diabetic women. The belief is that by preventing the pg from going to 40 wks they can minimise the risk.

katy - although your situation is different from the op - (she has insulin dependant diabetes, which is different from gestational) imo you are both feeling really anxious because you don't have all the information you need. Diabetes is a really complicated condition, and I think that healthcare professionals generally give patients a bare minimum of information. I have a real bee in my bonnet about this!

Experiences can be good, but it is impossible to feel completely positive, relaxed and in control of a situation if you are not well informed about the implications of your condition. You do have options, it is just a case of getting someone to talk to you about them. Your consultant is not there to tell you what to do - they are there to provide you with a service!

LovelyBertha i totally agree with you, the information just isn't given and cause woman stress that sometimes could be avoided!!

I was never told me or my baby were at hight risk or that my daughter would be checked after labour that we had to stay in , with that being a complete surprise and the horrible labour were know one could be botherd with me or even check my blood sugars completely stressed me out as a result i had PND. i was actually told of a load of times because i was told diffrent things by diffrent mw's one said to lie back and so i did another came in telling me she has already told me to lie on my left side!!

I really with the nhs could be more informed and patient with people.

the risk of stillbirth is raised in women with diabetes if you go to term, so you won't find anyone who won't induce you at 38/39 weeks. i have type 2 & have had 2 children. both were 50th centile. i was induced twice, 1st was 24 hours, failed ventouse & forceps. 2nd was 8 hours & i pushed her out in 5 minutes, a much better experience. however, since you had a section first time they might be a bit twitchy about inducing you again & you therefore might have an elective section. good luck.

With a bit of luck, if we keep bumping this thread, someone with specialist knowledge in diabetes might find it...

I'm also type 1 and due to be induced in 2 weeks so at 38w.

The reason my obstetrician and diabetes doctor told me are:

-The placenta may not work as well after 38-39 weeks and therefore put the baby at risk

• As the baby will probably be big (mine was 6lb9 at 35w) there is a better chance to get a VB if induced at 38w

I have to say I have been explain he procedure for the induction and the diabetes nurse explained to me how they will deal with the diabetes side of it (they will put a drip of insulin and glucose to regulate each others when I won't be allowed to eat anymore). She also told me to go back to my pre-pregnancy insulin doses after the birth.

As for the baby, I was explained that they will check its blood sugar regularly to see how it is (but I wasn't given any time limit on how long it will be).

I will try to give an update after the birth.

good luck GuernseyFrench and let us know how you get on, you must be so excited :-)

Hiya,

As promise here is the story of my LO birth. It finished as an EmCS because of the head position and not because of the diabetes. I was told that I can have a VBAC next time!

Went to the ward at 8am on Wednesday, as ward was busy I was put under monitor to check on LO. At 2pm, I was given the 1st pessary and walked along the corridors of the ward for most of the afternoon. Was given the 2nd pessary at 8pm and 45mn later, my waters went and I started to have contractions (mostly on the lower back). So I asked for the Tens.

At 1am on Thursday, I was transfered into the labour room where I was given some diamorphine in order to help me sleep / relax.

At 6am, I was put under 2 drips because of the diabetes one of Actrapid isulin and one of glucose. I went on gas & air at that point.

At 10am, I was only 3cm dilated so they decided to put me under another drip to accelerate the contractions, so I asked for an epidural as all the others painkillers were just making the pains less strong but they were still painful. Once the epidural kicked in, it was a bliss!

Contractions were on a completely irregular pattern and the mw had to increase the drip twice in order to keep them going.

At 7pm I was 8cm dilated so they told my DH to go home and have some sleep. A bit later, I told the mw that I thought the head had drop, after a check I was found to be fully dilated but they were not able to decide in which position his head was.

So they called my DH back and the obstetrician to come and have a 'look' at me.

When DH walked into the room, I was pushing! 5 mn later the obstetrician arrived, examined me and told me to stop pushing as the baby's head was not position properly and therefore I'll need an emergency cs.

At that point, both the baby and I were started to be in distress (my BP was high up, I had temperature and baby heart bit was sky high!)

So they brought me down to theatre, increased the epidural, DH got changed and Samuel was born at 11.41pm on Thursday!

Labour officially lasted 22.15 hours

Unfortunately, he had breathing difficulties as he was very mucussy (sp) so he was brought to intensive care where they discovered that he had an infection so he was put under a drip of antibiotics.

His blood sugar at birth were 1.4 and they stopped checking them after 24h when they reached 3.9

CONGRATULATIONS on the birth of little Samuel, it sounds like it was exhausting. and i am glad that both are you are fine. was the infection you had GBS by any chance?

Hope the little one is doing ok? and thank you for sharing your story.

x

xkatyx what do you mean by GBS?

Well i had GD with ds3 and originally they told me that they wanted to induce me at 39 weeks - i had regular scans and the growth was ok.

The time they wanted to induce me was Easter bank holiday weekend so they were too busy this was after telling me all the risks if i went over 39 weeks.

I went into labour on his due date and had him at home - 7lb 13oz. I had been told if Id gone into Hospital i would have been placed in the high dependency room with monitors and wires and not been encouraged to move about

lovelybirther

Wow, I might be the person your looking for

Diabetes type 1 (insulin dependent) where the insulin producing beta -cells which are normally produced by the pancreas is destroyed by the immune system and has to be closely monitored during pregnancy.

normally in pregnancy , various hormones block the usual action of insulin. This helps to make sure the growing baby gets enough glucose. The body then needs to produce more insulin to cope with these changes.

With Diabets type 1 the body is not able to produce this insulin so it is injected as usual..normally a higher dose given depending on the blood sugar levels of the mother.

Gestational diabetes works in a different way yes (similar to type 2), BUT I must add that mothers who have gestational diabetes may need to take insulin. Gestational diabetes is where the mother produces too much glucose (sugar) in her blood. The pancreas then does not produce enough insulin to absorb it all. It can be very common for women (around 30%) who have had gestational diabetes to be diagnosed with diabetes type 2 later in life. It goes away after the birth.

Laners it is possible for you to have a natural birth but only if your insulin and glucose levels have been properly monitored, amended correctly and you have it under control. The reason I say this:

In babies, who's mother's have 'whatever' type of diabetes that isnt under control have added risks such as:
if you produce too much glucose and not enough insulin is injected/made the baby will retrieve this sugar causing high birth weight(macrosomia), the baby will also start to produce extra insulin to combat the extra sugar its receiving and may carry on this process once born. This can lead to low blood sugar levels (hypoglycemia)and baby will need to be fed within an hour after birth and may be subjected to blood glucose testing every few hours until stable.
Baby may also be born with jaundice and need specialist treatment - but around 75% of 3-4 day old babies will have jaundice and this will normally disappear on its own.

hoxtonchick the risk of still birth is increased when a mother has any type of diabetes...but is very rare and in cases tends to happen once passed 40 weeks and the mothers glucose levels have not been properly managed in the first trimester of pregnancy..this is when the fetus is developing and this is when congenital diseases and malformations happen.

Diabetes of any kind, can increase risk of congential health problems such as heart defects and respitory distress (breathing difficulties). This tends to happen if baby is of a very high birth weight (over 9lb 4oz) as the fat baby has stored during pregnancy sqaushes the lungs and stops them from developing fully/expanding properly once born and also baby may have swallowed the meconium if past due date which can restrict the airways.

It is very possible to have a natural birth when you have diabetes type 1, type 2 or gestational. You will have to have your glucose levels taken every 2 weeks and conform to a strict diet (if type 2) inject exact amounts of insulin required as and when if type 1 or gestational...sometimes in type 2 this may be needed also.

I am studying to be a midwife .. so soz for any extra info you may not want/need

If your baby is thought to be of good weight, below 9lbs and above 4lbs then there would be no reason for induction if below 40 weeks. Induction can lead to unecessary complications/interventions such as ventouse, forceps and most likely end in C-section. If you are going to birth a larger baby work on pain coping strategies..this is a reason the NHS do c-sections as they think mother's wont be able to cope with the pain of birthing a large baby. I know of a 15 yr old girl who was having a 10lb baby boy and had gestational diabetes...came into be induced at 40 weeks and gave birth naturally. (we chatted as I left the hospital with my premie baby).
It can be done. It has been proven that electrical heart rate monitors can cause a decelerated heart rate if left on for over 30 minutes, so have them check baby and then take it off. Find a position that is comfortable for you and try a water birth it will take some of the pressure off. (now a water birth is optional...they say that people with diabetes shouldnt have a hot bath/get into hot water/sauna as it lowers blood sugar levels...typically as you sweat and sweat out the sugar in your body. Also diabetic people may lose feeling in the nerves in the feet and burn themselves. But a warm bath/tub can be soothing) You do what you want when you are in labor...if baby seems in distress then get up and move about, try and stay calm and if you end up needed a crash c-section then that is what has to be for the sake of your baby. Its scary I know, but needed sometimes.

I'll just add at the bottom here that you should have been taking a 5mg supplement of folic acid up until 12 weeks, not the 0.4 dosage for pregnant women without diabetes (but it will be too late now if your doc didnt say this to you) it helps keep malformations of baby at bay...

Sorry for the loooonnggg post

I hope you get a midwife and consultant that is supportive of you and gives you some more info on your pregnancy and birth. Good luck Laners.

I just put that is will be too late now...but just read again and your only 9 weeks lol so take that extra folic acid!

lovelybertha sorry spelt ur name wrong ;)

I like your story racmac its encouraging!

GuernseyFrench - GBS is an infection a baby can be born with which makes them poorly, also know as group B Strep. I only know about as my sisters baby had it.

Chellesgirl ooh a midwife i hope you dont mind i have a few questions , i had GD diabetes with my last baby, not my first though, me and DH would like to ttc soon, is there any chance it wont come back? also i was told when in labour with GS i had to lie flat on back nnot move etc and my baby was back to back, it was terrible would of loved to be able to move. Has that changed now? and also with GD do i need to take more folic acide before TTC?

Also complete diffrent subject, what is a midwifes pint of view on AD'S? im currently on citroplan 20mg for mostly anxiety, what would a midwife recommend with that? i am a very anxious person and i know i wont be able to get through pregnancy without any help.

Sorry for the bomard of questions any help would be really appreciated.

nonono xkatyx studying to be lol...not quite there yet!

Right ok then for your questions...

1. It may come back in your next pregnancy but that doesnt mean to say it will, with GD only time will tell.

1. Just cause you have GD does not require you to be fully monitored nor laid on your back for your whole labor..its just cruel. Lying flat can actually increase blood pressure and if your GD isnt well controlled it can raise sky high. It is best to kneel over the back of the bed so that if you feel your sugar levels dropping i.e weakness, dizzyness and all that you can easily sit back down on the bed, and if in extreme cases may need an CS you can be taken on that bed.

3.Your baby would have been back to bak because (im guessing here) not enough room to turn as weighty? right? correct me if im wrong? If a large baby is suspected nowadays they like you to lie on your back as normally gravity takes hold doesnt it, with a weighty baby its more likely if not in distress to come our pretty quickly (as larger babies are easier to push out than premature as they are ready to be born)
If you was induced then your baby may have needed the extra two weeks to turn but never could????

1. with GD you dont need to take extra folic acid, only with type 1 and 2 as they are long term and start from the begginning of pregnancy. GD normally starts in the 2nd and third trimester and by this time baby is practically fully developed...just needs fattenning up.

Right well for me I would reccommed you took up hypnobirthing and practiced from the very start of pregnancy. Are you religious???? Then your congrgation can offer you great support this way...yes I know neither of these offered on the NHS lol...

with regards to the medical side of things e.g. drugs then that would be a doctors call..but fi you look on the box of your citroplan and tell me what the active ingredient is...I have a feeling its citalopram...thats referncing from my national pharmacy association medicine interact qual, i would be able to to tell you the questions and suggestions that you could ask your consultant at the hospital.

Sorry i spely my AD wrong yes it is citalopram whoops.

Yes my baby was a little big she was 8lb 6oz and 2 weeks early induced because of the fear she was bigger. She got in a lot of distress in the end and had to be sucked out.

My GD was controlled on diet as it was very "mild" i think the requirement is 8 i think mine was 8.1 is was 1 point over i never actually had sugar in my urine or anything but i did have a lot of fluid round the baby and when i ate and tested my blood sugar it was fairly high, also my baby was born with big chubba cheeks which i was told was a GD sign :-)

I'm not religious.

Thank you soooooo much for the advice, i have all these question that have really been worrying me, and really know one to ask. your fab thank you.

ahhh chubby cheeks! arent they the cutest!

well ok 8lb 6...thats not too big if you ask me..yes to you it might seem so and also to thers, but GD and D2 can cause baby to be much larger and by all means your lil girl would not have been classed as having macrosomnia - obv the only way to tell this is once baby is born... so in your case induction may have seemed the right thing to do...but i'm personally not a fan of inductions myself!

i had 2 inductions 1st he was 2 weeks and 2days late he was 8lb 10oz .. so the doctors where happy for me to have my second child even though they thought she was bigger even though im tiny, im only 5ft if that! but fortunetly they both come out fine no stitched etc!

That whole one born every minute program has scared me abit lol all the things that can go wrong im actually more scared to go through it than with my first 2 lol

Congratulations GuernseyFrench! Well done - sounds a bit harrowing.

Chellesgirl - Thank you. Really interesting posts. You'd better watch out, with a font of knowledge like that it wont be long before you are getting summoned to threads - 'Oi Chellesgirl.. etc etc..'

hahaha lovelyBertha no thanks, i think i spend waaay too much time on this thing as it is!

wow no stitches xkatyx honestly your midwife/consultant whoever delivered baby must have been good...theres not many midwives out there that can stop a perineal tear...my mom used to be a midwife way back in '92' and she now comments when she sees programmes on childbirth - and when me and my sister both gave birth and recieved tears..how annoyed she was at the midwife not sticking her hand in (sorry tmi) to guide baby out.

Dont let one born every minute scare you...they seem to only be showing the worst of births! I havent yet seen a nice relaxing, calm birth and its possible. My birth with DD was amazing. Though midwife werent brill...I gave myself and my Dp all the gratitude

HA HA can i book you to be my midwife please

I think there are far to many midwifes that are a bit dismissive (prob spelt that wrong)and really dont help you feel at ease or reassure you, as you prob can tell i'm a HUGE worrier when it comes to my kids and pregnancy, i desperatley want another baby but dont know if i may wprry myself literraly sick lol

xkatyx maybe a long shot here been as your on the 'panic' meds at the moment but have you tried cognitive therapy.

My best friend was a very anxious person (and I mean VERY) and she went to the doc finally after not been able to sit her GCSE's (now this was a few yrs back )and they put her on Citroplam as she was constantly having panic attacks, but they also sent her for cognitive therapy - talked about the deep routed reasons as to why she felt that way - and everything led back to her parents relationship but they also gave her a book to read and when I was going through anxiety after dd was born she referred me to this book and it worked a treat for her - i didnt get to read it - was in a state of depression pretty bad, didnt even wanna read the newpaper cause afraid of seeing anything about hospitals in them.

I really would urge you to do cognitive therapy if you want to do something before having another baby, that wont need more drugs...and in the end will make your pregnancy healthier one and a happier one.

AND yes I would be at anyones birth for free! just to gain as much experience with the physical side of it as EVERY birth is different.