Any pregnant Type 1 diabetics?

[dieciocho]

Hi,
I'm looking for other pregnant Type 1 diabetics in London, just to have someone to keep in contact with and share advice/horror stories/support each other etc.
I don't actually know anyone at all with Type 1, despite having had it myself since 1989

Epi not epu!

Well I have a neurological condition and so the anaesthetist didn't want to do it (have since found out it's not a problem). I had diamorphine but it didn't touch the pain, dd was back to back too. I know in some hospitals they routinely give epidurals before they put you on the drip.

Spotty, even if they won't give you an epi it'd be worth asking about a spinal instead - they're meant to be more straightforward than an epi, not sure exactly how though!

I had my viability scan yesterday morning, pleased to report that all is well, in the right place, single heartbeat seen, and I've been booked in to the diabetic antenatal clinic for next week. Can't make the appt time, mind, so need to phone up and change it - I hate automatic appt systems which phone you with the details at 7pm as a) I'm in the middle of putting the kids to bed and b) there's nobody available to speak to you if there's a problem!

The good news also is that because of the problems with my last pregnancy, they want me to have another scan in about 3 weeks time, not sure whether I'll want/need it but it's nice to have the option.

I don't think I'l request one this time tbh Rue as I managed last time...

Glad your scan went well, the appointment system sounds rubbish!

Rue - congrats, that is lovely news!

I'm also glad someone brought up the birth options. As far as I know a water birth is not an option for me, purely because they only have the birthing pools available in the midwife led centre, and I'll be in the consultant led ward, so it's not that there's any safety issue as far as I know, it just isn't practically possible. I hope at least there's an en suite shower or bath!

On the types of induction, I'm really interested to find out more. A few of the books I've read (in particular the LLL book weirdly titled 'the Womanly Art of Breastfeeding') it did list some particular interventions / hormones you should try to avoid if you can. In particular one particular hormone and also them rupturing your membranes (breaking your waters).

However, on the very initial chats I've had about it, I've also been met with "well, we'll just have to do what's best for baby" line. It feels like if you try to push back on that line it's like you're saying "no, I DON'T want what's best for my baby" which of course is not what you're trying to say at all.

I was also told that if I'm induced for more than 12 hours they would automatically move to section, but I'm not really sure I follow the logic there. I mean, lots of people take a couple of tries to be induced and while I appreciate that they want the baby out early, I really don't think 12 hours one way or the other would make much difference, would it? I'd really rather avoid a section if I can - I think it must make those early weeks with a brand new baby so much

I think I'll just have to continue my research so that at least the next time we discuss it I'm better armed with information. Any other pearls of wisdom from you ladies appreciated too

FFS, I can't spell or even it turns out complete sentences any more. Sorry, but hope you can decipher my meaning!

Bona I think the hormone they are probably saying to avoid is the Syntocinon. It's a drip and it makes your contractions go from zero to three in ten straight away and then they turn up the strength every hour etc.

ARM (breaking your waters) is best avoided I think but if it's that as a last resort then I would be OK with it. I would much rather just have the pessary and go into labour like that, seems more natural I think. I'm lucky that the labour ward (consultant led one) has got a pool, it's nowhere near as nice as the MLU across the corridor though.

I think it goes:

• Pessary
• ARM
• Devil drip
• CS

The pessary has to be left in for 12 hours (?) so if they need the baby delivering quickly they won't bother

Good news Rue!

Urgh, it's all so worrying/confusing. I've read a lot, but this makes me more concerned: I don't want to be arguing with people at the crucial time or, in fact, ever. I hate confrontation!

My hospital offers mobile epidurals with a weak dose so that you can still move around. That'd be a good option, right?
I'm not sure about risks with epidural; anyone else?

I was hoping to go for diamorphine if needed; good choice or not? Best of a bad bunch I suppose.

I understand that high risk types (us) are "not allowed to use pools." B^gger.

Hmm I will double check on the pool thing today and let you know.

I think lots of people recommend the mobile epidural, I think epidural risks can include getting a bad headache afterwards, increased need for instrumental delivery/CS and possible nerve damage not sure of stats though....

I had diamorphine with dd. It's a bit like being drunk or doing ecstasy I've seen people on it n OBEM and they're completely spaced out, I didn't get this so it's hard to say as it's different for everyone. I would definitely try it before going for an epidural though as you might find it's enough? Also I made them give me another dose less than an hour before dd was born and her APGAR scores were fine, no ill effects from it.

Thanks spotty - will look into it more. Would definitely like to at least give the pessary a try and give it time to work if possible.

dieciocho - I think the best thing to avoid arguments at the crucial time is to write a very detailed birth plan in your notes, and make sure DH / DP is as familiar with it as you are so that if you are in too much pain he can fight your corner for you.

At the moment, I would like to avoid an epidural but of course have never done this before and may well be screaming for one! I think that in true risk terms they are very safe, but my concern is more about the fact that all medical interventions / drugs can have an effect on the bonding experience / breastfeeding establishment afterwards. So, am going to try going it alone and see how I go but DEFINITELY not ruling anything out!

Just to chip in - I went for the 'staged' approach last time. Gas and air, then pain relief in the form of pethadine and then finally what must have been a mobile epi as it literally 'took the edge off'.

This time I'll be missing out the pain relief stage. It sent me bonkers and I hated it. I was just totally out of it for hours and hours and had what must have been a 'bad trip'. It really affects me still and for days after I didn't feel right at all.

If needed (I'm secretly hoping the baby will 'pop' out after half an hour this time...) I'll be going for a full epi. I had no ill effects at all from that. No back ache. Nada. I would say if there were any bonding issues at all it was the pain relief that did it as I felt so odd.

Also DS's heartbeat slowed right down.

I must add as a disclaimer though that I know a few people who had pethadine and were fine.

Strange as it sounds for me personally an epi birth is more natural in that your actually 'with it'!

Is anyone as frightened as me about their heart scan or has everyone had that now. I've been so naughty and Googled about birth defects...

Out to lunch and forgotten my injection

Salad for you Spotty :-(

puds - I have not had my heart scan yet (16 weeks today) so am also worried, but resolutely not googling!

Also, friends of ours (non diabetic) had a defect picked up on their regular 20 week scan several years ago. They knew their little girl had a heart problem which would need surgery soon after birth. Their daughter is now 4 - yes, they have some stressful times and she did need surgery, but she is now thriving and you would never know she had a problem as a baby.

So, I guess all I'm saying is that problems might be picked up but it might not necessarily be the end of the world. Hmmm, might have to do some googling now....

p.s. bad luck about forgetting pen. Go for a salad or something like a steak / chicken with veg but no potatoes / chips / rice / pasta.

Bona that's really comforting actually. x

A school-run friend (not diabetic) of mine had a baby a few weeks ago with a heart defect, her baby was transferred up to the local specialist hospital, had an operation at a few days old and is now home and doing really well the problem was diagnosed at the anomaly scan too and they had lots of consultations about possible outcomes/treatment options etc before she was born so knew what to expect - she also had lots of extra scans to keep an eye on the baby and how she was developing/growing.

Ok I have info!

Spoke to my lovely mw who's given me some info in expressing colostrum, haven't read it yet still in the car park! She said not to start until 36 weeks.

Regarding the birth she said we can do sweeps from 37 weeks and with it being second baby if might bring on labour naturally if not hopefully pessaries will work and ARM as last resort.

We cannot give birth in the pool but should be able to labour in it in the early stages. Chance we may not need to have a sliding scale at all but she will go into more detail on everything at about 34 weeks. I'm feeling a lot happier now. What else did she say..... Umm oh yeah the reason I was straight on sliding scale and not allowed off the bed etc last time was simply because I was so ill.

What's the sliding scale?

Sorry.

spotty thanks so much for the information! Will look forward to more detailed posting on colustrum when you've read it all . Sweeps also sound good. Fingers crossed that does the trick!

I've heard of sliding scale, but never experienced it. If at all possible, I will refuse it. It is basically a mixed insulin / glucose drip. I am expressly going to refuse consent for that - while I am conscious I can manage my own insulin requirements and don't want to be tied down (literally) to the bed. I really don't see why it would be necessary and think you are much more likely to have hypos or hypers while on it...

I had the sliding scale but no idea why! I was fit and healthy! Perhaps the gas and air/pethadine making me less with it? I was hooked up to it from the beginning and had MASSIVE anxiety about 'handing over' my control as tend not to trust people who aren't diabetic/diabetic specialists! I kept having thoughts about the MW accidentally overdosing me with insulin. It really concerned me at the time but never thought to question it.

Thanks for the info Spotty. Very interesting.

They put you on the sliding scale and then make you test every hour. I don't see why you can't test every hour and if you're struggling then go onto the sliding scale. I think it is in the NICE guidelines though...

As a side point they put you on sliding scales when you have a general anesthetic and when I was about 12/13 I went for an op and they messed it up, luckily it was before I went under but I had quite a bad hypo! Anyway it's something else to think about and discuss with your care team.

Had a quick flick through the leaflet and it tells you how to hand express and to aim to do it about 4 times a day for ten minutes each time and how to store it etc. MW also gave me some syringes to store it in

I think I'm just going to put on my birth plan NO SLIDING SCALE. As you say, spotty, if you are testing regularly anyway, why on earth do they need to hook you up in advance? Seems crazy (maybe more appropriate with old mixed insulin regimes, but doesn't make any sense with modern basal / bolus regimes).

Am very intrigued to hear how expressing goes. Look forward to detailed updates!!

Well I will start in six weeks

Yeah I think if they need to prep you for a CS then they can just put you on a siding scale then, also they start beeping every time you move which is most annoying!

Sounds mental to me.