GD and feeling like I've failed before its even begun

[McFox]

So, a wee bit of background here first. I work in healthcare, with a specific focus on diabetes and cancer, so I'm very knowledgeable. I'm also very healthy - I eat really well and am active every day. I'm also into living as natural a life as possible; I make all of my own cleaning products/toiletries etc. - in short, doing things 'naturally' is really, really important to me.

I’m now 32 weeks pregnant and had planned as natural a birth as possible in a midwife led unit (because my DH was freaked out by a home birth, which was my true preference). However in the past week I’ve been diagnosed with gestational diabetes, and it has turned everything upside down.

My sister had GD, and given that my work is on the genetics of chronic diseases, I had an inkling this might happen, but I’m still shocked.

So, I had my first hospital appointment yesterday and was bluntly told that I “have 0% chance” of being midwife led now, as I am considered high-risk, and that I will probably be induced at 38 weeks on the labour ward where they will do their best to allow me to still move around but I can’t use the pool, and will most likely need to be hooked up to so it might not be possible to be mobile at all.

I’ve also been put on metformin as even though my diet is super healthy (all the dietician could tell me to do was to eat more), my bloods have been marginally (as in .1 or .2) over twice in the past week.

I am just distraught. Intellectually I know that this is absolutely the best thing for the baby, but emotionally I have gone from really looking forward to the birth to absolutely dreading it. I know that the only important thing is that I have a healthy baby at the end of this, but I feel like I’ve failed and am so upset.

My sister was induced twice and had one horrible and one good experience. Both babies were healthy, so this should console me, but it’s not helping at all, and I feel like I’m being totally selfish for even feeling like this at all.

I don’t know what I’m asking for here, if anything. I suppose that I just need a bit of hand-holding and to know that I’m not alone in having felt like this.

Hiya. I have T1 diabetes and so don't feel quite the same as you, as I was diagnosed aged 18 months. However, I do know how it feels to worry about the effects of a chronic condition on pregnancy so if I can help at all, please ask.

I have a question for you! Why can't you have a water birth? I was hoping for one and am sad to hear it may not be possible.

:( I'm also under the consultant for a chronic condition (APS) and the worry just wears you down. It must be so hard to find out part way through, too. At least with me I could steel myself as to 'what to expect' prior to even TTC.

Is it possible to speak with the consultant for a firmer plan to help make birth as much in line with your plan as possible?

Vjones, I don't know why. I didn't even get a chance to ask - its no exaggeration to say that I was in with them for less than 4 minutes.

Squizita, I was so shocked at how brusque they were that I didn't get a chance for my brain to process it all. I'm going to write out some questions for next week (I'm at weekly appointments from now on) because I didn't get a chance to say any of the things I wanted to.

I was diagnosed with GD with DC1 and have refused testing this time as was soooo marginally over the diagnostic limit last time and within limits when testing 4x daily too. My hospital are still treating me as if I have GD anyway, despite having lower post-food readings in this pregnancy.

My colleague was diagnosed with GD at the same time as me and hired a private midwife/planned a home birth (although she ended up being blue-lit to hospital due to meconium in her waters) – is this a route you could go down?

If your levels are being well controlled then it does seem to be heavy-handed not to allow you to labour in water… but then this seems to be the blanket approach to GD.

I totally understand how you feel. I was diagnosed with GD at about 25 weeks and am now 35+5. Initially I was left confused, emotional and absolutely ridden with guilt and although the care and information I was given at my GD clinic wasn't great, the actual people were ok (although I'm under "consultant care" and have yet to see the same consultant twice!
It took me a long time and lots of tears to come to the realisation that it wasn't my fault for having GD and that I really am doing the best that I possibly can for my baby, however suspiciously the diabetes team at the hospital look at me! My nurse may as well have said she didn't believe the figures I was writing down in my little booklet because I'd managed to get them down so much through diet control.
I constantly get different information from different people depending on who I talk to at the hospital and was initially told I would be induced at 38 weeks in the main labour ward, rather than the smaller midwife led unit I'd also been hoping to use. At my last scan the baby was still showing as very big so I was then told I would have to have a c section, then a few minutes later the consultant felt my bump and changed his mind and said he disagreed with the scan and thought my baby was by no means huge and he had no worries about it whatsoever! I have my last scan scheduled for next Monday and am hoping that it agrees with my mw's latest measurements which show the baby to be between the average and large lines on my growth chart.
At my antenatal class, however, I specifically asked if I'd be able to be active and mobile during labour if they had to monitor me and if I'd still be able to use the birthing pool and the mw said yes and there was no reason I shouldn't still be able to have the birth I want (albeit not in the unit I want) just because I'm being monitored more closely. She also stressed in no uncertain terms all through our classes that they can only make recommendations to us, they can't make us do something we don't want to do and that if there is something specific we want to happen or not happen we should write it in our birth plan and make sure our partner knows our wishes so they can speak for us if need be. So next time you go to hospital I would definitely have a list of questions ready and don't just accept the answers you're given, ask them "why" if they say something you don't like. It sounds like your readings have been much lower than mine were to start with (initially it wasn't unusual for mine to be in double figures, but I've now managed to get them down to the 6-6.5 mark post meal).
This has turned into a mammoth post, sorry. But it's a subject that has been very present in my life for the last ten weeks and I just wanted you to know that you're not the only person to feel guilty/emotional/confused by it all and to urge you to stand up for yourself when it comes to what you want to happen at the birth. Obviously I'm not advocating going completely against medical advice just for the sake of it, but at the same time I've learnt to question everything they tell me and learn the reasons behind it...and if the reasons behind it aren't good enough or are just generically applied to everyone then I make my own mind up (after discussing it with dh of course!). In my experience the GD team at the hospital try and make me feel like I'm deliberately harming my baby but the obstetrics side of my care has been much more understanding, reassuring and approachable.

Hand holding here. I was also devastated to be diagnosed with GD, but I fought back and won. I maintained my diet control, despite the scepticism of the diabetes clinic, and I had a home water birth. In my experience it's easier to get a home birth than a midwife-led unit one as the rules are actually less restricted.

There is lots of stuff out there about asserting your right to make choices in your medical care. Try AIMS and the Association of Radical Midwives for advice. The Home Birth group is also very supportive, even if you're not planning a home birth. I made it clear that I wanted to address the potential outcomes from GD rather than view it as a complication in itself. If any problems had shown up, I would have then discussed ways of dealing with them. With the support of amazing community midwives, I got a consultant to sign off my home birth, and return me to the low risk population at 36 weeks. He was even willing to consider this if I took Metformin, depending on circumstance.

In your position, I would explore not taking the medication for a few more days, to see how your control is. If you feel it's been over-prescribed, then discuss it at your next appointment. I know people who have rejected metformin and gone on to have great diet control.

Well, firstly, you need to stop thinking about failing, guilt, etc. Seriously, just put it to one side. It's a waste of emotion.

You need to look forward.

I know you say that you planned a natural birth - so do the vast majority of us. But there are loads and loads of reasons as to why it doesn't happen for everyone, and GD is one of them.

Here's what happened to me at my induction. First they monitored the baby for an hour, then inserted the pessary - not sore at all. Then they monitored the baby for another hour, and then I was off the hook for the rest of the day, so I went for a walk around the hospital, went to the cafe, read the paper.

I spent the whole morning in the bath - ok, it's not a birthing pool, but it was bloody brilliant at helping with the contractions. Got out, stuck my TENS on and that took me to 4cm.

So you might not need to be attached to monitors etc for quite a large part of your labour. And there's nothing stopping you sitting on a ball, being on all fours, crouching, having a bath - any of those things, just because you're in a ward and not a birthing centre.