Oh bother! Advice and experiences, pleeeease!

[PrettyCandles]

Apologies for long, detailed post, but if you can possibly advise me or share experiences (positive or negative), please persevere!
I'm 35.5w pg with my 3rd child. At my 33w check sugar was found in my urine (++, all previous checks were NAD). The midwife took blood, result showed just over 8 units of sugar (IIRC it should be between 4.something and 7.something).
(This is something that happened at the same stage in my previous two pgs, it was controlled by diet and most of my subsequent tests showed NAD or, at maximum, +. The babies were born without any problems, very healthy, weighing 8lb10 and 9lb3. Dh and I are both tall and broad. OK, I'm fat, too!)
This ++ result came after a couple of weeks of summer-holiday over-indulgence in icecream, cakes, chocolate, etc. I went back to eating sensibly, and at my next test I had NAD again. I've had two tests this week, both NAD.
I'd been refered to the Consultant Obs because I have a fibroid - standard referal, and she's quite happy to sign me off back to midwife-led care as regards the fibroid, but is making a huge deal about glucose intolerance and possible gestational diabetes. She scanned me and told me that the baby's abdominal circumference is on the 91st centile. She wants to scan me again in two weeks' time.
She also wants me to have a glucose intolerance blood test (I ended up having a random glucose test today instead).
Point is, I want a home birth this time, and the consultant is talking to me about possibly having a baby that is too big for me to deliver unassisted, even mentioning what happens if the shoulders get stuck.
But my understanding is that late scans are notoriously inaccurate - the consultant even said that she can't predict the baby's birht weight from it. And as I've had two big babies already, and I'm far from petite myself, surely I'm able to deliver another naturally?
So what do I do? Surely as long as my urine shows NAD there is no need to further investigate my glucose tolerance? Am I endangering myself or the baby by resisting any further investigations and by my confidence in being able to give birth naturally and at home?
And, should I persuade the consultant to sign me off for a home birth, would I find that, when I call for the midwife, I get the response "there's no-one available, you'll have to come into the labour ward" being their way of ensuring that I give birth in hospital?

Sorry - long old post. I had a similar blood test result with my third child at about the same stage of pregnancy. It was the week after Easter so midwife and I sensibly blamed the extra chocolate and all my following tests were fine.

Beans were only measured at 12wk & 20wk scans and were roughly all the same size. At birth they weighed between 8lb6oz-8lb12oz. So no differences there either.

Midwife didn't refer me to a consultant and I went on to have a lovely home birth. Admittedly my midwife and I are relaxed to the point of being unconscious.

If your current beans measurements are similar to your previous beans then tell the consultant. Is the size of the baby the consultants only concern about home birth? If there's another reason then fair enough but if you've had big babies before I can't really see why this one would get stuck

I don't think your consultant will pretend to let you have a home birth and then send an ambulance - they don't tend to shy away from upsetting people!

Thanks for replying.

I had my previous two in a different county, and so there's no data here on their sizes. As it happens, both my previous babies were scanned at about 33w as well, but when I mentioned that to the consultant, suggesting that it might be possible for them to get that information from my previous hospital, she seemed distinctly uninterested in the idea.

bump

hi pc, congrats on the pregnancy . i have pre-existing diabetes & have many many scans when pregnant. one off growth scans aren't particularly accurate late in pregnancy, but serial ones do give you a good idea of what to expect. the weight of both my children was predicted extremely accurately by these. hope that helps a bit.

So if she's measured abdominal circumference on one machine, and two weeks later measures it again on a different ("more accurate", according to her) machine, is that likely to give a decent prognosis? Or will I have to have further scans? By the time I have this next scan, I'll be term, and that's leaving it very late to get the birthing pool.

2 is better than 1! if you do have gd everyone will get a bit jumpy. i doubt they'll let you go beyond term. or have a homebirth. sorry to be the bearer of bad news.

no advice, had similair happen when having dd. Ds was 9lb1 born but 15days over so all the way through they told me possibly suffered Gestational diabetes etc and tested for it when pg with dd. Told me she would be 10lb plus by scan measurments. I didnt want homebirth so didnt hinder in that way but dd was born and only weighed 6lb14ozs so my huge 10lber plus was diddy by comparison. Hope it all works out for you. Also like you am fat which I think adds to the must be more likely to have bigger babes. Am pg with no.3 and am awaiting the must have GTT etc again.

I was in pretty much the same position as you, PrettyCandles. DS1 I had a + glucose in my urine at around 30 weeks, trudged along for the GTT but all was fine. He weighed in at a hefty 10lbs 1oz, 3 days overdue. 2 years later, pregnant with DS2, I had the same + glucose in urine at 30 weeks but this time failed the GTT and controlled it with diet (in theory... no one actually told me what I should be eating so I just stopped eating chunky KitKat bars and cut back on sugary stuff). A growth scan at 37 weeks put DS2 at 7lb 15 and he was born spontaneously 3 days later at 8lb 4oz.

Fast forward 5 years to BabyDragon. I was determined to have a homebirth. Midwives ummed and ahed because DS1 was way outside their normal limits for "allowing" a HB routinely. I spent the whole pregnancy avoiding all sugar for 3 days prior to my MW appointments and drinking loads of water the day before. Whether this worked or not I don't know but I didn't have any glucose show up in my urine this time round! I refused a GTT "unless my urine sample shows a problem". At 30 weeks I was allowed to be booked for my homebirth. A growth scan put BabyDragon at around 8lb 4oz at 36 weeeks (IIRC) and she was born bang on 40 weeks at 8lb 10oz. The consultant I saw and whom I had to "convince" to let me have a homebirth had no qualms for letting me have one given I had successfully delivered 2 large babies before. My midwife was also more than happy to allow me a HB but had been unable to book me one routinely because of DS1.

Er... I've forgotten the point I was trying to make and what exactly you wanted to know. Whilst at one of the consultant appointments I was left holding my hospital notes and there was a letter from the diabetic clinic from DS2s pregnancy which clearly stated that should I embark on a future pregnancy they would want to see me at 27 weeks or so. No one mentioned it at all though and I never went!!

Did you have GD, Nemo?

Oh, and BabyDragon was a straightforward home waterbirth with no problems. Much quicker than either DS.

pretty candles no IK am just fvat...lol same weight with all pregnancies.

they have a legal duty to provide you with a midwife to deliver your baby at home.

i had to have a gtt just because i am fat- i hadn't even tested positive for sugar or anything.of course it was normal.it's like they are determined to find something wrong.

i'm sorry but it's so much shit. you stick to your guns prettycandles.

I don't think that they do, Alexsmum. If I'm under consultant-led care (as opposed to midwife-led care) then I think they can say that for medical reasons they don't consider it safe for me to deliver at home. I got put under consultant care because of the fibroid, but the consultant has now got her teeth into the sugar issue.

I just don't know whether it would be sensible to fight for a home birth, just how big the baby could grow, how realistic their predictions may be. I'm not going to compromise my child's safety! But OTOH I'm now having nightmares and bursting into tears left right and centre at the thought that I might have to go to hospital alone, if we don't find someone to come and look after our children. New thread.

My guess would be that it would be worth agreeing to the test because if it comes back OK then the consultant is more likely to sign you off for a home birth. Mind you, I guess the problem is what if it doesn't come back OK...

The legal duty, IIRC, is to provide you with midwife support where 'clinically appropriate' -- so I think you are right that if the consultant doesn't OK it you may not be able to get a midwife-assisted home birth.

Whereabouts are you, by the way?

It will depend on your GTT results. I had gestational diabetes with ds2. They say the shoulders are larger than the head if you have GD. They baby also needs to be checked for their blood sugar level after birth. My ds had a hard time getting his to a normal level after birth and spent time in special care.

Right. I've bought a tub of Diastix and I'm testing my urine every day. So far 0 each time. Hah! I knew they were making too much of a fuss. I'm convinced that that one ++ was merely a blip. If my urine stays at 0 then I think that the GTT is irrelevant.

I'll go for the second scan next week, but if I've been at 0 all the time until then, then I am going to fight tooth and claw to be signed off for a homebirth. I've birthed 2 big babies with no difficulties, and nobody expected no3 to be any smaller, and until now nobody has expressed any concerns regarding my ability to birth this one. I'm sticking by my guns.

I'm at Royal Berks in Reading, Lemonaid.

What are your community midwives like? Would they be the ones to deliver you if you had a home birth? Can you get yours on side to help you?

The scans are pretty incorrect and so are GTT's at this late stage...there is a fair bit of lituriture doubting the very existence of true GD, etc...!
I had similar issues and was also fighting for my Homebirth....anyway, with ys I refused a GTT (it would have not changed my mind about Homebirth anyway, as that is still possible, and especially if diet controlled is working well and if you decide to breastfeed there really is no probs in general...nothing that can't be handled by a m/w at home)but, after talking to m/w's on UK midwifery yahoo group and talking ato a Diabetis specialist Nurse I agreed to hvae a HbA1c bloodtest done, as that is apparently much more effective anyway to show what has been happening in your body!
HTH

this is what Homebirth org has to say:
link

Oh and for grothscans...with ms I had one at almost 38 weeks and they believed that ms was only just 5Ibs after the scan...hm....fastforward 3 days later he was born weighing 7Ibs14oz...not a prob, but kinda a different size and surely he has not grown that much in 3 days, lmao...with ys I refused all late scans!

Go for it, PC! It's good to see you sounding more like yourself.

Hooray, well done for sticking to your guns.

Just to let you know that the consultant has signed me off for a home birth. Yay!

great news pc .