35w and at breaking point. Don't know what to do.

[Stroan]

I'm 35 weeks pregnant with my second DC, very much planned and wanted.

This pregnancy has been tough. HG (mostly severe nausea) kicked in exactly two weeks after the positive test. It took 8 weeks to get any help from doctors as no-one would prescribe the medication that worked until I begged for a termination (please don't judge, i can't forgive myself but I really felt that bad and couldnt take care of my DD). I'm still struggling now but the medication takes the edge off.

I had several big bleeds and infections which were all a bit scary/miserable and added to the overall stress.

I realised at 16 weeks that I wasn't coping mentally and asked for help with anxiety and the guilt of requesting a termination. My referral was rejected by the perinatal team at the hospital I go to (nearest hospital but different NHS area) so had to be redone for the team who covers my address. It took 8 weeks to even speak to someone. The nurse comes out, has a chat, makes me feel a bit stupid and irrational then leaves. There's no action or treatment, no communication with the consultants or midwives at hospital. I haven't bonded with the baby at all and feel like I don't care about him, which I keep bringing up and no-one reacts to.

I also have gestational diabetes, which I had with DD. It kicked in at around 14 weeks and I severely restrict my diet while also trying to manage the nausea. It didn't work so I am now on medication and insulin to manage the diabetes alongside the diet.

DD was a large baby and had shoulder dystocia at birth. I was promised an ELCS in future pregnancies but had to fight for it. That process made me realise how traumatic her birth was and that I had actually suppressed most of the memories from it. My ELCS has now been signed off but a few doctors have suggested I will need some form of treatment for trauma in future. This baby is also measuring very big which adds to my anxiety. I am convinced that I am incapable of keeping the baby safe and that I don't deserve to have a healthy outcome to this pregnancy.

In the last few weeks, my blood sugar levels have dropped and I had a hypo in my sleep. The consultant told me if I had another one, they would admit me for steroids and prepare for an early delivery. I had one last week, they got me to go in for monitoring and then decided it wasn't actually a hypo so set an ELCS date for 39+1.

I haven't done anything to cause my blood sugars to suddenly stabilise and be really low - they sit just above the level that would be considered a hypo. I feel very unwell as a result - often as though I am drunk, shaky, weak, confused, my face goes numb etc. I feel on the verge of a migraine all the time and can't even watch TV or read a book. The doctor says these these are probably just general third trimester symptoms and unrelated to the blood sugars, but they started at the exact same time as my levels dropped.

I can't keep my sugars above the legal level to drive but the doctor doesn't care - she directed questions at my husband to find out if he could manage all the essential driving for things like nursery runs and they somehow all came to an agreement that I would just stop driving. I can't eat more to increase the levels as the baby is already big and that would most likely accelerate growth further.

That leaves me housebound. I have PGP so can't walk far. We live on the outskirts of a town but there's nowhere to walk to, not even a shop or any form of public transport. My family are hours away and my friends are all at work. The days I will have DD, we'll be stuck at home.

I'm aware this sounds dramatic but I feel like a prisoner. I don't enjoy staying at home anyway and now I'm completely trapped. I can't do any of the nice things I had planned for mat leave or even just go out for coffee.

So it's Day 1 of no driving and no company. I've cried all day, until I make myself sick and then it starts again. I didn't feel depressed before (just very anxious) but I definitely do now. I haven't managed to eat or drink, I've barely been out of bed. I feel like no-one cares about how I'm feeling as long as they all think the baby is ok, as though I'm just the vessel that is carrying him. I've started to have some quite scary thoughts about how I can just end all of this. I don't think I would ever do anything but the thoughts are getting a little too real.

I'm at my absolute breaking point and I don't have any options left. My community midwife isn't involved in my care at all because the hospital have taken over. The hospital don't care and the perinatal team aren't doing anything. I have 4 weeks left and don't know how to survive for that long. I asked if the ELCS could be slightly earlier and the consultant laughed.

Sorry this is so long, I didn't want to dripfeed. I know it all sounds ridiculous and that one person couldn't be so unlucky. But I don't know what to do as no-one seems able or willing to step in and help.

@kikibo it has definitely crossed my mind to prove it to them by upping my sugar intake and seeing if I feel any better. But I'm not really clear on the risks to the baby.

I am definitely struggling with how certain they are that nothings wrong. Surely different blood sugar levels affect people in different ways so why is it so hard to accept that low sugars are affecting me this badly?

They only consider a hypo to be 4 and under. I'm regularly sitting at 4.1 and the home testing kits aren't completely accurate.

Stroan i am very glad you have found someone to listen

@Stroan

Well, if it's only for a few days you have higher levels, I don't think that will do much damage (I think research is your friend here). It's sustained high levels that lead to big babies. Though I think with a CS booked, that's not really a concern either.
Off the top of my head, baby could struggle to keep up their sugar levels post birth, but I thought that's a concern anyway with GD. And that won't happen just because you increased your levels for a little while.

Do you get instantly better after eating? Might be a clue. Might not.

It's only a matter of either reducing the short-acting insulin a tad or eating a little more carbohydrates (a pitiful amount usually). Increasing the carbohydrates is probably the easiest, as it's easier to do in small amounts.

I mean, as long as you stay within the normal range, but slightly higher than now, they shouldn't complain.

@kikibo I'm not on insulin with meals unfortunately, just overnight for fasting levels. So it's my own body keeping things so low.

I don't feel any better after eating, even when I eat more carbs than I have been able to up until now. My levels are mostly dropping after eating which can be a sign of placenta deterioration, but the team insist it just means I'm doing well.

My last baby was very big and quite poorly after birth despite the GD being well managed, she also dropped through the percentile charts and I was under a lot of pressure. Keen to avoid anything like that this time. But maybe one day of eating more normally to prove that it is the low sugars making me feel like this can't hurt. I'm in clinic on Tuesday so could experiment on Monday.

Hmmm, indeed, low sugar levels could mean placenta deterioration, although apparently that leads to real hypos (3s and 2s) that can't be explained by having eaten less, doing more etc.

If you're on long-acting insulin (to bring down your base level), I would try and reduce the dose slightly and see what that does.

Apparently it's not uncommon to need less insulin the later in the pregnancy. Regardless of GD or not.

If I were you I'd also pick the brains of those on the diabetes.org.uk boards as they are people who have dealt with diabetes all their lives sometimes. Some of them also complain about woeful lack of knowledge from HCPs.

I do hope you get some relief from this, though. Good luck on Tuesday.

Thanks for all of the sympathy and advice.

After the team leader of my community midwife intervened, the decision was made to pull my ELCS forward to this week. Baby is also measuring really big despite my supposedly well controlled blood sugars!

The physical symptoms are still really tough to deal with but knowing it's less than another week makes it all a lot more bearable.

There's also plenty of support being lined up for post-birth which is reassuring.