Anybody go into labor naturally with T1D?

#1

Hi!

I’m currently 23 weeks (5 months) along, but early on my obgyn told me I would be induced at 38 weeks because of my diabetes. The more I read, the more I realize that diabetic inductions frequently turn into C-sections, which I want to avoid if at all possible. Baby boy looked great at the 20 week ultrasound, and as of a couple weeks ago my A1C was 4.9 (has been between 4.9 and 6 during entire pregnancy).

I want VERY much to be allowed to go into natural labor, and wonder if the typical higher risks of going past 38/39 weeks are more of a non–issue because of where my numbers are? Obviously, I have a little ways to go and things can happen between now and full-term, but I just want to hear from anybody out there who may have gone the natural route, without (or with very minimal) interventions?

Thanks!

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#2

Yes. I had my son natural and type 1. He was due September 16 and I had him September 5. This was in my early days of being diagnosed. He was 8.8. I was considered Gestational. Then after having him Type 2. Then type 1. Truly think I have always been Type 1 even as a child. Sounds like you have wonderful control. Mine stayed in 200’s alot during pregnancy. He just turned 10. My daughter is 14 and I was considered borderline then.

#3

Yes, I did, had an induction scheduled for 39w5d (a Tuesday) and I went into labor at 39w2d, which was a Saturday. It also happened to be a holiday weekend, which is how/why I managed to get the induction scheduled a bit “later” (my doc liked to aim for 39 weeks, but that would have been just after the 4th of July, and he didn’t want to be “stuck” at the hospital with me).

That said, my spontaneous labor was also a precipitous labor (less than two hours total) and in that regard it was a bit scary and stupid fast… I went from “hmm, that feels different” (not painful, but weird) to realizing I was bleeding a lot (still not fully aware I was actually “in labor” at this point, I felt a gush and thought my water had broken, but nope, it was all blood) and making the call to go to the hospital OMG right now because of that… and I got there at 9cm. What still angers me to this day is that the hospital staff did NOT take me serious at all because of the day my son happened to be born (7/7/07) and I imagine they’d already turned quite a few women away, and they kept making jokes that I probably wasn’t even in labor because I walked in on my own (husband was parking the car and dealing with our other two kids) and I was still talking and not screaming and I was just wasting their time (meanwhile I had bled through the pad I was wearing and part of the way down one pant leg, which I showed them, and they started to take me a LITTLE more seriously at that point. They took me back and got an IV into me as I was in transition and my baby was born about 5 minutes later… no time for any drugs :slight_smile: Explanation for the bleeding was just dilating so quickly - it really was a lot compared to my other labors (any bleeding I experienced with those was more like a light period or breakthrough bleeding), so I wasn’t really expected it to seem so “gushy”, and that was truly the scariest part - I was fearing all kinds of things like placental abruption, but that was not the case.

Craziest part? My doctor (or his partner) was never there for any of it… but the on-call doc also had T1 and he was freaking awesome.

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#4

I am hoping for no unnecessary induction as well (now 29 weeks). My A1C is also in the normal range and I am all for close monitoring but don’t think I will agree to induce early " just because diabetes ". Of course if there is an actual issue - preeclampsia, macrosomnia, fetal distress, placental issue, etc. I will take measures for baby’s safety, but I strongly disagree with blanketed induction protocols - it should be individualized

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#5

Hi. Two natural start of labor. My first at 38 weeks (they’d been trying to stop labor for the previous 2 weeks), and my second at 39.5 weeks. The second did end up in csection after 3 days in labor, for reasons unrelated to diabetes (she got tied up in the umbilical cord send couldn’t drop). No reason to automatically induce just because of Diabetes, particularly when it is well controlled.

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#6

Thank you ladies for your input! Had my 24 week appointment yesterday, and expressed my concerns about being induced early just because I have diabetes. Doc said as long as all looks good, they would be ok with me going to 40 weeks/full term.

What a huge relief! I was ready to change docs if needed, but was satisfied with that answer and happy not to feel a need to transfer at this point. From what I’ve seen here, and read elsewhere, going past 40 weeks doesn’t seem to be as common as people going into labor before that, so hoping that for me it will happen before that “magic” 40 week date of Jan 5th, 2017.

Any of you ladies self-monitor during labor? I have an insulin pump, and am trying to decide how to handle. I’ve read some horror stories about the hospital managing insuling dosages during labor, and wonder what any of yoir experiences have been with that?

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#7

I am Type 1.5 and 19 weeks pregnant so I worry about being able to carry to term. My high risk OB told me they usually let diabetic mothers go to 38 weeks and then they (and I quote) “take the baby” meaning induction or cesarean. Kind of pissed me off but I’m gonna talk to my regular ob and see if she will accommodate my plan to carry the baby as long as possible. Anyway thanks for posting this! It makes me feel better to hear that there are mothers with Type 1 who have been able to successfully have a natural birth. :wink:

Anyway to answer your question about managing your own blood sugar in the hospital, I would ask your ob. I am a nurse and while I have never worked labor and delivery, I have had patients who managed their own blood sugar in the hospital. The nurses will still need to check your blood sugar and monitor it, but your ob will be the one who decides if you can manage it yourself. Good luck! :slight_smile:

#8

I always manage my own blood sugar, except they wouldn’t let me during the c-section itself, when in hospital for any reason.

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#9

I just had my 30 week appointment! Baby looks great - 38th percentile :slight_smile: I get two weeks off now but then they want me to start coming in twice a week for BPP tests - holy appointments! Also holy insulin resistance!!! Good news - doc said he was willing to individualize for me (e.g. No standard 39 week induction barring *actual complications). I just hope I go into labor before 41 weeks lol that would be too long - I would be happy to go early :slight_smile:

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#10

Thanks for the feedback on self-monitoring. I have asked, and they seemed to be open to me self-monitoring, but a little apprehensive about my ability to do so during labor. My plan is to have my husband help out with it during labor if I need it, so it won’t just be me alone.

Of course at this point I’m planning for the best, and trying to mentally prepare for a less idea situation if that occurs. I will say, controlling craving and blood sugar is getting harder as this pregnancy progresses…so hoping I am able to keep up the numbers I’ve had so far to better my chances of having a natural labor and delivery.

Also, just know that there are doctors out there who are more willing to let you have the birth you want than others. If your current doctor insists on “taking the baby” at 38 weeks, just because of your diabetes and regardless if everything looks ok, you may want to start shopping around for another who treats you more like an individual. Good luck! Keep us posted :slight_smile:

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#11

Great news MariaM2! I feel the same about going before the 40 week point–in my case 40 weeks is Jan 5th, so would be nice to have the baby before my insurance deductible rolls over again LOL! I won’t give up on my plan for a natural labor just for that reason, but hey, a girl can dream :blush:

When did the insulin resistance start really kicking in for you? I’ve noticed the last couple of weeks my sugars have been pretty high, albeit I’ve given more into sweet cravings, but also when I eat normally, my body is just not responding to the insulin like it was even a month ago! I’ll be 25 weeks on Thursday, and it’s hard to imagine where I’ll be at 30 weeks, 35 weeks, etc. with my insulin requirements at this rate!

#12

For me it really kicked in around 19 weeks and the biggest changes happened around 25-28 weeks… I think two months ago my I:C was about 1:8 and I was taking 14 units Levemir and I am now up to 20 units Levemir with a 1:4 I:C (or less)… Crazy!

#13

Hooray! Sounds like some of your concerns are already gone, given your conversations with the OB. Fwiw, I had two uninduced labors, the first at 39 weeks, the second at 37 weeks, 3 days. My boys just wanted to make an appearance early! Also, I self-monitored during bother labors using meter, pump, and cgm. You can do it!

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#14

Wow! Thank you so much for your reply! Knowing other people’s experience with this makes it so much easier to handle…

I was 1:10 pretty much the first 3-4 months, and then it started creeping up…1:8, 1:6, and now I’m 26 weeks, and it’s 1:5 from 12am-3pm, and 1:4 from 3pm - 12am, as I tend to have higher sugars in the afternoon/evening hours. I’m on a pump, and my basal rates have gone up from 1.1/hr all day, to 1.1 from 12am-3pm, then 1.4/hr from 3pm - 12am…so basically a 2.7 unit/day total increase. My correction factor has also increased from 1:35 to 1:30.

I’m hoping it’s the same for me, that after a couple more weeks the increases in insulin requirements will slow down. It’s hard for me to say what my “normal” is because I was just diagnosed in March of this year (34 years old) after going into the ICU on Valentines day with DKA. Before that, they thought I was pre-type 2 for a couple of years, but I’m guessing now that was my “honeymoon period”. We almost stopped trying to get pregnant after that, but decided to give it a shot until my 35th birthday (Nov. 2016), and I got pregnant mid-April. A1C was 10 in February, but down to under 7 by April, and has been under 6 since May. Got my pump in June, which has been a godsend, but boy have I had a crash course in this T1D world the last few months!!!

It’ll be interesting to see after the baby comes, and I’m done breastfeeding, and I get my thyroid levels under control (I also have Graves disease), what my actual normal true-to-form insulin requirements will be.

I am so grateful to have found this forum, and appreciate each and every comment and support!

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#15

@Lauren17, how did you convince your docs/nurses/hospital to let you to self-monitor? Is this something your OB knew and okayed before labor, or something you addressed once you got to the hospital?

Also, did you have you be on a glucose drip due to not being able to eat during labor? How did that work with the self-monitoring?

Thanks!

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#16

curious as to how your pregnancy is going. did you have the baby?
i know there’s a great book on amazon about having a t1d and getting pregnant/having a baby.
i have heard that if you agree to a hep lock (which is just the cannula in your skin with no IV attached, but it means they can attach an IV asap if anything goes wrong) docs will “agree” to that. i personally don’t feel as if i should be “allowed” to do anything during MY pregnancy and MY labor. i will seek out doctors who will only intervene if something goes wrong. YMMV.

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#17

Just updating on my progress here. I am currently 37+5 and everything looks fantastic with the exception of baby girl being breech. I have a c-section scheduled for 40+2 if she does not turn or I go into labor before that… I chickened out of having an external cephalic version so still hoping that she may flip on her own with some at home exercises… She is smaller than average (has been 30th percentile throughout pregnancy) and there is enough fluid so here is to hoping. Although I was definitely hoping for a vaginal delivery if a breech baby is my only “problem” I’ll take it. T minus 17 days(or less)! How is everyone else doing??

#18

I’m only 6 weeks so it’s great inspiration to hear from those of you that are farther along on this path. So far, I’ve been focusing on keeping my bgs steady. Every few days it seems like there’s some new challenge to focus on - the latest one being that I seem to have a steady rise 2-3 hours after I eat that lasts for 1-2 hours. It’s made me wonder if the pregnancy could have triggered gastroparesis (and if the minor discomfort/nausea symptoms I’ve experienced are more related to that than to morning sickness).

#19

Congratulations on the pregnancy! Pregnancy hormones can actually help with gastroparesis according to my specialist (I am 10 weeks and have gastroparesis) i am yet to see any improvement as i have had morning sickness… all day sickness really for the last 7 weeks or so. My blood sugars were a bit crazy for the first few weeks but have settled down now. Only a small amount of carbs would send my blood sugar skye rocketing!

#20

Hi @MariaM2!

First want to say congrats! As I’m sure you’ve had that precious baby by now since your post was over a month ago :slight_smile:

I would love to get an update on how you and baby are doing. I am 37+5 today, and baby boy is in breech position (he turned bottom-down sometime between 35 and 36 weeks :astonished:). I have an ECV scheduled for this Thursday at exactly 38 weeks, but also have an appointment with a second doctor who has experience in vaginal breech deliveries. Unfortunately, he is located about 2 hours from where I live, not to mention I haven’t really been able to get a good feel for the risk vs. benefit of c-section vs. vaginal breech delivery if it comes down to those options. I have been at the doc every week doing NSTs since 32 weeks (w/ ultrasounds at 32 & 36 weeks), and other than the breech, all looks great with me and baby, and he has stayed around the 50th percentile for weight. When doc checked my cervix last week, nothing was happening, so I don’t think baby is quite ready to make an appearance yet. Still weighing my options, and just wondering how things turned out for you?

Did baby turn? Did you go into labor naturally? Did you have the c-section, or a vaginal delivery?

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