Hi all,
I’ve been type 1 for the past 7 years. I had my daughter almost a year ago now (can’t believe it’s been that long!) and I always meant to post here about how the birth went–with my goals to have a “natural” birth and being in control of my own BG the entire time with no IV, etc.
In short, all that worked!
Ultimately I liked my perinatalogist, but I had to argue a lot with her about not being induced (I went supposedly to 41 weeks) and procedures during delivery. Since I had my A1C around 5.0 the entire pregnancy (and for years prior) I argued that other than additional diagnostic tests I should basically be treated like a low-risk pregnancy. She argued that there was risk associated with merely being diabetic (rather than having high blood sugar) but could not produce the references for any articles to this effect. In my experience doctors don’t like it when you ask them to produce the data they’re basing their recommendations off of, LOL.
I managed my own BG, (with an insulin pump, though I normally prefer MDI due to no mechanical malfunctions) and delivered with nothing but a hep-lock (the IV cannula ready to go in case of emergency), which was my only concession to them. I did spike briefly up to 170 shortly after my daughter was born for some (hormonal?) reason, but otherwise stayed in the range of 90 - 115.
They wanted to test my daughter’s BG every few hours, but I made them stop after the first two normal results. She was born at the exact 50th percentile of weight.
I had no pain medication and didn’t feel like I needed any. I’m sure I was super lucky in terms of her position–she’s cooperative even now! I stayed home until I was 8 cm dilated and credit staying away from the hospital with how smoothly everything went.
Just wanted to offer some encouragement to any here who are looking to have a birth with as few interventions as possible and wondering if it is possible with type 1. It totally is!
As someone who is 31 weeks pregnant and hoping for the type of experience you describe, I can’t thank you enough for taking the time to share your story!
I have been mentioning to my high-risk healthcare team at EVERY visit that I don’t want to be induced merely because of protocol and that they have to promise me to reconsider their standard protocol if my control remains as good as it has been throughout the pregnancy (and as in your case, years prior). Unfortunately, I haven’t gotten their “approval” of this plan yet but they just keep saying it only makes sense to talk about it after I pass the 36-week mark, which seems reasonable. I also have the this ACOG opinion on hand to bring up if they do sound resistant after that point: Page Not Found | ACOG (basically stating that for well-controlled diabetes without any other complications, no induction is indicated).
I hope you and your daughter continue to be doing well! It would be interesting to read how you’ve managed breastfeeding (if you did it for any length of time) since there are even fewer resources on that practice and T1D.
Fingers crossed that I can write a post similar to yours after October!
My specialist was incredibly frustrated with my being adamant against being
induced. I almost felt sorry for her. If your provider is anything like
mine, she actually dealt with very few Type 1s with good control. Most of
her experience was with gestational diabetes.
Obviously there are indications for induction (results of the non-stress
tests, fluid levels etc.) and it’s sensible to listen to medical advice
from the professionals, but I found it helpful to remember that no matter
how much pressure I was getting they couldn’t “make” me be induced. I just
had to say no …and be willing to accept the risk.
Their job is protect against the worst case scenario (even if there’s an
incredibly tiny chance of that happening) and never mind the very probable,
but much less serious downside of a more painful labor because of an
induction or C-section risk.
The day before I went into labor I did cave and schedule an induction (for
a week in the future at what the docs considered 42 weeks), but was
actually planning on cancelling the appointment last minute if all my NSTs
and all looked fine still. So that’s a stall tactic as well. Not sure
that’s advisable, but it was my plan. I also never trusted their due date
and thought their 42 weeks was more likely to be 41 plus 1 or 2 days.
Breastfeeding has been a breeze! My daughter’s 10 1/2 months (another
October baby!) and I’ve recently been trying to reduce down to a morning
and nightly feed, but she’s not thrilled with the idea. The interactions
between my BG and breastfeeding are that I have avoided BFing the few times
I’ve been high (like over 160) and I have been going low during the night a
lot more often than I used to. I hypothesize that’s because my body is hard
at work making milk, but honestly after all the fluctuations during
pregnancy I’m not entirely sure what “normal” is anymore.
Your situation and approach (including the finding articles as evidence)
sounds so much like mine! There just isn’t much data about outcomes for
people in our situation because there aren’t that many of us and good
control is so much easier to achieve now than it was even five years ago.
We’re building that set of outcomes for those coming after us. I’d put
money down that everything is going to go great for you.
First kid I’m guessing? Enjoy the last few weeks of life as you know it. Go
out to dinner a lot and sleep as much as possible. LOL.
So wonderful to hear that everything went so well! (I’m a mom of a type 1 and always like to hear these stories.)
And it’s good to stick to your guns when dealing with the health care system. They are so used to just doing things their way and not having anyone question them that sometimes that throws them for a loop. But I always say that we have to be our own advocates and you did an amazing job!
I had a very different experience, but everyone’s is unique to them and their baby anyway. I was not induced, but my water broke sometime during week 39. However, I delivered a 10lb 4 oz baby a la natural (No pain meds or epidural). My labor and delivery took 21 hours.
In hindsight, I am sure that I should have been induced at around 38 weeks, to avoid such a large baby and post birth complications. (My daughter spent 9 days in NICU, I didn’t even hold her til she was 3 days old!) she got stuck in the birth canal and wasn’t breathing when she came out. All her organ functions took awhile to get started, and her heart muscle was enlarged for about 8 months post birth, apparently from birth trauma(?).
All to say, my birth plan for #2 is to be induced at around 38 weeks, and plan to have the epidural.
My a1c hasn’t been below 6 since I was diagnosed 7 years ago, which is surely partly my fault and partly my lack of education and support about type 1, since I was diagnosed in and have lived in Japan, and things are just done so differently here!
So excited to find some T1Ds as stubborn as me! Currently 19wks with my first. My A1C at conception was 4.9 and has dropped to 4.7 over the four months. My perinatalogist was actually speechless when I told him my A1C, which does not give me much hope that he knows anything about working with a mom with well controlled diabetes
I’ve started the conversation with my endo about no-induction (she is awesome and knows how hard I am willing to work) but she says ultimately my best advocate will be my perinatalogist (did I mention this guy seems like a misogynist as well? He only ever looks at my husband when he is talking, drives me insane!). I see him next week for my anatomy scan. Assuming everything goes well, I am going to bring it up… Last time we spoke he was trying to get me to start on baby aspirin to “prevent” preeclapsia. When i asked him if he still thought that was necessary with my excellent control and history of low blood pressure, he just said “they basically recommend it for everyone now” (not true btw). Needless to say, I have not started on aspirin and so far BP is holding at the same low levels it has always been.
All this is to say, I am so glad to have found some woman who have been through this same fight and come out of it with the birth thy wanted. I’m just getting ready for the fight, so wish me luck!
I know this thread is a few months old, but its so awesome reading everyone’s experiences and thank you @Mentha_piperita5 for getting the ball rolling on this!
I aim to have the exact kind of birth you describe although my a1c is not quite as good as yours. I only just had my first ob visit and they said I would need to go to a mfm, which I knew was coming but am NOT happy about. Was cruising around here looking to see if anyone had shared their experiences, and found this thread!
Also @Dessito thanks for that link! I’m definitely downloading that, saving it in multiple places, and making multiple copies!
Hi KCCO,
I saw the notification about your reply in this thread and wanted to check in again.
I can only speak to my own experience, but I really liked my mfm specialist, actually. I mean, I argued with her about certain things, but I got way more expert attention about normal pregnancy things like variance in weight estimations during anatomy scans and, heck, identifying the sex, than I think most people get. So who knows, it could be good.
Hello,
I just came across this forum. I’ve been a T1D for 26yrs, use a pump and cgm and have been well controlled for years. It’s definitely hard work. My A1C is 6.0, and I’d love to lower it more prior to conceiving. I’m curious how you, (Mentha )have maintained such a perfect A1C? When I was diagnosed in 1991, I was taught that I had to eat carbohydrates, and obviously over the years the number of carbs I consume have changed, but I’ve never been able to completely eliminate them from my diet. I recently learned about Dr. Bernstein’s Diabetes Solution, which is all about a low carb diet and higher protein. I’m following a modified version of his plan and since starting, I’ve shaved off at least 25 units of insulin a day. Having said all of that, I’d love to hear others’ tactics. I’m hoping to get my A1C as close to 5 as I can prior to conception. Looking forward to hearing from you!
Carrie
@Carrie18 I know you didn’t direct this at me, but I credit the keto “diet” for keeping my a1c in the 5’s. Look into it. Its very similar to Dr. B’s low carb diet. I think it needs a bit of modification for a type 1 vs a non-diabetic someone who just wants to lose weight, but its totally doable! I have rarely missed carbs. Although I will admit, I told my husband my first post-birth meal is going to be a huge splurgs on a certain Greek-style pizza from a little hole-in-the-wall place in my town! A low a1c is great, but I still wanna live my life! Lol.
@Mentha_piperita5 I did have my first mfm appointment almost 7 weeks ago and it wasn’t nearly as bad as I made it out to be in my head - isn’t that always the case? I went in, filled out a TON of paperwork, signed my name & birthdate like 80 gazillion times and then got right in. The nurse did bp & weight, verified my dates, then got me right into an ultrasound, gooped the jelly on my belly and started smushing around! She was really skilled, so she found the hb right away. All measurements were good, NT was fine, no worries there. She did say I had a couple fibroids in there, which I was super surprised about because I’d just had an HSG in Dec & there was nothing in there then! But she said they can come & go with pregnancy, the baby was getting more blood supply than they were, so that was keeping them under control, and there was nothing to worry about there. Then I got to wait and wait and wait to talk to the doctor who was a bit…umm cold? Eh, whatever. She went over my medications, verified that I didn’t want any genetic testing done & that was it. No one was pushy or anything. Yet. I’m not gonna let down my guard though!
Oh and then I had to do a 24hr urine collection which was super glamorous and they gave me literally NO INSTRUCTIONS except to keep it cold in between. Talk about a learning curve. But everything came back fine there too.
Monday morning I go back to see them again for the anatomy scan and we’re so excited! The grandparents and my husband are beside themselves! Lol.
The interactions
) she got stuck in the birth canal and wasn’t breathing when she came out. All her organ functions took awhile to get started, and her heart muscle was enlarged for about 8 months post birth, apparently from birth trauma(?).
and then got right in. The nurse did bp & weight, verified my dates, then got me right into an ultrasound, gooped the jelly on my belly and started smushing around! She was really skilled, so she found the hb right away. All measurements were good, NT was fine, no worries there. She did say I had a couple fibroids in there, which I was super surprised about because I’d just had an HSG in Dec & there was nothing in there then! But she said they can come & go with pregnancy, the baby was getting more blood supply than they were, so that was keeping them under control, and there was nothing to worry about there. Then I got to wait and wait and wait to talk to the doctor who was a bit…umm cold? Eh, whatever. She went over my medications, verified that I didn’t want any genetic testing done & that was it. No one was pushy or anything. Yet. I’m not gonna let down my guard though!
Talk about a learning curve. But everything came back fine there too.