First, a little back-story.
I love my Endo. Not in a creepy way, but in that in the 20+ years of living with D I have finally found a doctor I feel I can be open and honest with and who sees me as a person and not just a bunch of bg numbers. (Plus a ton of other reasons, but I don’t want to gush too much!) She’s been such a huge support during my entire pregnancy, encouraging, correcting, but not nagging and not always pointing to worst-case scenarios. She’s not all rainbows and glitter all the time, but we’ve got a great relationship going. And I’ve been doing really well with my management. Especially considering this is a suprise pregnancy and I my a1c was above 7 when I first found out.
But, she’s not asociated with the hospital I’ll be giving birth at, or with my MFM clinic.
This is a choice I made when I first found out I was pregnant and I made it for two reasons. First, if I stayed with her hospital/group I’d be transferred to their MFM and not allowed to work directly with her until after giving birth (their policy). Second, the hospital she’s with is downtown Chicago - great for appts during work, not so much for driving from the northern suburb I live in while in labor.
So I actively made the decision knowing she wouldn’t be able to join me at the hospital when time comes.
But I also really like the MFM group I chose. There is a rotation of about 7 Drs and they and their staff have all been wonderful and supportive as well. They’ve let me work with my Endo on the diabetes side and don’t try and over-ride her. I’ve been lucky with this and excited about the upcoming birth of my son because of all of this.
The hospital has a policy that I meet their Endo at least once before birth so she’s familiar with me and my needs once the time comes for baby to enter this world. Ok, Great!
We set up a meeting that I believe is supposed to be me getting to know her and vice-versa, we’ll talk about what the labor options are, where I’m at with my management, etc. I’m not told to bring anything specific to the appt and go in optimistic.
It was horrible.
She had the nurse take my pump, meter and cgm from me to download numbers before I was even in an exam room. Then she couldn’t download and asked me to write-out my bgs for her. Ok, fine.
Then the appt finally starts (an hour late!) and she’s all about the bg numbers, the old-fashioned questions (you’re only wearing flip-flops because of swollen feet, right? . . uh, right. . . .) and I totally felt like a little kid being quizzed. Nothing was mentioned about me personally, nothing was asked about how my actual pregnancy is going - and she has access to all the charts! - in fact she asked about family history and stuff that is in my chart. Basic first-time patient stuff. Ok, I get she probably needs a lot of this, but once we got through that, she starts needling me about individual bgs on the 7 or so days I had a chance to write out. And making me feel bad for the few highs with no mention of the three days of great numbers. Plus this is all the testing side and nothing from my cgm. Of course my tests show more of the extremes, besides meals/snacks that’s when I test! My cgm shows how my over-all trends are in great range for long stretches . . . .Sorry, I’m venting a little.
After this she finally gets around to anything pregnancy-related by giving me all the worst-case scenarios. Even the ones from bad management in the first trimester. I’m 34 weeks! Even if I had horrible control then (which I didn’t) what good does stressing me out about it now do? Better yet, when she got to the chances of complications to the baby now and during/after labor, she kept telling me he could be “fat”. Not “big” like everyone else says. But FAT. And she said it a few times. Even going into risks of him being Fat when he’s 6,7,8 years old. (BTW, so far he’s measured right on for his age. No issure from the OB side of him being big AT ALL!) She did say this is more likely with extreme highs, which I have had NONE, but she felt the need to use this scare tactic, why?
At long last, she wrapped up by TELLING me she was going to manage my insulin with my pump during labor. Which I’m totally fine with. Even better if my husband and I are able to do it ourselves and I can labor at home for a bit (fingers crossed!). But then she doesn’t feel my basal rates are correct (based on . . . ???) and wants me to do basal rate testing to check them. Ok, it’s always good to make sure things are on track, but really? You want a 34 week pregnant lady to go without food for 12 hours? And why does she get to decide if my basals are right or not? I’ve been working with my endo on this for months. They may need adjusting, but why does she get to make that decision?
(My husband was with me and later said he wanted to punch her a few times during the appt. Gotta love him.)
Ok, venting part over, now for the question.
How much hands-on time does the Endo have during actual labor? I’m starting to stress about the thought of having her in the room the whole time. Until now, I’ve been pretty comfortable with the general idea of labor. Even being in a hospital surrounded by staff and machines, etc. Now, I’m just freaking a little that there will be a person I actively do not want there.
(PS - I do realize that everyone has their own style of diabetes management and some may very much like what I’ve said about the MFM Endo. I appreciate this and to each their own. She does not have the style that I choose to follow and this is a very sensitive time for me to have to deal with it.)