Labor and having type 1 diabetes

I’m only 14 weeks and 3 days now but thinking of labor is starting to make me nervous. I talk to my endo today he said I will most likely still be able to use my pump during labor and they will check my blood sugar often. I’d like to manage my sugars myself with using my pump. He also said my insulin requirments will likely stay the same but to only use my basal rate I probably wont be bolusing a lot && right after labor I should suspend my pump bc my requirments will drop dramatically.

How was your labor? && was it hard to manage your sugar while being in so much pain. What happened right after birth did you go low? I don’t know anybody who has gone through labor being type 1 diabetic and being on a pump so I just really wanna hear about your guys expierance.

Also … were any of you induced? If so, why? Just everything about labor pretty much I’m interested in your guys stories

Please and Thank you.

I’m interested in hearing everyone’s responses too! I’m 29 weeks now, doing relatively well, but beginning to freak out about labor! I’d like to stay on the pump during if it is possible, but I’m wondering if I will be in too much pain to properly manage my own pump? I’ve read of women having their husbands take charge of the pump/blood sugars/insulin, but my husband isn’t ready for that right now… so if I need to train him, I better start!

Yeah I’ve heard of that too. I’ve been thinking of showing my boyfriend how to use it if anything I’l be right there I’ll see what he’s doing. I think he’ll be able to handle it. haha

I’m curious to hear answers, too.

I haven’t gone through labor yet (I’m just at 29 weeks), but I’ll contribute what my doctors have told me:

My OB said she wants me on my pump, and that they would only take over my BG management if I’m unable to do so (like if I’m unconscious!). She said I should just tell the nurses my BG numbers when I test or when they ask me to test. She also commented that, though that particular hospital has a policy against eating once you’ve checked in for labor and delivery (this is really common), she’ll have no problems with me treating my lows with liquids instead of the nurses doing so with a glucose drip. (She said the nurses can give me popsicles if I want something like food, and I’m going to bring my the juice boxes I like to use.)

My endo said that I may have to reduce my basal rate when labor kicks in, because it’s hard work. She also said that I’ll need to at least cut it by 50% after delivery, because insulin requirements will go way down “as soon as the placenta is delivered.”

I think that it depends laregely on your OB, but I think it’s most common to let women insulin pumps manage their own BG during labor these days. My OB did comment that they ask women on injections not to take their full basal dose once they know they’ll be going in for labor, but a pump can be adjusted at the drop of a hat so it’s easier to avoid lows.

My husband knows how to test my BG and knows when and how to help me treat a low, but I think that’s about all that’s necessary. Since I have a CGM, I doubt my BG will get so high that it couldn’t wait until a contraction is over with for me to bolus.

I had my pump and cgms on during labor. I didn’t have a problem with my blood sugars but once I went into labor i did a 50% reduction in my basal rate. I was able to keep my sugar in the 80s. After my daughter was born my sugars were pretty stable. I breastfed her for a few months and I didn’t have to do any boluses and still had quite a few lows.

I am 37 weeks and I will be having a c-section (but will be conscious). I will wear my pump and manage my own blood sugars.

I did train my husband in how to operate my pump (mostly getting familiar with the menu structure – he already knows what numbers mean and usually knows how I should react). I would not feel comfortable about him (or anyone else really) making decisions instead of me, but if I am unconscious, I think that he would make better decisions than a nurse.

After the birth, my endo told me to return my basals to my pre-pregnancy levels and to use temporary basals of 70-80% if I am having lows.

It is good that you will have total control. I hope that i will do that too. Considering that i might have a c-section too, that shouldn’t be a problem i guess, with everything being programed, because things will happen fast.
So when is the big day?:slight_smile:

We don’t know yet! The earliest is next week (?!?!), but if he is doing fine (according to non-stress tests and ultrasound) then my doctor will wait until we get closer to 40 weeks. I like that she is not scheduling it actually :slight_smile:

You have so little time…any emotions? I hope i will find time to tell us how everything went!

Hey Kristin! So soon you will meet your baby!! I am rallying for you over here. You have been such an inspiration to me during this pregnancy and I honestly wish you the very best of luck! You’ve worked so hard. It’s almost time to meet your reward!

Is there a reason why you’re doing a c-section? I know they’re measuring your baby a little big, but they won’t let you even try for a vaginal birth? Sorry if this was already asked / answered. I’m just trying to figure out what will be happening with us too. We’re nearly 33 weeks now.

The c-section is because of his size. She was considering letting me try for a induced vaginal birth, but he has grown beyond the point where she considers that safe.

His head diameter is 10cm and his abdomen diameter almost 11cm. I think that it is also a concern when the abdomen is measuring so much larger than the head because even if the head gets out, he could get stuck.

As you know, I really wanted a natural birth, but I am focusing on the goal now (a healthy little boy) and I feel that I have mostly dealt with the emotional issues because I want to feel just joy on the big day and give myself the best chances for successful breastfeeding. Since we are not inducing labor, I am going to ask her to wait for the c-section as long as she is willing to! It is nice that they don’t schedule it in advance here, but we are taking it from one non-stress test to the next one. Even if she will do a c-section, I would love to go into labor, just as an reassurance that he was ready to come out!

Aww that’s so exciting tho your so close now :)) Congradulations

It is great to focus on the outcome- your beautiful baby boy. I’m glad that things are working out for you so far. Just a few more weeks! Please keep us updated. I’m so nervous about labor, so I would absolutely LOVE pix of you and your little one as soon as you feel healthy enough to post. Good luck with everything.

My OB will start me on an IV insulin drip and and IV dextrose drip when I go into labor, and the nurses will check my bg at least once an hour and make adjustments accordingly. At first I was pretty bummed when I heard this, but then I decided that it might be nice not to have to think about and manage my own blood sugar for once! I am a nurse at the hospital where I will deliver (not on that unit, though!), and the nurses at my hospital are excellent, so I’m pretty trusting that they’re going to do a great job. Still it’s scary, no doubt about it! I’m really really hoping not to be induced, but I’m only 17 weeks along, so who knows what will need to happen. I will definitely fight induction unless I’m convinced it’s necessary.

Do you know if they start the dextrose drip no matter what or do they only use that if your blood sugars are dropping?

I am having a c-section and I was told that I will be first in the morning. So I will be fasting and just keeping my usual basal rates. So I’m hoping for really stable blood sugars before our son starts managing only his own blood sugars.

I’m sure it depends on the hospital, but my doctor said they start patients on saline and would not be giving my dextrose at anytime unless they need to bring my blood sugar up.

Sorry, when I said “dextrose drip” that wasn’t very clear. I think they would use D5 normal saline (which is only 5% dextrose), or maybe even just plain normal saline, and then I’m sure if your bg drops, they would give D50 (50% dextrose) IV push. I don’t really know for sure, though, and I’m sure you’re right that it depends on the hospital and the physician.

Ah OK, that makes sense. I just had no idea what dextrose drip meant!

Yeah, I wasn’t clear. There are all different concentrations of dextrose that can be given IV.