I’ve been type 1 for 18 years and am 22 weeks pregnant. Control has been good, although I’m still having some lows, and my A1C is 5 3.
The issue is finding a decent endo. I started with one who specializes in prenatal diabetes. We had a disagreement (which was stupid and caused by my anxiety after having a miscarriage last year). She is a four hour roundtrip drive away from me, so I decided to transfer. Ended up finding an ob I like pretty well and she referred me to a local endo. This one has been terrible. She wanted me to come weekly. I requested biweekly (seriously unnecessary given how well my blood sugars have been and the fact I wear a cgm). She also wanted me to check six times a day because Dex isn’t FDA approved for pregnancy.
So I played along for six weeks. At every appointment she harped on my having a big baby, how I can’t rely on Dex and other various things that aren’t an issue (no lady I am not swollen nor have I ever had morning sickness-thanks for asking again) and she just wasn’t on the same page as the ob or mfm. At my last appointment I told her coming every two weeks seemed ridiculous. She threw a fit and was pretty rude but said I’m a good patient so she would allow monthly appointments. Great.
But I was so irritated with her I made an appointment with the first endo. Honestly no one seems to be on the same page, but it probably can’t get worse. Has anyone else had trouble with their care team?
It was a long time ago for me. My kids are 25 and 27 now. As I recall in the early months, I went once a month but I faxed in my log sheets weekly. I tested seven times a day.
Then in the later months, I went every two weeks. At the end, I went to the hospital and sat there for the final month.
It was all worth it. I did everything they told me to do and didn’t squawk about it. My first pregnancy ended in still birth in the 9th month and I had good blood sugars the whole way through.
Pregnancies two and three were successful. I just wanted to have a baby so I went along with the whole thing.
I’m so sorry for your loss. How wonderful you were able to have two children. Were you able to deliver naturally or by C-Section?
I’m definitely a squawker lol. This second endo was just massively different than the first. I think that caused me some stress. Endo1 is highly recommended and works at a major teaching hospital. Endo2 has a private practice and I’m not sure how many prenatal appointments she has. Just frustrating.
Sorry to say mine was also a long time ago. My children are 25 & 21. For my two I saw my favorite endo who specialized in diabetes and pregnancy. I saw my OB (high risk) once a month in the early pregnancy and my endo every 2, but was sending log records weekly and saw my CDE on the off month. My team worked well together. They were all in the same building and worked well together. OB handled all pregnancy issues and endo handled all diabetes issues.
I also lost a baby in between my two and some of that was probably due to insurance changes and not having the same team. Sometimes insurance changes can have deadly consequences.
I did have a c-section with both. They were scheduled and all I wanted was a healthy baby, so I went along. My first, my water bag broke(had no idea what was happening as I never went to a birthing class) and the thought was I was in labor, why not continue. Again, I was game but told the nurses they would have to help me as I again, no classes and no idea what was going on. 18 hours later and not dilating, they decided on a c-section.
My second was 4 weeks before delivery date and blood sugars were dropping. At my weekly checkin with OB, he was concerned that the placenta was pulling away. So after talking with my endo, they said one more day & if I woke with the lows I was having, they would have to take the baby. Next day, low called in & was told to come in. Amniocentesis told us his lungs were ready and we had a happy healthy baby boy. Scary time but worth every minute of it.
I always feel as the patient you have the right to voice your opinion and you should be heard. And if they disagree, they have to have a really good reason for it and explained completely. And they should never be upset if your desires are different from theirs and you look elsewhere.
I hope and pray for the best outcome for you. Remember women with diabetes are having happy healthy babies everyday. It is a tremendous amount of work but worth it! And please don’t take our loses as something that will happen, bad things happen to everyone and while it was a life changing experience for me and my husband, it did give us our wonderful son, who we might not have had if the second went to term. Celebrate the pregnancy. Enjoy it. And can’t wait to hear how it goes along the way!
Both my live births were C Sections. The first one happened because my baby was also placenta previa. So I didn’t have much choice there.
The second baby was a C Section because her old sister was. It was a different high risk doctor who wasn’t interested in watching me take days to push a baby out because it was still three weeks too early. I wasn’t sure I was up for that either. I already had a toddler at home and needed to get out of the hospital and home to her.
Again, the goal was to walk out of the hospital with a baby in hand. I already had walked out of there once empty handed which is one of the worst things to do. So I went along with it. These doctors were hired because I was high risk and they were the best. I figured they knew more about it than I did so I went along with all their recommendations.
I have no regrets, except that the first baby was lost. I don’t care that I didn’t deliver them naturally. Labor and delivery is only but a moment in the lifetime you share with your child. The most important thing is to get them out the safest way possible.
The same questions every time (do you have swelling, morning sickness, etc.) are protocol. Don’t get upset about those and most of all, don’t take them personally.
If you’re seeing an MFM and an OB (or even just the former) that you are happy with and confident in, you don’t really need an endo as well. I can tell you that where I live (not a very large town) there is no endocrinologist whose professional insurance allows them to see women with T1D while they are pregnant. It’s idiotic, I know, but the point is myself and all the other T1D ladies who decide to become mothers do without an endo. In my case I only saw the MFM clinic and did fine. The monitoring is so close and the appointments so frequent that it was actually a relief to not have to do even more.
ETA: Oh, and I gave unmedicated vaginal birth, as was my goal, although I ended up being induced because I was 5 days past my EDD and the doctors (and my husband) were freaking out. In the end, I conceded for my husband’s peace of mind only, because I love the man, we are in this together and I understood that it’s psychologically more challenging for him not having any control in the whole deal. I ended up in 3-day-long labor with the induction meds stopped and restarted (they weren’t working right obviously), but other than that stuck to my original plan for no pain meds and vaginal delivery. Neither baby nor I had any issues, so thankfully I was lucky enough to do that.
I did have to remind everybody at every appointment during pregnancy that this was the plan, barring any worsening BG or other results from the monitoring. My BG remained in the low 5s and high 4s and all other indicators were great as well. I wish you the same, minus the induction.
I had T2 with the complication of having a single kidney going into my second pregnancy in 2011 and knew insulin would be needed to manage through it. I had a high risk OB who was fantastic and immediately placed me on insulin when I transferred into his practice at 16 weeks. I did not have an endocrinologist.
Second trimester I saw him every two weeks like clockwork. I emailed him my blood sugar readings every Thursday afternoon and he’d adjust the insulin dosage if needed. Months 7 & 8 I went weekly and the final month I went 2x per week with weekly ultrasounds in the same office. I did work throughout the pregnancy and thankfully I always had the first appointment of the day. My A1Cs were consistently at or below 5.5.
I was induced at 40 weeks, 2 days and had a normal delivery with no complications the following day. My daughter was a healthy 7 lbs, 2 oz and spent 12 hours in the NICU as a precaution only.
Don’t be afraid to push back against your care team. You are your own best advocate.
Thanks all, I appreciate each of your responses! I think it will be better to go back to endo1. She is with a major hospital and it was just less frustrating (vitals and questions once, better communication between providers). A lot of my frustration with endo2 had to do with those issues, so hopefully that will be better!
