I’m 38 weeks pregnant and ready to go into labor at anytime now.
Just waiting on baby and my body to cooperate.
So i’m having a conversation with one of my doctors about labor. I have a notoriously detailed birth plan which i’ve pretty much stuck to with all four of my kids. For my diabetic labor’s I wear my insulin pump and its never been an issue. Then with this pregnancy, all the sudden I hear that its now standard practice put the mom on an insulin drip. Anyone here this nonsense!!! I flat out said no way in heck am I doing this. The docts said they were ok with me staying on my insulin pump as long as my BGs stay at 110 or below during labor. The reasoning is they see babies coming out hypoglycemic when BGs in the mom are all over the map. Yea, duh, because its physically taxing event, stress on the body. What else is blood sugar going to do? Seriously! Don’t have to go to medical school to figure that one out.
I cannot believe this crap! Since when does a hospital claim to know more than me about managing my diabetes, especially during a physically traumatic event? Am I the only one who thinks this is absolutely nuts? And when did this happen? I had a child in Oct 2013 and this was never brought up at all.
I’m not ok with this at all. I usually get a heplock and hydrate myself and control my insulin through labor. Isn’t it bad enough that I feel like I have a handful of doctors up my lady parts for 9 months and now they want to intrude on this too. Grrrrr!
I know little about childbirth and labor with regard to diabetes. I am aware, however, that some hospital intensive care units use an IV insulin drip to control blood glucose in diabetic patients after a cardiac bypass graft operation. I read a study that showed that the patients treated with this tight blood sugar control protocol do measurably better than patients on the standard regimen. I remember reading this study and I was amazed at how tightly blood glucose could be contained – much tighter than I can do on my best day.
I think the protocol includes the ability to also add glucose to the IV when needed to maintain tight blood glucose control. It makes sense that tight BG control keeps post-operation infections to a minimum and promotes healing in those early critical hours.
If I was offered IV insulin therapy that was staffed by competent well-trained personnel with a suitable medical professional to patient ratios, I would opt for that course.
Good luck with your impending delivery! With four previous successful deliveries, you are a pro and your gut instinct is probably your best guide.
Thank you @Terry4 for your insights. I would opt for this option too if I were having surgery. I completely understand having an insulin drip for any surgical procedure.
Childbirth for me anyway is very awake process, that is unless it becomes a C-section. I don’t use pain meds at all and I do keep tight control of my BGs.
Thanks for the support! I guess I’m kind of a control freak when it comes to my pump and insulin management. Throughout this pregnancy my a1c has been 5.9 steady. I feel like I do a darn good job.
I guess the other thing that sits in the back of my mind is the fact that my labors are about 8hours long. Sometimes I eat small snacks throughout. I know how my BGs react to certain foods. Its already a stressful process, I don’t want it to be more stressful because I’m worrying if someone is going to mess up my insulin administration.
I know the high risk practice I attend sees many type 1 and 2 patients that don’t keep good control at all during pregnancy. I clearly do not fit in this category.
This is another reason why I’m a little ticked that this even a discussion point for me. Although, the hospital has recently gone under new management and I wonder if this is a policy push.
I also worry about handing over my BG management to just any hospital staff or situation. They are often undertrained, overworked, way more fearful of hypoglyceia than is helpful to you. If they had to choose between a 70 mg/dl and 300 mg/dl, they’d choose the 300 every time. The 300 is easily attributed to the fact you have diabetes, while a 70 that trends lower will be their responsibility.
I have only had one delivery so far and my doctor wanted me to keep my pump on but start a dextrose drip and I said no because I have always ended up high on dextrose. She came back and said she will do insulin drip with dextrose drip which they can titrate easily and quickly if my BG goes either direction. They used my basal rates for figuring out the rate but it was the best thing ever. I didn’t have to worry about anything diabetes related the entire labor. They checked my BG hourly and it was between 85-95 the entire labor. My nurse joked that she she didn’t think I was really diabetic.
And I’m 38 weeks too! Yay getting induced next week and I will push for the drip again. Since it worked so well last time I don’t trust myself to be on top of everything again.
