Type 1 and going full term pregnancy!

So I am 35 weeks pregnant and have maintained my BGs really well. My A1Cs have all been under 6.5. My doctor though is saying at 38 weeks he will take the baby out my C-Section no matter what. He also says they baby seems to look like a 38week old baby instead of 35. Has anyone gone full term? Is my doctor trying to push his own agenda on me and using my diabetes as a scare tactic? I have been told by many people, including nurses at the labor and birthing centers, how small my belly is and looks. I don’t know what to do and I am so frustrated right now.

Hi La La,
My first baby was born 3 weeks early. I was in hospital because I was so swollen, couldn’t get shoes on. They did an amnio to make sure baby’s lungs were ok, which it was. I went into labor myself and they did emergency C section (baby’s head was jammed in my pelvis while fetal monitor showed his heart rate failing). Baby was fine and weighed 8.5 lbs.

Three years later at 39 weeks my other son was born (C section, also, knowing baby would be large), he weighed in at 10 lbs.
That was almost 37 and 40 years ago. And so much has changed since then.

Everyone’s pregnancy is unique. There is a correlation between diabetics and big babies. But this is not a hard and fast rule.

Did your dr say why it has to be a section?
In any case if you are confident in his/her skills just list all your concerns and voice them next visit.
God bless you and your baby!

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It seems he just c-section all Type 1 moms at 38 weeks no matter what. I do not feel confident in his skills. I don’t think my baby is as big as he is saying she is. I am not against c-section if it is absolutely neccessary, but I feel like I am being cheated.

First thing’s first: congratulations!! I’m 34 weeks along, myself, with our second child. It sounds like you are doing an awesome job - what you’ve described is no easy feat!

I had an OB like that during my first pregnancy, too. I feel like it really depends on the doctor, what they think is “right” and what their experiences are that guide their viewpoint. It’s not uncommon for T1’s to end up with a c-section birth (this was my experience with my first; we induced labor and after several hours had to do an emergency c-section), but it’s not the only way.

A couple of other thoughts - your size does not determine the baby’s size. Also, ultrasounds seem to have a pretty large margin of error. http://well.blogs.nytimes.com/2016/01/11/high-birth-weight-predictions-are-often-inaccurate/?_r=0

Best of luck to you, whatever happens. :slight_smile:

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That link was very helpful thank you. at 35 weeks the dr said that the baby was measuring at over 7 lbs. He could be right but I have such a gut instinct that says he isn’t. Thank you so much! And congrats yourself.

I went full term with no c-section. My A1C was 6.0 most of my pregnancy. This was 21 years ago. My son was 9.9 lbs, but he has also been on the tall side his whole life. (6 ft 3 inches now) I was induced because my doctor thought he was going to be 11lbs if we waited. I think she just got my due date a bit too early.

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Hi @lala_wolf,

Congratulations! I am 31 weeks with my 4th child, 2nd T1 pregnancy.
I’m very much into self education and responsibility with any type of pregnancy. I wouldn’t settle for this behavior, but I’m kind of a ball buster for doctors because I’ve researched so much. Just because they are doctors doesn’t mean they get to bully or push patients around with scary jargon. Both of my T1 pregnancies, I was 5.7-5.9 range, my daughter was 7lbs 7oz at 39 weeks. My doctor was willing to go to 40 weeks but I wasn’t because I have other kiddos to take care of. I was induced. In my experience, induction is more common than C-Sections. I would start with negotiating an induction and go from there. I attend a large university hospital that has a dedicated high risk diabetes clinic. So my doctors focus on diabetic patients. Even these doctors don’t rush into C-Sections.

Just so you know, with my daughter, the sonograms measured her at 8lbs at 39 weeks. Doctors will even say its a pound up or a pound down. Its quite inaccurate. With this pregnancy, baby is clocking in range so my doctors aren’t pestering me.
Unless serious complications ensue, I’ve always had the support of my doctors to continue to 40 weeks with natural, vaginal delivery. Have you had prior C-sections? Many doctors are skeptical doing VBACS.
Also, your doctor needs to be specific with numbers saying your baby looks like a 38weeker rather than a 35 weeker isn’t enough. He needs to stick to weight, numbers, measurements- facts rather than generalities. My daughter had a large abdomen and that was cause for concern as well. Are you getting weekly NSTs? Are they normal?
Also, don’t want to scare you unnecessarily, but there is a high rate of stillbirth among diabetic mothers closer towards delivery- last month of pregnancy. I think a C-section is a little severe though.

I know this isn’t the greatest tactic, but if worse comes to worse, and I was in your situation, I would get a second opinion by another high risk OBGYN and take it to your doctor threatening to move doctors depending on what the second opinion is. Of course, you need to do what is best for you and your family. I have great intuition or “gut instinct” and if something feels wrong, it usually is. Ultimately, you need to do what is best for YOU and your baby and family.

Keep us updated,

Busybee

It is my first child so no prior c-section. My doctor did say that the baby was measuring at over 7lbs. I also had one NST and it was perfect, but my doctor said that that means nothing and that nothing good comes after 38 weeks for a type 1 pregnant woman. At 38 weeks I was told they were going to try to induce but he was pretty sure the baby won’t fit. I am going to get a second opinion, I just wanted to hear from other Type 1s what their pregnancies were like.

Wow! He sounds like a very old school obgyn. Does he still think T1’s take shots with a glass syringe? :smile: How many sonograms have you had? I get 2 NSTs a week starting at 28 weeks up until I give birth. Yes, it does matter. If fetal movement, fetal heart rate, placental fluid retention, and a host of other variables are showing well in weekly NSTs then this is evidence you and baby are good. This is ridiculous behavior.
All I can say is that I wouldn’t take this crap that he’s trying to feed you about a necessary C-section. Sounds like he is trying to look out for what HE wants in a CYA way instead of listening to what his patient wants and compared to what medically is the standard for T1’s. The baby won’t fit! HA! How do 10 lb babies make it out of women vaginally!? What a piece of work. Oh man, this doc really makes me mad!!! :rage:
Seriously, how long has he been practicing medicine? Treating T1’s?

More importantly, if you want more kids after this one, you do not want to start off with a C-section as your birthing history. It sets a tone you can’t go back and change.
Spare yourself from that frustration. Not only this, but women who have C-sections take more time to heal from that than a tear from a vaginal birth. Yes, I understand that for a large baby shoulder dystocia is a risk for the mother and baby. Do you a small pelvis?

So glad to hear you are going to get a second opinion. I would go so far to get a sonogram not from his office or staff. When a doctor is more concerned about the risk to him and his practice rather than the wishes of his patient, he or she is too biased in the matter. I understand that he may have a real concern for you and your baby but his opinions are not standard practice and reflect more of his personal feelings on the matter. C-sections nationally are decreasing and thats the way it should be.
What he is really saying when he says nothing good comes from keeping a baby in the womb of T1 pregnant woman after 38 weeks is that there is more risk, more importantly, he doesn’t want to involve himself or try for that risk. There are other variables that increase or lower that risk.

Please keep us updated on your second opinion and potentially a new doc.
My thoughts and prayers are with you. Don’t give up! Keep up the good work with your BGs all the way until the end. You are almost done! :blush: You are doing a good job. Its so worth it for that little one.
Busybee

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Here is where my guy instinct was thinking this doc is wrong. I just started having NSTs done last week at 35 weeks. And it’s only once a week. The week I saw my doctor and he said he was going to do C-Section at 38 weeks because the baby was really big he didn’t even do a sonogram. He just started measuring the baby yesterday and is only going to do it once a week as well. Which hearing all this making me think he is just covering his own butt. When I brought up that I didn’t want a C-section unless absolutely necessary that is when he compared a c-section to widening the vagina with a little cut. They both get the baby out safely and that is all I should worry about.

But all this feed back has been so helpful and just what I needed to hear. I am so thankful for your responses. I will keep you guys updated.

I’ve had 3 full term pregnancies with T1, no c-sections. My first two were induced at 39w and 38w5d (39w fell on a Saturday with her, my ob didn’t like to induce on Fridays if it’s avoidable, so I opted for Thursday), my third was a spontaneous (and precipitous) labor at 39w2d… for him, 39w fell on a holiday, and then there was the weekend following… and since I didn’t want to go early and have him share a birthday with his older sister, he was scheduled for induction on a Monday at 39w4d, but was determined to come on his own time :slight_smile:

Mine were also 7lbs15oz, 8lb1oz, and 9lb5oz… so not small, but not super huge either. The big one was actually the easiest delivery. My “smallest” baby actually had the biggest head. Do NOT agree to a C/S for a “big” baby unless you want one - you have every right to change docs at this point if you’re being pushed towards one and don’t want one.

Anyways, my #'s were great throughout labor and delivery with all 3 of them, and none of mine had any NICU time, and only borderline low-ish BG’s (low 50’s)… not even actual lows for a newborn (which is <50).

I had weekly NST’s starting at 32 weeks with all of them… moved up to bi-weekly at 35-36 weeks, then every other day (well, M, W, F) with a BPP after 37-38 weeks with all of them. I was comfortable with the amount of monitoring I received. The second two had a different OB than the first (I moved) but my care was handled very similarly… except that my OB did not make it to the hospital for the birth of my third, the on-call OB with the hospital delivered him, but it was okay because he turned out to be a T1 himself, and was pretty awesome in general.

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So switching doctors or even getting a second opinion is impossible. No one is taking my insurance. So I guess I have to hold to my guns and just say no.

My second pregnancy was after T1 diagnosis and I went full term although they did an amnio to check for lung development and induced 2 weeks early, she was a healthy 8lb. This was 36 years ago and even without pumps, cgm’s or blood test meters, I was always well controlled. I would get a second opinion. C Sections are all too common now even for non diabetics. Do your research and be informed and then go with your gut. You’ll be fine and good luck!

Do you live in a small town or a moderate to large city?
I’m a little baffled at this, not because I don’t believe you or lack of trying on your part, but I’m sure there is some other doctor who will accept your insurance and see you. Are you looking for High Risk OBGYNs? These are the docs really that have the expertise to deal with diabetics during pregnancy. Another place to find one is through your endo, endo’s can be well connected. I would ask your endo first and then maybe get an in that way through a referral. Sometimes cold calling yourself isn’t the best avenue. You kind of have to get a little creative. See if this works.

Busybee

I live in an in-between town. It’s not small but it’s not LA. I will ask my endo and maybe talk to her about it. I tried only two high risk OB-GYNs but one my insurance was SUPER sure that they would take my insurance.

Keep working the system, do not give up. Sometimes things are hard, but we can break through if we are patient and persistent. Meanwhile, keep your ground with your current obgyn. No c-section means no. As my husband would say, this guy is on the moon.
Busybee

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My first pregnancy was full term.I had a very tough time pushing him out but all turned out well.My second was taken a week early by csection.If I had to do it all over again,a csection would be my choice as I healed very well and it was a breeze as apposed to the first one.I was awake during the whole procedure so I didn’t miss anything.

My first was natural delivery at 38 weeks 7 lb 3 oz. My second was cs at nearly 40 weeks (nothing to do with my diabetes - She got tied up in the umbilical cord and could not engage - So we went to cesarean after 2 days of labor with no progress). She was 7lb 6 oz. My Dr said if ever i.had a third we could do vbac. Haven’t been lucky enough to get pregnant again. Your Dr is very old school to think that type 1 diabetes is an automatic cesarean. It should not be. Follow your gut on this.

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