Well that didn't take long.

[heathenmom]

DH and I go to the same family doctor. We've seen her for years and I thought we had a good relationship with her. She's always seemed respectful of my opinions and decisions. I have a wellness physical scheduled in a couple of weeks. DH hurt his foot yesterday and wanted her to check it out, so he went in this afternoon. I asked him to let her know that I was pregnant and to ask if I should keep the appointment.

She wanted to know what our plans were for prenatal care, and dh told her we were hoping for another homebirth (she knows dd#2 was born at home). She told him that I was going to kill the baby, that I was diabetic now and that was completely different. She also told him that no midwife or birthing center would take me, which I'm sure is accurate but just seemed vindictive at that point.

My bG is COMPLETELY under control; the last time I saw her, she said that my a1c was at NON-DIABETIC levels. I take very good care of myself. I would never, ever do anything to intentionally hurt our child. I am just livid right now, AND floundering. I was counting on her to at the very least sign off on my FMLA papers. I can't take FMLA-covered maternity leave without a doctor's signature on the paperwork.

I can't believe that I didn't even make it to 6 weeks pregnant this time before the bs started.

[ancoda]

I really do not know you or your situation much at all, but wanted to give you a virtual hug. I do not really know if there is a difference between how diabetics you already have and gestational diabetics but I have had GD through 2 of my 3 pregnancies and was borderline to test positive during my other pregnancy, and only used a doctor for my first pregnancy which was the one that was taken care of the worst.

As long as you listen to your body and keep an open mind to changing your plans if your body says you need to I am sure you will do great.

[smeep]

Wow. SO inappropriate, and I would be sure to tell her that. She has NO place treating you like that, not to mention it's absurd and based on lack of information/misinformation!

FTR, plenty of out-of-hospital midwives (homebirth and/or center midwives) will take on diabetic mums provided that it stays under control. There may or may not be any in your area but I have met PLENTY of women with well controlled diabetes who had out of hospital births and plenty of midwives who will take those clients on.

[ssh]

The diabetes might mean you need more prenatal care to keep your sugars under control and more untrasounds to make sure the baby isn't getting too big. Also if you aren't on insulin you will probably need to be. But I don't see how that means you can't have a home birth. There are more stillbirths with diabetic moms who carry to 40 weeks than with non diabetic moms so some Drs. like to induce at 38 weeks. I went into labor at 37 weeks so the issue didn't come up.

[mwherbs]

sorry she felt free to use extremes to comment to your husband.
How is your blood sugar under control, Via diet and exercise or through meds? Other issues with diabetes have to do with vascular changes that occur over time - basically blood sugar control has the most impact but there are other related issues , from degrees of malnutrition to immune system changes and circulatory health, kidney function.. diabetics have a higher incidence of preeclampsia and or non-preclamptic high blood pressure , there is also an increased risk of near term unexplained loss and increased risk of some defects so it is a bit concerning and there are things to be aware when doing self care. If you are using meds to control your blood sugar who are you going to obtain them in pregnancy if you UP?

[heathenmom]

Everything that I've read regarding diabetes has led me to understand (please correct me if I'm wrong) that if your bG is tightly controlled (and I mean to non-diabetic levels, not to the ADA-recommended levels which are not low enough to stop nerve/cellular damage) then the risks are negligible.

I am on a very very low dose of Metformin and glipizide; I've never needed insulin, even with my GD pregnancy. My numbers were never sky-high or anything, and changes in diet plus the small amount of medication brought my a1c down to non-diabetic levels. My doctor told me that if I added daily exercise (which I've since done) I'd be able to come off the medication completely. I just haven't been in to see her since then. And that was a good question mwherbs ... if I DO need meds during the pregnancy, I don't know what I'll do. I foolishly believed that my family doc would help with that, but now I highly doubt it.

I LOVED our uc and would be so happy to have another one, but as someone with health issues I also understand the need for some additional monitoring, up to and including NOT uc'ing if it wasn't appropriate. If I could get that monitoring without people trying to scare the shite out of me, and from someone who would trust that I'm not an idiot nor am I someone with a death wish or out to kill my baby, I'd be FINE with it. But they take one look at me (overweight, OLD , and OMG she's DIABETIC TOO) and never get to the facts: active, healthy, NO health problems as long as I eat properly and exercise ... which I do.

I hate this. DH told me last night that THIS was why he was so reluctant to have another baby, and I understand completely. We both want this baby, but being put in a position where you have to either choose a fully-medicalized pregnancy and birth or completely up/uc just doesn't seem fair.

Thanks for letting me vent here, ladies. We'll figure it all out. I'd just hoped not to have to deal with so much negativity so early on.

[klemomma]

Can you go to a midwife or OB for prenatal care and just still have a UC if your health and the baby's health permits?

That's what I would do. I'd find the best care provider I could. Then, I wouldn't say a word about homebirth - unless you can find a good HB MW to work with. Then, you'll know what your health status is as you get to the end, and you and DH can decide whether you are okay to UC or if you need to be in a hospital at delivery time.

Hugs to you, mama! I know how it feels when you are okay with medical care as long as it is respectful, and then they make you feel backed into a corner by being disrespectful and scare-tactic-y.

HH9M :-)

[heathenmom]

That's starting to look like the way we'll go. I got the name of a potential-maybe-possibly-less-crazy ob from my friend who's a doula, and there IS a hbmw in our area now. It can't hurt to at least talk to her.

[amyjeans]

Sorry to hear that your doctor was so mean. As far as paperwork...a doctor is a doctor as far as FMLA- a chiropractor could do it for you. I believe it doesn't have to be a "birth" related doctor.
I wish you a peaceful birth!

[homebirthing]

I have signed FMLA as a traditional midwife. That part should be fine. I bet a chiro or someone along the alternative treatment lines could do that.

[heathenmom]

Thanks, y'all. I'm much calmer now. My good friend-doula suggested the chiro option, and I'm CERTAIN my chiro would sign my paperwork. I'm much less sure that my company would accept it, but we'll cross that bridge when we come to it.

My friend also gave me the name of an ob who has apparently offered to provide backup to a lay midwife from a neighboring state who has local clients. That ob is covered by my insurance, so my current plan is to set up an appointment with her and we'll see how it goes. Until determined otherwise, I'm assuming that (a) this pregnancy will be uneventfull; (b) I will still need some meds [at the very least, I'll need an Rx for my diabetic test strips so that insurance will cover them]; (c) I will want at least some monitoring of the baby via u/s, which won't be covered by insurance unless a doctor refers me.

I'm requesting my prenatal records from dd#2 BEFORE I ask to have them sent to the new ob, though. I really want to know what the old ob had to say before I meet the new one. I know that she uses me as a cautionary tale to her new patients: OMG there was this one patient whose baby was BREECH and she was scheduled for a c/s and she just STAYED HOME AND HAD THE BABY! Personally, I think it's less a cautionary tale and more a bad reflection on them (why should I have had a c/s if I was able to have a perfectly safe and healthy uc at home), but I digress.

[alicia9178]

Originally Posted by heathenmom

I know that she uses me as a cautionary tale to her new patients: OMG there was this one patient whose baby was BREECH and she was scheduled for a c/s and she just STAYED HOME AND HAD THE BABY! Personally, I think it's less a cautionary tale and more a bad reflection on them (why should I have had a c/s if I was able to have a perfectly safe and healthy uc at home), but I digress.

HIPPA VIOLATION!!!!!! Do you know that you can sue her for that? That is SO WRONG!!!!!!!!!!! Your personal medical information is your own...she cannot just go around using you as osme sort of example...this is MORTIFYING to me and to be honest as a RN if I ever got caught doing that I could loose my job, get sued, and be slapped with a HUGE federal fine.

[smeep]

Originally Posted by alicia9178

HIPPA VIOLATION!!!!!! Do you know that you can sue her for that? That is SO WRONG!!!!!!!!!!! Your personal medical information is your own...she cannot just go around using you as osme sort of example...this is MORTIFYING to me and to be honest as a RN if I ever got caught doing that I could loose my job, get sued, and be slapped with a HUGE federal fine.

I could be wrong, but I don't think it's a HIPPA violation unless she's giving out personal identifying information about heathenmom. Not to say it's right for her to do that, but I don't think it's technically a HIPPA violation. However, I do wonder...heathenmom, how do you know that she does this? The fact that you're aware that she uses it as a cautionary tale makes me wonder if she did, in fact, give out identifying information.

[heathenmom]

Originally Posted by smeep

However, I do wonder...heathenmom, how do you know that she does this? The fact that you're aware that she uses it as a cautionary tale makes me wonder if she did, in fact, give out identifying information.

No, I don't think she's giving out personal identifying info. A friend of a close friend is a patient with their practice. She (the patient) shared with my friend a conversation she had with the ob, and my friend -- who was privy to LOTS of details concerning my pregnancy and prenatal care -- knew immediately that it was me.

Honestly, I'm not offended or angry in the least ... I think it's pretty funny.

[BirthNut]

Sorry, I didn't get a chance to read all the responses, but I have been in a similer situation, twice none the less. With my last baby in 2005 I had HORRIBLE uncontrolled diabetes, was morbidly obese, insulin wasn't working & Metformin was making me sick, so my primary Dr decided that we would wait until after he was born to do anything about it. My blood sugars did regulate while I was pregnant, but you could just tell it was out of control to begin with. I saw an OB for shadow care & a homebirth midwife who had no problem taking me on. My son went to 44 weeks & after a 66 hour labor we did transfer to the hospital & had a cesarean where I did get a little guff because I didn't see the OB after 42 weeks since they did start trying to push a cesarean.

Fast Forward to this pregnancy (currently a few days over due) my diabetes has been under control with diet & exercise over 3 years. I was seeing a CNM/OB group for care up until 34 weeks when the OB tried to get me to have a repeat cesarean. Anyhow from the beginning the CNM saw no problems with me having diabetes, they just closely monitored me to make sure everything was indeed under control. All my tests have been perfect, baby is perfect size, etc... Since I refused the cesarean the OB did release me from their care so we are planning to UC this time. The homebirth midwife that I had last time though is graciously on stand by for me if I need her & if a true emergency arises we can always go to the hospital if needed.