Gestational Diabetes and the Birth Plan

[Liora]

Does anyone have an example of talking about GD in their birthplans?  I'm interested in labor interventions but primarily in treatment of the newborn of a GD mom.  I know I'll have a fight on my hands to reduce interventions on my babies and want to make sure my birth plan is specific but realistic.

For example,

Barring clinical symptoms of hypoglycemia, no testing of blood glucose until after the first breastfeeding session.

Breastfeeding within 1 hour of birth plus every two hours after that to stabilize blood glucose

No supplementation of formula at any time

No supplementation of glucose water until hypoglycemia is verified by lab tests (unless extremely low)

Supplementation is preferred by SNS

If SNS is not available supplementation should be done only AFTER breastfeeding and by a non-nipple method (syringe, cup, etc.)

Are these things realistic?  Am I forgetting something?  I hate saying "unless extremely low" without knowing in my mind what that number would be.  I know that <40 is bad but how bad is that?  At what point is it an emergency and requires IV glucose?

Can you hear my stress level? :) 

TIA for any info!

[lifeguard]

I had gd with ds. I didn't go into as much detail as you did on my actual birth plan - although I had all those things in my mind. I simply said that I wished to nurse before a blood sugar was taken & then it would only be taken IF he showed signs of low blood sugar.

I also made sure it was clear that the baby would NOT under ANY circumstances be separated from myself or dh. We both knew what we wanted & I felt that with that provision in place we would be able to prevent anything happening we didn't want to. Plus I felt that we would be able to discuss anything that came up as it came up.

To tell you the truth though non of it was an issue. I held ds immediately, he had good apgars (9 & 10) & then dh took him for the first hour while I was stitched up (I had a terrible tear). As soon as I was back to the room he nursed & both slept.

[msmiranda]

I am very interested in this as well ... and I'm going to have to copy your wording for my postpartum plan!  Those are exactly the things I am worried about.  Can't wait to hear what others have to say.

[womenswisdom]

You might also ask that the heel stick be done while nursing or at least skin-to-skin.