Gestational diabetes/1 hour test/3 hour test/etc. etc. ETC.

[HappyMamaBeth]

I'm actually asking this for my sister who is currently about 28 weeks pregnant.  She just got the results of her 1 hour glucose screening, and her result was in the 180s.  Her midwife told her that's nearly high enough for them to diagnose GD without doing the 3 hour screening.  She's scheduled for the 3 hour test on Tuesday and called me in tears because she's terrified.  She barely kept the glucose drink down before the 1 hour blood draw and had diarrhea for the rest of the day. :(  I told her to cancel that appointment and to just buy a glucometer and start using it when she wakes up and 1 hour after each meal and to adjust her diet accordingly if necessary.  She's going to talk to her best friend who is an ARNP working on women's health for more specifics on that.  I just think it's completely ridiculous to attempt the 3 hour test.  (I think the 1 hour test is pretty ridiculous too but that's for another post.)

She's worried that this will be another thing they'll use to argue against her having a water birth.  She is delivering in the same hospital where she had her son--one of the few hospitals that actually allows water births (not just laboring in the water).  She delivered her first son with no complications and he was 9 lbs 1 oz.  Now they're saying they want to monitor this baby's growth BECAUSE her first child was over 9 lbs, and if baby is estimated to be over 9 lbs, she can't deliver in the water.  So.... her previous successful, uncomplicated, PERFECT water delivery of her first baby is the reason they may not allow her to deliver in the water this time.  That makes NO sense, right???  I'm so upset for her.  

She called her husband after she got off the phone with her midwife's office and he said, "Maybe we better start looking into home birth."  I know the thought makes her nervous because of the "what ifs" but I told her that I thought it was worth looking into for sure.  She's going to talk to her doula (who is the same doula she had with her first baby) to get her thoughts and opinion as well.

Any advice/suggestions as far as the "gestational diabetes" issue goes??  I told her I would post here on her behalf and let her know what I hear (she's a busy busy lady!).  Thanks in advance!

[spughy]

Well from those numbers it does sound like she has GD - I know well the feeling of not being able to keep the glucose drink down, that stuff is vile (my mw is finding me another option, bless her).  If she's willing to accept a diagnosis of GD then I don't see why she'd have to do the 3 hr - the only reason they'd ask, with that result from the 1 hr, is if she tried to argue the diagnosis.

As far as the waterbirth goes, I think she needs to ask about the rationale behind not allowing it with a GD diagnosis.  Given that it's a gentler process for mom & babe and the main risk with GD is a bigger baby and therefore harder birth, I can't see why they wouldn't actually encourage it, unless fetal monitoring is an issue?  If the hospital is in favour of water births generally, there must be something I'm missing there.  Possibly getting the reasoning behind that guideline sorted out would help - or your sister might find that she was actually simply misinformed :-)  However, a home birth MIGHT be more problematic - bigger babies DO carry higher risks of shoulder dystocia and other things that a hospital birth (if it's not a horrible, outdated hospital) are better equipped to deal with.

IMHO GD isn't something to treat lightly, although with proper positioning and patience, especially with a second or subsequent baby, the risks of having a larger baby are often overstated, and if it's uncontrolled it can definitely be a risk to the baby in terms of seriously wonky fetal/newborn blood glucose levels.  But if it's well-controlled, I haven't heard of many cases that resulted in serious complications.

[hollydolls]

Predicting baby's size is a tricky process and you can easily be off by a pound or two. (So saying her baby is 9+ pounds doesn't mean it really is that big, but it sure means they'll still treat her as if it is.) Perhaps this is something to discuss as well.

http://pregnancy.about.com/od/fetus/f/bigbaby.htm

My first was 9lb, 9oz and my second was 7lb, 5oz. (I didn't have GD.)