I'm 8 weeks pregnant with my second baby, and had a low risk PG and home birth with DS. Long story, but I've been planning concurrent care with a homebirth midwife as well as an OB practice as my backup plan. I wanted to do some care with the OB practice because I wanted to get an anatomy scan and be somewhat known to them in case I need to transfer care. Complicating factor is that I work as a contingent RN with the OB group in L&D.
Background: I had trouble conceiving, and had an ultrasound that revealed a polycystic-appearing ovary in October. I had no PCOS-specific labs tested, but have markers such as obesity and hirsutism; the OB said I was "borderline" PCOS. I switched to a low-glycemic diet and lost 15 lbs. I started taking myo-insoitol to decrease insulin resistance that can come with PCOS (and has been shown to help PCOSers conceive). I've been a regular exerciser for some time now, so nothing has much changed with that. I conceived in January. With feeling queasy/fatigued in early PG, I've been consuming a lot of carbs over the last month or so. It's all that appeals/stays down. I stopped the myo-inositol when I learned I was pregnant.
Ok, so my BMI is 30, and the NP I saw at this OB intake visit ordered a Hgb A1C drawn with the usual first visit labs. She also ordered a 1 hour glucose challenge, which I didn't have time to complete at that visit, and planned to do surrounding my next appointment in 2 weeks. I got a call from the office nurse today that my A1C was 6.4 which is "borderline." She stressed doing the glucose challenge and that then the "plan" would be determined.
I'm freaking out a bit...if I fail the glucose challenge at 10 weeks PG, is that a diagnosis of pre-pregnancy diabetes rather than GDM? If I'm diabetic, that risks me out of midwifery care, and I'll be subject to hospital birthing and all it's attendant interventions, including recommended induction, which totally differ from the home birth I've had before and am planning again. Very anxious about this!
Any thoughts? Thanks in advance to anyone who weighs in.