GD frustrations for client - Mothering Forums

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Old 11-07-2008, 03:38 PM - Thread Starter
 
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Hope you all can offer some advice. My client, who is seeing the best options for hospital birth in our city, has GD. Because she's with CNM's, apparantly the protocol is that she also see a specialist. She's due in December, and now the specialist is "not liking her numbers". But they say baby and mom look good. They will put her on insulin and induce if she goes past her due date if she doesn't get her numbers exactly in what they are considering normal range. AND she cannot deliver with the midwives (there's only one o.b in the practice), or have the water birth she was planning. She says the midwife she talked to after the appointment with the specialist "couldn't really give her an answer" as to why these things were no longer possible. Hmmmm, could that be because there's no good reason? What do you think, wise women?

Lucky mama to Isaac , born on Valentines Day 06', certified birth doula, midwife apprentice
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Old 11-07-2008, 06:09 PM
 
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http://www.sonoma-county.org/health/...eetsuccess.pdf

It makes sense to me that a woman in her situation would be best served by having an OB as her provider. She has many high risk factors. The diabetics with the best outcomes are the one's with "tight" control. Their blood sugars are consistantly in the goal range. The advice makes sense to me.
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Old 11-07-2008, 09:21 PM
 
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There is a HUGE difference in the risks of a pregnant women with 'true' diabetes and GD.

Just as an example, in Oregon, being 'gestational diabetic' does not risk women out of our care (for homebirth and freestanding birth centers).

There is a lot of controversy around GD, so I won't get into it right now. But, essentially, the risks of a diabetic pregnancy are very different from that of a GD.

Mama to ds#1 (7) and a ds#2 (1 1/2)
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Old 11-08-2008, 01:16 PM - Thread Starter
 
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Thank you, Reha; that seems to be what I'm reading - the huge difference between the two. I know many midwives consider GD a "variation of normal".

Lucky mama to Isaac , born on Valentines Day 06', certified birth doula, midwife apprentice
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Old 11-08-2008, 08:28 PM
 
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Since I have a decent idea of the practice you are referring to, this must be something new for them. I had a client birth with them in Sept., had GD, on meds and was still a mw patient. Let me know if you need more info.

Nichole, mama to 6 blue-eyed babies, LCCE, doula, apprentice mw
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Old 11-08-2008, 09:50 PM
 
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Our scope of practice for our state defines insulin dependent GD as "out of scope of practice", so we have to transfer care to the OB. I can imagine that there are a number of scenarios that can crop up during labor/birth where "managing" the client's BS levels would be required... seems to fall out of the range of normal & low risk birth.

But, if a mom can control her numbers with diet alone, she is still considered low risk.
Due to informed choice, many clients do not choose GDS... we will recommend it based on a combination of med hx, diet hx and sx/sx.
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