Hashimoto's and pregnancy and birth... - Mothering Forums

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#1 of 8 Old 04-13-2010, 07:56 PM - Thread Starter
 
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I am trying to prepare myself for the decisions that will be coming in my pregnancy. I am around 12 weeks pregnant with my 6th child (9th pregnancy) and I have just been diagnosed with thyroid issues... namely Hashimoto's. I have had one hospital birth (my oldest child who is now 12), and four homebirths, two of which were unattended. Our 4th child was supposed to be a midwife attended birth but he beat her to the party. Our youngest who is now 4.5yo was a hospital transfer of an unattended (planned that way) and he stayed in the NICU for 13 days, his life was not in danger but they were pretty happy to have us and wouldn't let us go for that long. I am a very pro- homebirther, in almost any other circumstance than the one I am in I would not even really consider the hospital. I am trying to figure out what our plans will be for the birth, we are currently seeing a CNM who is very supportive of hb, she does not attend the birth but is happily the backup for any issues that may come up or transport to the local (very small not very high tech hospital).
This is our issue, I have a pretty serious medical issue going on right now, my Hashimoto's has me in hyperthyroid right now and even if we get it under control there will be the risk of thyroid storm during labor, my mw and my primary care doc ( a homeopath who is very laid back, in 10 years I have never seen him stress, not even when our son was in the NICU) are both worried about the risk to me if I have a storm. I am concerned about the risk to me (and the baby) if I were to have a thyroid storm, though I am coming to terms that I would be more worried about me, this is selfish but I have 5 other kids and a husband with whom I would love to grow old with.

I am about 10 to 15 minutes from the small, not so great hospital where my back-up mw works and I am pretty sure that this would not be a best choice for care in a thyroid storm. I am about 30 to 40 minutes from a few very good hospitals (one of which has a level 3 NICU) that I feel would be much better equipped with dealing with a thyroid storm. The problem is that I have very fast labors and births, the longest was 5 hours and that was my first, with pit. The shortest was about an hour or so and that was the last one who was 35 weeks, they are pretty sure that his earliness was due to an undiagnosed thyroid issue and that it is possible that this pregnancy may be pre-term as well. I am trying to decide what will be safer for us both. I feel that homebirth would be our ideal, though I do not think there are any mw who would attend due to the danger of thyroid storm. I could be unattended and at the first signs of trouble transfer in to the closest hospital which is 10 or so minutes away, though they may not be well equipped. I could unattended and plan to drive over the state line to call the EMS and transport to the high level hospital that would be better with the possibility of thyroid storm. OR I could listen to my mother and sit in the parking lot of the hospital 40 minutes from home starting at 32 weeks in case I go into labor (she was serious about this)

I am just trying to work it out and be at peace with my decision..... thanks for your support!
~laura

laura, dh Brian, ds Rory 14, dd Ellie 13, ds Caelan 11, ds Seamus 9, ds Finn 7 and Penelope 2 !!!!

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#2 of 8 Old 04-14-2010, 05:13 PM
 
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I have hypothyroid -- maybe hashimoto's and I didn't realize if it was treated I would be at risk for thyroid storm. No one has told me this -- why is your dr. concerned about this? I've had 3 hospital births and am planning a homebirth this time.
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#3 of 8 Old 04-14-2010, 06:00 PM - Thread Starter
 
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When I first spoke with my MW she was concerned with a thyroid storm, right now my
Thyroid issues are not being controlled, though we are working to see that they will be soon.
I am currently in a hyperthyroid state with antibodies, which means I have been
Diagnosed with hashimoto's but my thyroid has not totally given out yet.
I am not sure of the statistics for hypothyroid pregnancies and thyroid storm but I do know
That hyperthyroid pregnancies are more likely to have a thyroid storm, though the percentages
Are pretty low I and my doctor and mw are all concerned with the chances
After researching I have found that many things can trigger thyroid storm including labor, surgery and
Illness.
I know that in reality I will most likely be fine but the fact that thyroid storm is fatal without treatment and
Even with treatment it cn be fatal I would rather not take that risk for me.


I know that Hashimoto's is generally diagnosed only when a person has high levels of
thyroid antibodies, which is a blood test that is usually ordered when other thyroid tests
Are done. I would guess that if your endo has not said anything you either have not been
tested for antibodies or they are negative.

We are still waiting for more results to compare levels and determine whether
I also have Graves disease, which would also explain the hyperthyroid
Levels I am experiencing now.
~laura

laura, dh Brian, ds Rory 14, dd Ellie 13, ds Caelan 11, ds Seamus 9, ds Finn 7 and Penelope 2 !!!!

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#4 of 8 Old 04-14-2010, 06:31 PM
 
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I did just read up on thyroid storm and it does seemt to be related to hyperthyroidism (which I've never been diagnosed ... only a long long time of hypo). They did check me for antibodies once and it was negative... I will ask my endo next week if I should be concerned about this. Didn't want to hijack your thread -- I just got a little freaked out. My endo upped my meds (doubled them) when I found out I was pg this time (first pg I've been on thyroid meds ... it was uncontrolled/untreated for 10 years) and I feel like I have tons of energy -- feel better than normal in that respect so I'm thinking my levels are close to normal.
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#5 of 8 Old 04-16-2010, 11:57 PM
 
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I have Hashi's and just get my levels tested each trimester. I have never been hyper during pregnancy though. I always go hyper postpartum. It's very common for it to play out that way. I guess I would focus on getting your levels under control for now and then decide what to do in regard to the birth after you have that worked out. I would be comfortable homebirthing as long as my levels were fine in the third trimester.
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#6 of 8 Old 04-19-2010, 08:41 PM
 
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Are you seeing an Endocrinologist or an Internist? I would work with one of those specialties to get my thyroid under control and then homebirth. I have hypothyroidism and my sister has Hashimotos so it's likely that I do to, but I haven't been tested for it. Neither one of us has had or had mentioned to us about thyroid storms. Are they random or just when it's not controlled? What is the consequence of having a thyroid storm in either pregnancy or labor? What would the hospital do about it? Those are the questions I'd start with.

Sarah-wife, mother, doula, and teacher.
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#7 of 8 Old 04-21-2010, 02:01 AM - Thread Starter
 
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Well, right now I am waiting for Friday to see a new Endocrinologist, the last two were not very thorough. I went to see my Midwife on Monday and she was very concerned about the fact that I am clearly Hyperthyroid right now and it is not being controlled. I am having a very crazy heartrate as well as losing 5 pounds in the past month, I know that the weight loss is due to the hyperememsis but the Midwife was very clear that as long as I am in Hyper I will most likely not be gaining weight no matter what I eat.

I am very happy that the Midwife was very supportive of our choice to have a homebirth, she is fine with us having a homebirth as long as we can get the thyroid under control. Though there is still a risk of thyroid storm we are safer when the thyroid is better controlled. Now that we are into the second trimester we are getting to where the doctors are more likely to take all of the symptoms I am experiencing seriously as they can affect the baby soon.

I am just so happy that the baby's heart rate is doing well and is below the rate when they are worried about risk. I am finally beginning to believe that we are going to have a little one, it is just so hard after having so many difficult miscarriages. I was so excited when the Midwife was positive about the birth and this little one is actually measuring a bit bigger than the others all did at this gestation, this is good for the future!

Thanks for the support, I know I am a bit nuts right now, it is just so disconcerting to find myself in this situation. I have had pretty relaxed pregnancies and now here I am with this going on... makes me a bit crazy

~laura

laura, dh Brian, ds Rory 14, dd Ellie 13, ds Caelan 11, ds Seamus 9, ds Finn 7 and Penelope 2 !!!!

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#8 of 8 Old 04-21-2010, 02:15 AM
 
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If you can get your thyroid in decent/good control by the third trimester than I would think that you could go forward with a homebirth with good back-up. If you are still in an uncontrolled state and symptomatic I would seriously think about going forward with a hospital CNM birth.

I've had Hashi's since #3 was 6 months old. Aside from the initial events leading to dx and PP adjustments (I just get more and more hypo) I've been pretty lucky and stable and the hashi's has far and away been the least of our worries. I get tachycardic if you look at me wrong but it doesn't seem to be related to my thyroid at all.

Karen, homeschooling Catholic mom to 8. #9 due 6/10
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