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Women's Health > Mamas with type 1 diabetes
txtarheel's Avatar txtarheel 04:44 PM 05-06-2008
Here's what I posted on my personal blog...

Our new little one - Casey Howard B. joined us at 1:11 AM on May 2. He weighed in at a whopping 10lbs, 8.5oz, 24 1/2" long with a 39cm head and even wider shoulders.

Despite all of our best efforts, 2 weeks of mostly non-stop prodromal labor and over 25 hours of labor, he proved to be related to his brother, unable to enter my pelvis and born via c-section at the recommendation of two different care providers who wanted to avoid that outcome as much as we did. But he's happy, healthy and content with a head full of red hair and nurses like a champ.

My experience was orders of magnitude better than last time - partly because we knew what we were going to the hospital for and partly because the staff was so amazing to us. They even let me walk to the OR and climb on the table by myself. The little bit of time he was away from me once he was born, Monty got to stay with him the whole time. Once his blood sugar dropped to 39, the nursery staff immediately brought him to me to nurse while we were in recovery - never a mention was made of feeding him formula or giving him pacifiers or bottles while we were in the hospital. He's been so much easier to nurse than Johnson - partly I credit to the fact that I know a bit more about what I'm doing as far as positioning, but we didn't even have to try to teach him to latch. The hospital was not only amazing about not mentioning/pushing formula, they didn't even care if we co-slept. When the nurses came in and we were sleeping together in the bed, all they did was raise the rails on the side of the bed and tiptoe back out.

My recovery has been much smoother than last time as well. I've managed without taking anything but high doses of ibuprofen once the 24-hours morphine from my spinal wore off. I have very little pain and can walk, even up and down stairs without too much trouble. The hardest part for me was leaving Johnson at home for so long and not being able to pick him up at all now that we are home. But, he's warming back up to me - he wasn't too sure at first. And he's starting to show some interest in his brother. Hopefully we'll have a good settling in period in the next few days.

[Addendum for this thread]
No one feels any of this has to do with my diabetes. That's one nice thing. Apparently, I have some quite odd anatomy at the top of my pelvis as to how my pelvis, uterus and cervix relate to each other. I was managing to dilate, but without the help of Casey's head to do so. The shape just doesn't seem to allow a baby's head to enter my pelvis to help dilation and help the head mold to an appropriate shape. My MW's feeling was that if I managed a vaginal birth, I'd have been in hard labor for 3-4 days, pushed for hours and likely had a baby who had to have his collarbone broken and likely nerve damage to get out as well as leaving me with a 3rd or 4th degree tear for which I'd have to go to the hospital and have surgery to repair anyway. We decided that the risks for a c/s were lower at that point. We also knew that since I'd been in labor for quite sometime, the problems associated with an "early" baby were unlikely since he was working hard to get the job done on his own.

It seems unfortunately that I'm in the small minority for which c/s are likey a good thing and no one thinks I have much of a chance of a vaginal birth even if I had a smaller baby in the future. Luckily, my Dr. is more that happy to take the same course we did this time - let the baby initiate labor, labor at home for the benefit to the baby and his respiratory development, assess the situation and see if there's a chance of a vaginal delivery and then worry about the section. I'm just grateful that the experience was so much better than last time and think I could manage doing it all again, even if the outcome was the same.

widemouthedfrog's Avatar widemouthedfrog 07:53 PM 05-06-2008
Welcome, Casey!

I am so glad that (almost) everything worked so well.
It sounds like all of your organization and discussion paid off.

Congratulations! Enjoy your little ones.....
~pi's Avatar ~pi 02:29 AM 05-08-2008
Welcome, Casey! : What a great name.

I'm sorry to hear that the HBAC/VBAC did not work out. I'm so glad to hear that it was a significantly better experience for you this time, though. Wishing you smooth and easy healing. :
DentedHalo's Avatar DentedHalo 04:18 PM 06-09-2008
New one checking in. I'm not a mom yet, but hubby and I began talking about having kids lately. I'm still wading through the posts here, and learning more and more by the minute.
txtarheel's Avatar txtarheel 10:22 PM 06-09-2008
Welcome! We're glad to answer questions too. It'll take a while to read through all the posts here, but there is a lot of good info.
widemouthedfrog's Avatar widemouthedfrog 01:01 AM 06-10-2008
welcome from me, too! feel free to respond here or PM with any questions, though I didn't start my pregnancy with type 1 - so I don't think I am as qualified as some of the others in early pregnancy and type 1 management.
vbactivist's Avatar vbactivist 06:21 PM 06-13-2008
Hello again!

I have posted here in the past - I was diagnosed with Type 1 when 5 weeks pregnant. I had a baby girl Nov. 1 2007 - she was born with a congenital heart defect. The cardiologist said it had nothing to do with the diabetes, but the genetecist said it probably was because of the diabetes

Anyhow - you all were so helpful last time when I asked about pump sites. I have been inserting on my back hip where I think Tricia suggested since my daughter was born. But now it is swim suit season. I am frustrated (actually had a mini tantrum this afternoon). It is hard enough to find a suit that fits. Now I have to find one that works with nurising and the pump. Actually I am really depressed today about the diabetes. I hate it. I feel like I don't want to live sometimes if it means living with it forever. I'm sorry. I'm sure this sounds ungrateful. Please don't quote this post, as AI plan to take it down at some point. I guess this turned into a vent when I really just wanted to know what everyone does for swimwear. Last summer when I was pregnant, I inserted at the top of my abdomen, and kept the pump in my"bra". But this year with nursing, that won't work. I guess I am thinking a two piece and weraing the pump on the band of the "shorts". But I don't want anyoen to see it. I especially hate the way the tubing looks. Even if only a little bit is visible. I feel like a freak hooked up to a machine. I'm sorry.
DentedHalo's Avatar DentedHalo 06:50 PM 06-13-2008
I am sorry to hear that your babe ended up with with the defect. I'm pretty sure that even the most recent studies on T1 and congenital heart defects show more confusion as to how those really happen than actual answers. I'm not trying to trash any particular group here, just stating that a study that provides "mights" and "maybes" is generally totally useless in the great scheme of things.

As to your outlook on diabetes - you don't sound ungrateful at all. You have been diagnosed very recently, and T1 can be quite a horror to deal with until you get used to it and start treating it as a somewhat tamed evil twin. I think everyone goes through this phase, and the phase tends to come back occasionally when once in a while you just get fed up with pumps\testing\counting carbs and all that jazz.

I'm not sure if this will work for you, but I can tell you what I did when I was fed up and hating my diabetes. I found a few friendly ears and I whined like nobody's business. I think it helped me because I eventually got tired of whining and went back to scheduled programming.

Trust me, you are not alone in your feelings. I bet you there are more people here who have at some point in time felt the same way you do now. It really, truly eventually goes away - I think at a time when you make a conscious peace with your new lifestyle.

Can't help you with your pump problem though. I'm on insulin pens.
widemouthedfrog's Avatar widemouthedfrog 07:27 PM 06-13-2008
vbactivist, you mean you don't like wearing the COOLEST mp3 player ever? (Actually, I did use my pump the other day when I was asking a kid to turn off his tamagotchi during our nature programs. i whipped out my pump and told him i'd stop beeping if he did)

I heartily recommend online forums (insulin pump forums, email group for for whining and complaining. And this one, of course. I don't go to Diabetic Mommy too often, but it seems like a good venting place too. My dh and my mom are both serious worriers, so while I vented with them in the first 6 months, I often go online to b$%ch now.

Honestly, the "I hate this" does start to go away. At least it did for me. Took about 1-1.5 years, though. I've now had diabetes for three years, and there are some days and weeks when I go through my routines so smoothly that I forget it is there. I put in a lot of effort at the beginning to create good routines and to understand how my body reacts to different things, though.

There are other days and weeks - like allergy season - when I can't go a moment without remembering it, and it brings me to tears. I find that it can be hard to talk to those who do not have this - even though they understand to a degree, it is difficult to understand that you need to be on top of this EVERY MINUTE. That is what online discussion is good for. Or real-life support groups, if you have them in your area.

For example, about a month ago I was having serious allergies to tree pollen AND my site failed right after dinner, which meant that my blood sugar was flying into the stratosphere. And my mother-in-law needed me there RIGHT NOW for a family photo. Everyone was grumbling about how difficult I was being by opting out of the photo, while I was silently working on putting in a new pump site in the bathroom, trying not to disturb the party. See! I grumbled here. Now I feel better. Maybe. :

Two positive things I have done in the last year:

Went on CGMS sensors full time. I use them for a lot longer than recommended, so they are not actually that expensive. I like to know what my blood sugar is doing at any particular time, and for me the certainty is worth a lot. Even though I have another device on me and I look a little bit more "BORG".

I have also started running in the last year, and I am training for a marathon for the Canadian Diabetes Association. I found that getting type 1 really crushed my sense of my body as a good, whole body. Running is helping me get that back. It is hard to manage with the insulin and exercise, though.

Back to the pump site and where to put the pump bit:

We are lucky enough to have a pool in our complex, so I just leave my pump at my house and head over to the outdoor pool in the summer. I wear a minimed, so I need to take it off for swimming in the public pool and I have to put it in a special locker, and that makes going to the public pool a bit too much stress.

However, I am thinking of starting triathalon this fall, and I plan to bring out my old solution: swim shorts. I got them when I started the sensors, because I put the sensors in my thighs and I didn't want everyone to see them. Shorts also have pockets, they come in cool colours, and you don't have to shave you know where. Not that I said that. : And you might start a new pool trend. Or you could just pretend to be really, really modest. The pockets sometimes come with little snaps, so you can snap your pump inside.

So get a great bikini top - or whatever - and pair it with a funky pair of shorts.

Of course, my qualifier - I have absolutely no fashion sense, so this might not work for you.

Take care!
~pi's Avatar ~pi 11:06 PM 06-13-2008
vbactivist, Sometimes it just sucks, doesn't it? How long are you going swimming for? Can you bolus for the missed basal and just take the pump right off? I take mine off to play sports, to swim in the ocean, etc. FWIW, I don't really try to hide mine, and the vast majority of people think it's an mp3 player.

Also, as the mother of a toddler who is really not happy with any outing or activity unless there are highly regular instances of : (side note, until I nursed an active toddler, I did not appreciate how truly perfect that smilie is) I still tuck the pump in my bra when wearing certain outfits. It does take a little more deft handwork, but it is not out of the question.

Longer term: have you thought about the OmniPod? Or even MDI?

DentedHalo, welcome, welcome, welcome!

Tricia, hi! Inspiring news about the marathon and CGMS.

I am buried with work at the moment, so have to scoot, but I wanted to say I will post my own update when life calms down a little.
widemouthedfrog's Avatar widemouthedfrog 11:31 PM 06-13-2008
I agree with ~pi, most people think it is a fancy mp3 player. Only other people who wear a pump know it is a pump. And they are always overjoyed to find someone else who wears a pump.

If you're bothered with having others see it, why not make up a 1-liner about what it is - and be done with it? I work with kids, and since my sensor/pump sometimes goes off during a program, the kids see the pump when I check it and turn off the beep (it is in my pocket otherwise). When they ask what it is, I say - it's an insulin pump, I have diabetes. It gives me medicine. You can leave out the medicine part, but I find that the first part sounds a bit abbreviated and they end up asking what it does, anyway. I don't really like referring to it as medicine, but the kids tend to get it, anyway.

If they press further, like the kids in our complex have - or my daughter has - I just say that everyone needs something called insulin so that their body can use their food. They have something inside them that makes insulin, and I use a pump. I tell my daughter that she has a pump inside her. That is ALWAYS the end of the story. Well, except if you are my daughter, and then you have to ask annoying questions like, "What colour is MY pump, mommy!?"

Adults rarely ask - unless they know what it is. Adults are like that.
widemouthedfrog's Avatar widemouthedfrog 07:57 PM 06-14-2008
Oh, and I don't go into autoimmune issues or anything like that with little kids. I just present the pump as an alternative to a pancreas. I know it isn't, of course.

If parents ask, I do talk about type 1 if they press the issue a bit. I just say that yes, it can be challenging to manage and that it is a balancing act with insulin, exercise...and that I find that the pump and sensors help me with this. Because I am often doing a public education program at the time - about nature, not about diabetes - I tend to keep things lighter. If they seem interested, though, I will talk about it in depth after my teaching is over.

The major questions they ask:

* Does the pump test your blood sugar and give you insulin for that?
No, I still have to use my brain to figure out how to balance insulin, food, and exercise, and that can be hard...because as the mom of a three-year-old, my brain is already taxed.

* Oh wow, you got diabetes when you were pregnant. You're lucky, that goes away.
Well, gestational diabetes is what most people get if they get diabetes when they are pregnant. It does go away (often), but it can be a sign you're at risk for type 2 diabetes later. I happened to get type 1 diabetes when I was pregnant, which is the autoimmune one (like MS) that people often get as a child. It doesn't go away. It means that my pancreas doesn't make insulin anymore. A quarter of all type 1 diabetes actually happens when people are over age 25.

I know y'all know all these things, these are just my responses to common questions about the pump and diabetes. I find that having a ready answer helps me feel better about explaining.

And the last one is only applicable to people in the situation that vbactivist and a couple others on this list have - type 1 started when you were pregnant.

So, I don't really have an issue with people asking me questions when they see my pump.

However, I still dislike the "OMG, you're really terribly sick and I feel sorry for you" looks that I get sometimes. Then I whup all of them climbing 150 stairs, and I feel better.
Asarum's Avatar Asarum 07:25 PM 07-02-2008
hi Im new here also, ive been looking for a forum where i would fit in. i think i may have found it here. i have type 1 and ttc, we would love to have a homebirth and i was wondering if anyone here has or know of diabetics that have. we are meeting with some midwives open to the idea this month. any advice on what to ask them.
thanks looking foward to getting to know you all.
DentedHalo's Avatar DentedHalo 09:39 PM 07-02-2008
Howdy Asarum!

I have type 1 as well and I have about given up on kids for the time being. I am having real difficulty in finding providers who are willing to accommodate me - my town is not diabetic friendly all around, never mind a diabetic pregnancy.

I would be really interested in hearing about your experience with the midwives.

I know I read at least two stories of diabetics having fully blown home birth. Here's one:

As you can see from the story, the biggest battle is often finding understanding providers and banging your head against the system.

Welcome to our little tribe. I hope you stick around, the ladies here are positively great.
widemouthedfrog's Avatar widemouthedfrog 11:47 PM 07-02-2008
Hi asarum, welcome! I didn't start out my pregnancy with type 1, so not a lot of experience there.

dented halo, if I had acquired type 1 before I got pregnant, I know that I would certainly have looked into adoption. But I lean that way anyway. My dh, with his worrying tendencies...he might have been convinced to adopt too, even though he also has concerns about adoption.

Now, even having had a wretched pregnancy (during which I was diagnosed with type 1), I would be ok getting pregnant again. However, I don't think that I would want to do it without a glucose sensor. If you have insurance, they should generally cover you during TTC and pregnancy. That is one of their few exceptions to the "we never cover CGMS" rule.

Getting pregnant with type 1 would seem to me to be a matter of careful planning and a leap of faith, since we all know that this is not the easiest thing to control at all times.

I think that the hardest thing for me to practice during pregnancy would be self-forgiveness. I am now fine with the occasional "bad" blood sugar readings. I don't berate myself, I just deal with them. However, I would have a harder time if I was also carrying another little human.

Good luck with your decision!
~pi's Avatar ~pi 12:54 AM 07-03-2008
Welcome, Asarum!

In addition to the 2000 story DentedHalo posted (it's also posted on the first post in this thread, along with another such story that took place in Vermont in 1999), I know two women with type 1 who planned homebirths in the past few months. One (on this tribe - txtarheel) transferred to hospital for reasons unrelated to her diabetes. The other (not on this tribe) had a homebirth for her second baby.

I had MWs who were willing to do an 'oops!' homebirth with me in 2006, though I ultimately ended up going to the hospital for an induction.

It really depends where you live, what the regulations are there, and whether or not you can find midwives open to the idea. I do think the options are slowly expanding. I'm trying to get some of these cases written up so that they are at least out there in appropriate journals.

The questions I would ask would include:

- What do you see as some of the issues specific to my diabetes that might present additional challenges during pregnancy/labour and how would you prefer to approach them?
DentedHalo's Avatar DentedHalo 02:22 AM 07-03-2008
widemouthedfrog - My insurance covers CGMS, I kid you not, only for those whose diabetes is mismanaged. I'm out of luck on that, although I am certainly not bothered by it, considering. But $$$ is not an issue, I am going to buy my own anyway because I'm one of those very geeky people who like to try new gadgets out.

I think you are a damn strong person, too. I can yak all I want about diabetes, but I've lived with this thing for nearly my entire life. I can only imagine how awfully difficult and stressful it was to be given the diagnosis during pregnancy. There's so much information to absorb and process at the beginning, mind boggles.

Originally Posted by ~pi View Post
The questions I would ask would include:

- What do you see as some of the issues specific to my diabetes that might present additional challenges during pregnancy/labour and how would you prefer to approach them?
Brilliant question, that. Further questions:

- What is your knowledge of Diabetes Type I? (I'd rather educate a midwife than deal with someone who thinks they know stuff about diabetes and are wrong. In my opinion, each diabetes is different and each one of us has different circumstances. You probably don't want to end up with someone who applies the same set of rules to every diabetic client they see.)

- What is your approach to management of diabetes during labor? (This can be a killer question. I have already spoken with providers who, despite being shown materials pointing to the fact that self or spouse-aided management in labor works perfectly fine, were still dead set on the hospital\IV with insulin and dextrose approach.)

Asarum - Is your significant other on board with your diabetes? Does he know about as much about it as you do? I think having a fully educated partner can be the make or break in any circumstances, not only in pregnancy and labor. My hubby was nothing short of a life saver for me twice already - once when I got really ill and had no chance in hell of getting medical assistance, and another time when I had all the medical assistance in the world, but the assistance was clueless about diabetes. Having someone who knows all the ins and outs, and who can properly assess your situation is priceless under such circumstances. In my case, it saved my life twice.
Asarum's Avatar Asarum 09:09 PM 07-03-2008
thanks for the support. i have a couple appointments this month with some midwives. im trying to put together some questions, so if anyone has any advice on that please let me know. i will keep you updated on how it goes. your support means a lot it hard to find good support, most people are just scared for me.
thanks again,
DentedHalo's Avatar DentedHalo 01:14 PM 07-23-2008
Gang, first I'm gonna gloat (because I'm happy like a pig in s**t), then a question.

Our poor ~pi was subject to a few frustrated PMs from me when I joined MDC, due to the fact that I was having difficulty with finding a good endocrinologist and I was out of my mind angry. Well, those times are over.

There was a staff rotation at the practice I go to, and I got to see a completely new doc. He's fabulous! He's also from Europe - totally different diabetes mindset. No freaking out about my job (no schedule whatsoever, often working nights, what diet?), no insistence on seeing a nutritionist, no pushing of anything etc. Told me to call him if there's a problem, if I have questions or want any tests done.

My A1c runs squarely at 6.4 (my comfort level), no health issues, no complications - with the earlier docs it was a battle because although everything was fine, I didn't fit their management plan. I was told to change jobs so that they could manage me better (!), constant pushing of an insulin pump (nothing against, I just don't want one right now), one doc wanted to change me from Humalog\Lantus to a pre-mix because all of her patients were on pre-mix and she wasn't comfortable with me being on something else...

I told my new endo all of the above, and his reaction was rather priceless - "Why tinker with something that works perfectly fine?"

Yah, no, really....

Gloat over, now a question.

I'm on the thinner side (5'8", ~115-120 lbs). I've been like that pretty much all of my adult life, it's what's normal for me. When I was at the endo's office, a new nurse there remarked that I must be getting hell from doctors about my weight. I used to and I've certainly been accused of anorexia before, but then the nurse explained what he meant. To wit:

"There are young girls with diabetes who basically do anorexia by insulin." He explained that apparently it's a fairly new trend, but some folks out there simply lower their dosages of insulin to nothing, eat much less and maintain very low weight that way.

I can see how that could work, but holy cow...

Is anyone familiar with this?
widemouthedfrog's Avatar widemouthedfrog 02:37 PM 07-23-2008
dentedhalo, congratulations on finding a new endo! Isn't it lovely to have someone who treats you like you're the manager of your own diabetes? That's why I switched, too. I know that so many people struggle with understanding diabetes and/or try to ignore it, so I do understand the health care provider's perspective. However, it is refreshing when they're able to break out of the "must do it my way" mode into "wow, you're managing ok, here's some leeway to do it your way" mode.

The weight thing you're talking about is diabulimia. I struggled with close-to-anorexia as a young teen, but I like food a lot now. However, I have met people at our clinic who've had it, and boy, it sounds awful. Anorexia is inherently a struggle to exert some control over your life, and I guess people with diabetes find it even more necessary to feel in control of something...since so much of this disease makes you feel like things are beyond your control.

On a side note, have you ever been checked for hyperthyroid? I believe that this can manifest due to an autoimmune disorder too. I am mildly hypothyroid, though not enough that any endo (including my new fab one) will do anything about it. However, the marathon training I am doing at the moment has made me really lean - I'm the same weight as I was, but a lot of muscle.
DentedHalo's Avatar DentedHalo 03:36 PM 07-23-2008
Originally Posted by widemouthedfrog View Post
I know that so many people struggle with understanding diabetes and/or try to ignore it, so I do understand the health care provider's perspective. However, it is refreshing when they're able to break out of the "must do it my way" mode into "wow, you're managing ok, here's some leeway to do it your way" mode.
Yup. I unfortunately live in a border town, where the docs often see more DT2 patients than DT1. Poverty is horrendous here, so is lack of even the most basic education - the docs don't have a choice but to force everything on their patients, and "because that's the way we do it" is basically the simplest concept that allows them to keep their patients reasonably healthy. DT1 patients are not that much different, and with all of the above you have the added "bonus" of poverty making for horrible nutrition.

However, there's something to be said for weighing the facts and seeing what's in front of you. If I applied the same lack of flexibility to my own job that my previous endos applied to theirs, I would have been kicked out of my guild a long time ago.

The weight thing you're talking about is diabulimia. I struggled with close-to-anorexia as a young teen, but I like food a lot now. However, I have met people at our clinic who've had it, and boy, it sounds awful. Anorexia is inherently a struggle to exert some control over your life, and I guess people with diabetes find it even more necessary to feel in control of something...since so much of this disease makes you feel like things are beyond your control.
Dang, it even has a name. I was just surprised to hear about this, because I know that diabetes alone can be a royal pain in the a** at times and I didn't think that anyone would want to add anything extra to that. Now that I think of it, it could go both ways - someone with anorexic tendencies would have the perfect tools (diabetes\insulin) at their disposal, and a diabetic could easily get into the mindset of "the less, the better" with the added "bonus" of less injections\controls with the very low levels of carb intake. Thanks for the info, much appreciated!

On a side note, have you ever been checked for hyperthyroid? I believe that this can manifest due to an autoimmune disorder too.
Yup, had thyroid checked - nothing out of line. Being lean is an inheritance form my dad's side of the family - they're all tall and thin. At 5'8" I'm the shortest one in I think 3 generations. I also run and exercise, mostly because of my work. After all the hours of having my rear end glued to my chair, my backbone would crack in half if I didn't get some movement.

How is your marathon training going? I think it's fantastic that you're doing it, and I sorta wish I was able to make that kind of a commitment to something. I bet you're going to ace it!
widemouthedfrog's Avatar widemouthedfrog 02:37 AM 07-24-2008
Originally Posted by DentedHalo View Post
How is your marathon training going? I think it's fantastic that you're doing it, and I sorta wish I was able to make that kind of a commitment to something. I bet you're going to ace it!
Marathon training is going pretty well, though I've been tired the last week. Dd is not napping any more. I don't know about acing it, but finishing would be good. That's the kind of running category I'm in.
emmabird's Avatar emmabird 07:25 PM 08-27-2008
hi ladies~
my name is emily.
i was just diagnosed with T1 this march, but am now under control. my first post-dx a1c [now] was 5.6. of course, i'm probably honeymooning a bit, but due to my interests in natural medicine and food therapy, i keep my sugars tightly controlled.
i am not pregnant and have not been ever, but within the next year, my partner and i would like to start our family.
i joined this forum b/c of my concerns with [perhaps] being bullied into induction, c-sxn or iv glucose drips, etc. while i understand that out-of-hospital birth is not really an option for t1 gals, i want to have as natural birth as possible. my internist said something great: "it's not the t1 that puts a woman at risk, it's a t1 woman who doesn't have tight control." this gave me hope that i will be able to plan and have a healthy pregnancy, but also a healthy birth.
i am hoping to just learn and listen from all of you, and hopefully get my questions answered as i move into this next phase of my life over the next year. thank you sisters!
my first question then, is induction always necessary? i've read some articles that said t1's are always induced [slightly] early b/c of the 'placenta maturing a bit fast' due to something about our sugar fluctuations....? i wouldn't want to be!
fullofgrace's Avatar fullofgrace 09:40 PM 09-01-2008

In the interest of limiting FYT to subjects not hosted elsewhere on the board, we have moved your tribe here. You're still a tribe, which means you're still support-only.

If you have any questions about the move, please do not discuss it on the boards. Rather, contact an administrator (in green) via Private Message or start a thread in Questions and Suggestions where one of the administrators will answer you.

Thanks, and happy posting!
~pi's Avatar ~pi 03:02 AM 09-03-2008
Welcome, Emily!

Originally Posted by emmabird View Post
my first question then, is induction always necessary? i've read some articles that said t1's are always induced [slightly] early b/c of the 'placenta maturing a bit fast' due to something about our sugar fluctuations....? i wouldn't want to be!
It depends a little bit on where you are, what sort of HCPs you have, and your relationship with them.

In general, yes, T1's are induced earlier than non-diabetics, mostly due to concerns about stillbirth. For a long time, 'early' meant 37-38 weeks. It was seen as a tricky balance because T1 is associated with both an increased risk of stillbirth and an increased risk of delayed lung maturity.

I have noticed a slow shift in attitudes going on as more and more women are maintaining very tight control throughout pregnancy. Tight control generally means less chance of complications. It is becoming more common now to delay induction until 39 or 40 weeks or, in rare cases, beyond. It used to be that people got freaked out as insulin needs fell towards the end of pregnancy, thinking that it was a sign of placental deterioration. There seems to be somewhat less panic about it now.

It would be pretty unusual to find medical practitioners who would support going beyond 40 weeks (though a few do) but it is, ultimately, your decision. My opinion is that it is a highly personal thing. You really have to decide what is important to you.

I struggled a lot with the induction issue. I had 'negotiated' to go to 40 weeks assuming all looked good, but I started getting pressure at 35 weeks despite having really gorgeous control. I had originally thought to perhaps push the 40 weeks if I had to, but in the end, I gave in to the pressure and was induced the day I hit 40 weeks.

I had no caregivers who were explicitly supportive of going beyond 40 weeks, and I was not prepared to take what I saw as complete responsibility for any negative outcomes. I realized some time afterwards that I already shouldered that responsibility whether I realized it or not, and that I needn't have looked externally for approval of my decisions. If I were in the same situation today, I don't know if I would make quite the same decision, but on the bright side, I really learned a lot about myself through the whole experience.
widemouthedfrog's Avatar widemouthedfrog 02:26 PM 09-05-2008
welcome, Emily!
I developed type 1 during pregnancy, so needless to control wasn't the best during pregnancy. My HCPs had a policy of inducing any people with diabetes around 38 weeks. Luckily for dd, she came at 37.5 weeks. And really quickly, too, so I basically arrived at the hospital and out she came. No need for any drips or anything.

I was really torn between the options. Knowing that my control hadn't been great, and knowing that lung maturity could be an issue vs wanting to make sure that the placenta wasn't deteriorating.....

My insulin needs started dropping quite early and quite rapidly. I recall that this happened ~7 weeks prior to my due date, ~4 weeks before dd was born. The placenta causes insulin resistance, which is why they are concerned that dropping insulin needs may = declining placenta.

As far as I know, they can't check the placenta's health. They did do two late-term ultrasounds on me to make sure that dd was still growing well, plus lots of kick counts and non-stress tests. I was ok with all of these at the time because I was quite overwhelmed with all of the new diabetes stuff.

I think that they can check lung maturity, can't they? Though this might have involved an amnio sort of procedure, and I don't think that I was willing to go there.

Good luck with all of your choices! I am not sure what I would do if I had to do it over again. Most likely I would once again count on our family history of having babies three weeks early.

ETA: If I did do it again, I would be picky about my choice in care providers. The people I had for dd's birth were the only ones around here would would take me...because my doctor at the time did not deliver babies. They knew very little about type 1 and pregnancy, because they didn't deal with a lot of high risk pregnancies. If I did it again, I would make sure that I had an endo I trusted and a doctor I trusted, and I would work on educating them and discussing things with them before I even became pregnant.
iamlsh's Avatar iamlsh 11:46 AM 10-24-2008
Hey all I have recently found this site, and then subsequently this thread. I am a type 1 diabetic of 17 years, pregnant with my third. My husband and I are considering home birth. Does anyone here have any experience with this?
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