Mothering Forum banner

1 - 15 of 15 Posts

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #1 ·
<p>I had a horrible hospital birth with dd#1.  DD#2 was born at home unassisted.  I was dx as t2 diabetic in December 2009 and I feel myself being shuffled towards another stress-filled hospital birth full of interventions that I don't want or feel that I need.  I'm not expecting any answers or solutions ... I just need to get all this off my chest somewhere where I feel like folks will be somewhat sympathetic.</p>
<p> </p>
<p>I have big babies.  #1 was 10 lbs. 9 oz.; #2 was around 11 lbs.</p>
<p>I cook my babies longer than "normal."  #1 was born at 40w1d; #2 was born at 41 weeks.</p>
<p> </p>
<p>I've found an ob who's at least willing to discuss stuff, but at my first visit (last week) he told me that #1, I never should have been allowed to vaginally deliver either of my children, since they were over 8 lbs. 14 oz. and #2, as a diabetic, I should be delivered (implied "one way or another") by 40 weeks due to the increased risk of stillbirth past that point.</p>
<p> </p>
<p>I reminded him that I had ZERO complications birthing EITHER of my babies, including the 3 hour labor and tear-free birth of the 11-pounder.  He made a note that I have a "generous pelvis," which at the time I thought was funny but is starting to piss me off the more I think about it, since it didn't seem to sway his position that bucking ACOG recommendations was risky.  (I'm not sure how he took my retort that plenty of ob's have no problem going against ACOG's recommendations concerning vbacs ...)</p>
<p> </p>
<p>At that appointment (I was 2 days shy of 20 weeks), he wanted me to agree to an induction in my 39th week.  I told him I would try to keep an open mind but that I wasn't agreeing to ANYTHING this far in advance, especially an intervention that was likely to end in c/s anyway if my body wasn't ready.  He accepted that for now, but I just don't want to face yet another pregnancy where I'm pressured at every. freaking. appointment. to do something that I don't think is necessary or appropriate.</p>
<p> </p>
<p>Finding another ob just isn't an option.  He really is one of the most accomodating ob's in the area; he's the backup ob to the midwives at the local fsbc and I'm not going to do any better than him in this town.</p>
<p> </p>
<p>Am I just being pig-headed, putting my own concerns over the wellbeing of my babies?  I of COURSE want my baby to be safe and healthy, but every freaking TIME they've insisted that I just HAVE to do x, y or z or my baby is going to die, they've been wrong.  But I AM diabetic this time, even though my blood sugars are controlled.  I have no idea what the ACTUAL risks are, or how to find them.  Research on diabetics usually lumps everybody in together and doesn't separate out women who have well-controlled bGs.</p>
<p> </p>
<p>I HATE this.  I want my baby and me to both be safe and healthy, but I'm so, so scared of birthing in a hospital.  The hospital this guy delivers at has a 40% c/s rate. :(</p>
 

·
Registered
Joined
·
742 Posts
<p>Ugh, what a bad place to be. I'm so sorry mama. I know you were kicking around the idea of a UC, but obviously with your special circumstances I can see where that option may be daunting or scary to you and why a hospital birth may be a safer option for you.</p>
<p> </p>
<p>Truthfully, this guy seems like he is going to push you right into a c-section. You do have control though. Even if you have to fight every step of the way (you shouldn't have to, I know) it is still YOUR body. You know your body can birth these bigger babes, it's done it twice before! I'm sorry, when someone begins talking about what they will "allow" with my own body, I can feel my blood pressure rise! The best thing to do if you continue with this OB is to just be straight up 100% stick-to-your-guns honest and confident about what you are or aren't willing to consent to, in a firm but respectful way. "I respect your opinion but I will not consent to that". Lather, rinse, repeat.  He may get all grumpy and combative and that stinks but ya' know what, so does an unnecessary c-section.</p>
<p> </p>
<p>I don't think you're at all putting your own concerns over the well-being of your babies!! My goodness, you KNOW you want your babe to be healthy! However, the mama's stress level, personal safety and comfort level are all factors that influence baby's health so I think wanting to be as low-stress, safe, and comfortable (not just physically, but mentally, spiritually) as possible IS an indicator that you are not putting yourself before your baby. Besides, the mortality and complication rate for c-sections (with both babies and mamas) is higher than vaginal birth so I can see why you're trying to avoid that! You know yourself that you would consent to a c-section if you felt it was a necessary or emergency situation. At this point, you don't (and I agree) so I see nothing wrong with doing everything you can do avoid it.</p>
<p> </p>
<p>My unsolicited advice would be to stay at home as long as possible before heading to the hospital so there isn't a lot of chance to do anything unless there were an emergency situation. I wouldn't induce at an arbitrary time for the doctor's comfort levels.</p>
<p> </p>
<p>What do your instincts/gut tell you?  Thankfully, you have a good amount of time to figure this all out. I am no expert but if your T2 is well-controlled I don't know how big of a problem it truly is. Your body has already told you your body can handle bigger babes.</p>
<p> </p>
<p>You're in my thoughts, mama.</p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #3 ·
<p>Thanks so much for that, TB.  <span><img alt="hug2.gif" src="http://files.mothering.com/images/smilies/hug2.gif" style="width:38px;height:16px;"></span>   We have our 20-week scan tomorrow; if everything looks okay with that, and if the baby and I stay healthy, another uc is still on the table.  I'd rather have an attended homebirth with this baby, but that's just not going to happen financially.</p>
<p> </p>
<p>It's just so stinking frustrating to have to fight my way through every pregnancy.  I know I can do it; I've done it twice before.  I was just hoping so much to have ONE pregnancy be peaceful and stress-free.  Not meant to be this time around. :(</p>
 

·
Registered
Joined
·
742 Posts
<p>I think peace can still be found, mama. It will take a lot of 'in one ear and out the other' on your part, and releasing the idea that the OB is going to ever acquiesce to your wishes. He doesn't have to agree, but he absolutely cannot do anything you don't consent to. Period. You have the power in your hands.  Peace begins with you having 100% confidence in your decisions and communicating that to your OB. You can even tell him you will sign whatever liability/AMA forms he wants, but you are maintaining autonomy over your body and choices concerning your unborn baby. There doesn't have to be a fight, simply "this isn't up for discussion". If he threatens to drop you from his care, just know you can go to a hospital at any time, anyway. You can even go to a walk-in clinic and have them test your BP, urine, fetal tones etc. You have choices. Don't allow anyone to threaten, bully, or scare you. I know it's easier said than done but your body has already proven twice what it's capable of. Those are pretty good odds from where I'm sitting.</p>
<p> </p>
<p>Blessings mama.</p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #6 ·
<p>As a t2 diabetic, the baby and I are at higher risk; I want more monitoring than I had with dd#2 (my uc baby) so that I'll know if interventions become unavoidable.  Also, while not on insulin, I do take oral meds to help control my bG.  My pcp refused to prescribe them to me while pregnant and insisted that I see an ob to manage things.  So here I am.</p>
 

·
Registered
Joined
·
2,181 Posts
<p>If your blood sugars are well controlled, you may well have a smaller babe this time! You probably were a diabetic or at least pre-diabetic with your other babes, so that I'm sure contributed greatly to their larger size.</p>
<p> </p>
<p>I think I would just take the 'oh we'll see' route with your current OB if he's the best one. Every time he mentions scheduling an induction, say it's a ways out and you'll need to wait to schedule due to dh's work (or whatever....dd's birthday....grandma's anniversary....just lie every time...LOL). Then, when it gets really close...."OH I don't have my calendar. I have a lot of appointments that week. Will have to let you know at the next visit....again and again.  They can't strap you down and MAKE you do it. But off and let your body do it's job. Deal with the end at the end, don't borrow worry right now!</p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #8 ·
<p>Could be, re the size thing, but with dd#1 I wasn't diabetic of any stripe (passed all the stupid tests).  With dd#2 I was gd, controlled with diet.  I think I just make big babies, and I'm okay with that.  <span><img alt="shrug.gif" src="http://files.mothering.com/images/smilies/shrug.gif" style="width:29px;height:15px;"></span>  I'm not sure what I'd DO with a regular-sized kid!  LOL</p>
 

·
Registered
Joined
·
1,848 Posts
<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>heathenmom</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16195456"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p>As a t2 diabetic, the baby and I are at higher risk; I want more monitoring than I had with dd#2 (my uc baby) so that I'll know if interventions become unavoidable.  Also, while not on insulin, I do take oral meds to help control my bG.  My pcp refused to prescribe them to me while pregnant and insisted that I see an ob to manage things.  So here I am.</p>
</div>
</div>
<br><br><p>I understand that. What exactly are you or baby higher risk for? These questions can help lead to exactly what YOU plan to get out of prenatal care and help you to decide what is appropriate. In terms of what your ob wants, it isn't up to him. You call the shots regardless. It sicks, but you will have to be demanding if needed.</p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #10 ·
<p><br><br>
 </p>
<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>Mamatoabunch</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16195518"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border-right:0px solid;border-top:0px solid;border-left:0px solid;border-bottom:0px solid;"></a><br><br><br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>heathenmom</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16195456"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border-right:0px solid;border-top:0px solid;border-left:0px solid;border-bottom:0px solid;"></a><br><br><p>As a t2 diabetic, the baby and I are at higher risk; I want more monitoring than I had with dd#2 (my uc baby) so that I'll know if interventions become unavoidable.  Also, while not on insulin, I do take oral meds to help control my bG.  My pcp refused to prescribe them to me while pregnant and insisted that I see an ob to manage things.  So here I am.</p>
</div>
</div>
<br><br><p>I understand that. What exactly are you or baby higher risk for? These questions can help lead to exactly what YOU plan to get out of prenatal care and help you to decide what is appropriate. In terms of what your ob wants, it isn't up to him. You call the shots regardless. It sicks, but you will have to be demanding if needed.</p>
</div>
</div>
<p> </p>
<p>That's a great way to approach it!  Here goes:</p>
<ul><li><em>Higher risk of birth defects with uncontrolled bG in very early pregnancy.</em>  I don't think this applies to me, since my numbers pre-pregnancy and in early pregnancy were at non-diabetic levels, but I'll be more reassured after the anatomy scan tomorrow.</li>
<li><em>Higher risk of a large baby. </em> This TOTALLY doesn't worry me, at all, although I'm told often that macrosomic babies of diabetic mothers are built differently and are at a greater risk of getting stuck.  I get it, I'm just not worried about it.</li>
<li><em>Higher risk of placenta issues.</em>  As long as I can maintain tight control of my bG, this shouldn't be an issue.</li>
<li><em>Higher risk of PIH or Preeclampsia.</em>  Ditto RE tight control.</li>
</ul><p> </p>
<p>So, what I want most from my prenatal care is the drugs!  LOL  Just kidding, although that is important in my case.  I also do want the option of NST's later in the pregnancy.  I'm monitoring my own bG and bp, so I'm staying on top of those things.</p>
<p> </p>
<p>That was a good exercise for me, thanks!</p>
 

·
Registered
Joined
·
1,848 Posts
<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>heathenmom</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16195616"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a><br><br><p> </p>
<p>That's a great way to approach it!  Here goes:</p>
<ul><li><em>Higher risk of birth defects with uncontrolled bG in very early pregnancy.</em>  I don't think this applies to me, since my numbers pre-pregnancy and in early pregnancy were at non-diabetic levels, but I'll be more reassured after the anatomy scan tomorrow.</li>
<li><em>Higher risk of a large baby. </em> This TOTALLY doesn't worry me, at all, although I'm told often that macrosomic babies of diabetic mothers are built differently and are at a greater risk of getting stuck.  I get it, I'm just not worried about it.</li>
<li><em>Higher risk of placenta issues.</em>  As long as I can maintain tight control of my bG, this shouldn't be an issue.</li>
<li><em>Higher risk of PIH or Preeclampsia.</em>  Ditto RE tight control.</li>
</ul><p> </p>
<p>So, what I want most from my prenatal care is the drugs!  LOL  Just kidding, although that is important in my case.  I also do want the option of NST's later in the pregnancy.  I'm monitoring my own bG and bp, so I'm staying on top of those things.</p>
<p> </p>
<p>That was a good exercise for me, thanks!</p>
</div>
</div>
<p><br>
There you go! You are more aware, you know what you want specifically and what seems logical to you. You are always in control, even if the OB has a different opinion. The only problem I for see is what do you expect from the NST and what will you do if they give you negative results, sometimes those results are skewed. Will you do U/S's to check placenta? Are they accurate? There are options, like herbs, for PIH.</p>
 

·
Registered
Joined
·
412 Posts
<p>Hugs to you, mama.  It must be tough to be in this position, with the "big baby" tag, the "advanced maternal age" tag (I think I remember from another thread that you are over 35?  or am I confusing you with someone else?), plus Type 2 diabetes on top of it.  And longer than 40 week gestations.  That is a lot of "strikes against you" from the perspective of a cautious OB.  It doesn't sound like he is really open to discussing things based on what you have described.  Even if he is worried about the risk of stillbirth or shoulder dystocia, it is your right as a patient to choose an expectant management course of action rather than early (and likely unnecessary) intervention.  While your risks are elevated compared to the average woman, as they say, three times a small number is still a small number.  Controlling your bG is really important in helping promote the best outcomes, and you are doing that... I think that docs are so used to noncompliant diabetic patients that they lump everyone in together, which is completely unfair to the women who work their asses off to keep tight control of their bG,  (Just curious, do you record your numbers and report them to the OB?  If not, maybe doing so would help show him that (a) your diabetes is well controlled and (b) that you are very serious about your baby's health.) </p>
<p> </p>
<p>I think the thing that concerns me most about what you report that he has said is his contention that every baby suspected to be over 9 lbs. should be delivered by c-section.  That just seems extreme to me (though it's not the first time I've heard it).  That combined with the 40 weeks/risk of stillbirth thing leads me to believe that his primary concern is potential liability.  As a former attorney, I know that you can't "sign away" your right to sue, but if you could maybe talk with him about his liability concerns and reassure him that you understand the elevated risks but prefer expectant management and that you are willing to accept responsibility for a bad outcome, perhaps that would help put his mind at ease about taking the expectant management approach.  OBs (and a lot of parents) view risk this way -- they want to avoid even the smallest possibility of a perinatal death no matter what it costs the mom and baby in morbidity risk.  That's a legitimate view, but it is not the only view, and those of us who view risk in a more expansive way have the right to have a say in our care. </p>
 

·
Premium Member
Joined
·
2,441 Posts
<p>Can you continue your prenatal care with your OB, making sure your meds, NSTs and labwork are all okay, and then just simply not show up at the hospital when it comes time to deliver?  If everything is normal up to that point, would you feel comfortable birthing at home?  I am a nurse, I have worked in Ob/Gyn and we had several patients who did this.  We had no idea they were planning on homebirth all along - they just did it!  We were fine with it - I know some offices might not be, though.  Actually, I shadowed care with a hospital group of midwives last time I was pregnant even though I knew I was going to birth at home.  I told them when I was around 32 weeks and they did not bat an eye.  Just an idea....</p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #14 ·
<br><br><div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>tracymom1</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16196942"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border-right:0px solid;border-top:0px solid;border-left:0px solid;border-bottom:0px solid;"></a><br><br><p>Can you continue your prenatal care with your OB, making sure your meds, NSTs and labwork are all okay, and then just simply not show up at the hospital when it comes time to deliver?  If everything is normal up to that point, would you feel comfortable birthing at home?  I am a nurse, I have worked in Ob/Gyn and we had several patients who did this.  We had no idea they were planning on homebirth all along - they just did it!  We were fine with it - I know some offices might not be, though.  Actually, I shadowed care with a hospital group of midwives last time I was pregnant even though I knew I was going to birth at home.  I told them when I was around 32 weeks and they did not bat an eye.  Just an idea....</p>
</div>
</div>
<p><br>
I actually have NO problem doing this.  It's what we did with dd#2.  Technically it was a precipitous labor; after a 31 hour labor with #1 I sure as HECK wasn't expecting her to come in 3 hours!  I also knew that if I went in, the ob on call (whom I'd never met but has a horrible reputation) would cut first and ask questions later.  So we stayed put.<br>
 </p>
 

·
Registered
Joined
·
2,074 Posts
Discussion Starter · #15 ·
<p><br><br>
 </p>
<div class="quote-container"><span>Quote:</span>
<div class="quote-block">Originally Posted by <strong>msmiranda</strong> <a href="/community/forum/thread/1292284/feeling-powerless-to-control-the-slide-towards-a-highly-medicalized-birth#post_16196541"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border-right:0px solid;border-top:0px solid;border-left:0px solid;border-bottom:0px solid;"></a><br><br><p>Hugs to you, mama.  It must be tough to be in this position, with the "big baby" tag, the "advanced maternal age" tag (I think I remember from another thread that you are over 35?  or am I confusing you with someone else?), plus Type 2 diabetes on top of it.  And longer than 40 week gestations.  That is a lot of "strikes against you" from the perspective of a cautious OB.  It doesn't sound like he is really open to discussing things based on what you have described.  Even if he is worried about the risk of stillbirth or shoulder dystocia, it is your right as a patient to choose an expectant management course of action rather than early (and likely unnecessary) intervention.  While your risks are elevated compared to the average woman, as they say, three times a small number is still a small number.  Controlling your bG is really important in helping promote the best outcomes, and you are doing that... I think that docs are so used to noncompliant diabetic patients that they lump everyone in together, which is completely unfair to the women who work their asses off to keep tight control of their bG,  (Just curious, do you record your numbers and report them to the OB?  If not, maybe doing so would help show him that (a) your diabetes is well controlled and (b) that you are very serious about your baby's health.) </p>
<p> </p>
<p>I think the thing that concerns me most about what you report that he has said is his contention that every baby suspected to be over 9 lbs. should be delivered by c-section.  That just seems extreme to me (though it's not the first time I've heard it).  That combined with the 40 weeks/risk of stillbirth thing leads me to believe that his primary concern is potential liability.  As a former attorney, I know that you can't "sign away" your right to sue, but if you could maybe talk with him about his liability concerns and reassure him that you understand the elevated risks but prefer expectant management and that you are willing to accept responsibility for a bad outcome, perhaps that would help put his mind at ease about taking the expectant management approach.  OBs (and a lot of parents) view risk this way -- they want to avoid even the smallest possibility of a perinatal death no matter what it costs the mom and baby in morbidity risk.  That's a legitimate view, but it is not the only view, and those of us who view risk in a more expansive way have the right to have a say in our care. </p>
</div>
</div>
<p> </p>
<p>I really appreciate your viewpoint.  And yes, that's me ... I've got a LOT of "strikes" against me, any way you look at it.  So frustrating, but something I have to acknowledge and work around.  And as horrible as my initial post sounds, it really was a good appointment.  We talked for nearly an HOUR, about my previous births, diet & exercise, all kinds of stuff.  I've never had an ob take that much time with me, ever, and he did seem genuinely shocked and disturbed about some of the things that happened with my first birth.  I understand his perspective, but I appreciated that he talked to me as someone who is educated and experienced when it comes to MY body and birthing.</p>
<p> </p>
<p>I really needed to be reminded that nobody can take away my power over my own body.  I have choices, and I have the final say.  Thanks to all of you for that ... you ladies rock.  <span><img alt="blowkiss.gif" src="http://files.mothering.com/images/smilies/blowkiss.gif" style="width:26px;height:23px;"></span></p>
 
1 - 15 of 15 Posts
Top