[eastkygal]

My sister is 27 weeks along with her 3rd child this Friday. She had both of her previous children naturally. They weighed 5.6lbs and 7lbs. She is under the care of an OB who has responded very well to her wanting to birth this baby naturally as well, especially since she did the previous two. However, she just found out that she has gestational diabetes and her levels are through the roof. They did a vaginal ultrasound of the baby and he is weighing in at 3.8lbs. She gained 10lbs. in 3 weeks eating normally. They haven't mentioned c-section to her yet, but did say that they would induce her at 36-37 weeks, and she is now high risk.

I will be acting as her birth coach. I had an unnecessary c-section for "big baby" at the hospital she will be delivering at - though different doc. I don't want her to go through an unnecessary surgery. The doctor is saying that to goal is to keep mama and baby healthy and baby under 9lbs. I'm expecting them to give her an ultrasound every time she turns around to "weigh" him. They have already made her watch a video on natural labor and birthing and sign a waiver saying she was fully informed, so she can't sue them for it hurting too bad or something - protocol. We live in a city that is c-section happy and not very supportive of natural childbirth. In fact, there aren't any midwives here unless you are doing homebirth and go direct entry. My sis isn't comfortable with that.

I just want to be fully prepared, and I want her to be fully prepared for what might happen. It may be we have to fight a doc, or may not. I just don't want mama and baby to suffer anymore than might be necessary.

If you have experienced gestational diabetes, I'd love to hear your experience and share it with my sis. Both the good and bad. I want to get a mama's and natural birth advocate's perspective.

Thanks mamas.

 

[SublimeBirthGirl]

I'd control my sugars, buy a glucose monitor, and find a midwife.

 

[chandasz]

Have to agree with the above.

The other reason they like to induce GD babies aside from "large baby" BS- is that there are studies that show a higher risk of stillbirth from GD.

Now- I'd do some research and look at the risks of that then weigh them with the risks of induction, having a preemie, and the likely c-section that follows an induction that early....

It is VERY important that she takes care of herself and eats well for her situation and EXERCISES!!

Remember that u/s measurements for weight are notoriously WRONG

 

[flyjawn]

i had suspected gd with my second pregnancy but i refused the test because of it's innacurracy. i read up on gd, watched my sugar intake, tested my glucose levels often and gave birth at home to a perfectly healthy 9lb 12oz baby boy.

has your sister been referred to a nutritionist to help her understand diabetes?

 

[dillonandmarasmom]

Ditto what everyone has said! I had gd with both kids. DS was born via c/s after loads of pushing and a very stuck and swollen kid. I used the Bradley method (definitely *not* a gd-friendly diet plan, btw). He came on his own 3 weeks early and was 8+ pounds. I did not know I had the issue until much later with him.
With DD I was diagnosed early on, worked with a nutritionist, checked my levels regularly and kept my weight gain pretty steady. She was born early at just under 8 lbs.

I would definitely learn about proper nutrition and make sure she exercises every day. Also important is a moderate snack before bed. A banana with peanut butter or some granola (no sugar) or oatmeal is good. This should keep her sugars from dipping down too low by morning.

BTW, I have my glucose monitor with toms of lancets and strips int he closet if she'd like one for free (though her insurance may cover it, too). I'd be happy to send it FFS. Let me know

.

 

[JanB]

Diabetics, gestational or otherwise, do not, repeat NOT, need to be induced at 36-37 weeks just because they are diabetic. (If there is some other emergent problem, such as preeclampsia, that's different, of course.)

I controlled my diabetes with insulin for all three pregnancies, and my OB didn't even breathe the word "induction" -- both my dd and ds2 came at 39.5 weeks. I assume that had I gone to 40 and beyond, induction would have been on the table, but early induction before 40 weeks just for diabetes is an outmoded protocol and is absolutely unnecessary and can lead to all kinds of problems with the baby. Trust me, I've been there with my first birth. I'd fight that early induction tooth and nail.

I think your sister needs to find a care provider that is more familiar with recent standards of care for pregnant diabetic women, frankly. If that's not possible, then she needs to be strong and simply refuse that early induction. It will be a lot easier for her to do so if she can demonstrate to her OB that she has several weeks/months worth of good blood sugar control under her belt. For that reason and also for her health and the health of her baby, it's important for her to get her blood glucose into good control as quickly as possible. If that means insulin, she should go on insulin. A lot of people are scared of insulin, but if it means the difference between a healthy mom and baby, and a preterm macrosomic baby with poor lung development, I think the choice is clear.

Btw, Bradley is completely compatible with a GD diet. If I remember right from my Bradley classes, it basically pushes a very high-protein diet (80+ grams per day?). Protein doesn't really cause your blood glucose to rise (for type 1 diabetics, it sort of does, but for gestational you pretty much don't have to worry about limiting protein intake) and actually can slow down the glucose spike caused by carbohydrates, if you eat protein along with your carbs.

In general, for diabetes, you want a low-glycemic diet, meaning that you are eating primarily foods that are low on the glycemic index. You can do a Google search for glycemic index to read more about what it is and where most foods fall on it. Essentially the idea is that when you do eat carbohydrates, you are eating carbohydrates that don't make your blood glucose rise very fast or very high -- whole grains, and low-glycemic fruits (berries are usually a good choice) are good. Although, everyone's body is different, and one of the reasons for doing home blood glucose testing is to find out which foods make your own personal blood glucose go high or not. Some people can handle bananas; I can't. But I respond well to pineapple, which many diabetics don't. And so on, and so forth.

This is getting lengthy, so I'll wrap up, but basically my point is that she can still absolutely have a natural birth, but she might have to fight for some things she wouldn't have had to fight for before. And finding a provider that doesn't have the silly rule about early induction would be well worth her time and effort at this point.

 

[Reha]

Quote:

Originally Posted by chandasz The other reason they like to induce GD babies aside from "large baby" BS- is that there are studies that show a higher risk of stillbirth from GD.

Just curious about where you have seen this statistic....according to the research guru Henci Goer, there is no higher risk of stillbirth with GD (although there is with true type 1 & 2 diabetes).

 

[Reha]

Quote:

Originally Posted by flyjawn i had suspected gd with my second pregnancy but i refused the test because of it's innacurracy.

: VERY inaccurate test/screen....

I am of the party that unless a woman has undiagnosed TRUE diabetes, then GD is a 'diagnosis still looking for a disease'.

 

[azjen43]

I received a diagnosis of "borderline" GD with my last pregnancy, unfortunately, just weeks after my brother died from complications of type 1 diabetes. Needless to say, I was pretty freaked out. I did my homework, checked my sugars frequently, and was able to control my "GD" with diet. I was also following the brewer pregnancy diet for the most part, with a few modifications. My OB mentioned inducing on my due date, saying that the baby was getting too big...five days later I birthed a 7 lb, 6 oz baby girl completely naturally. As the PP said, it's just really important to keep your blood sugar levels under control.

 

[JanB]

Quote:

Originally Posted by Lennon : VERY inaccurate test/screen.... I am of the party that unless a woman has undiagnosed TRUE diabetes, then GD is a 'diagnosis still looking for a disease'.

Yeah... but the thing is, the OP mentioned that her sister's blood sugar was "through the roof", which IMHO is a red flag that this isn't just a GD misdiagnosis, but is potentially indicative of a longer-term problem, whether true diabetes or pre-diabetes or whatever. (Of course, it also depends on exactly what "through the roof" means in this situation.) I mean, I've heard from people who were diagnosed with GD and never saw a single level over 140-150 or so. To me that does not indicate a serious problem. But if you're seeing 170-180+ on a regular basis (or fasting levels into the 120+ range) then that's a problem that you need to address, whether the reason is "gestational diabetes" or an undiagnosed pre-existing problem.

 

[eastkygal]

Thank you for the advice and help. After seeing the last post, I'm wondering if something may be horribly wrong. They told my sister hers was 298. She did have toxcemia (sp?) with her last child. Her first child was born when she was 15... she remembers them telling her then that her sugar was a little high, but not really concerned. She does have a history of diabetes in her family.

That said... things seem to be doing pretty well with her controlling her diet. This morning first thing her level was 103. She mentioned to me that after she ate it was 120. She did say that she feels exhausted and that food is tasting kind of gross. The OB has said that if the baby seems fine, and her health is good she will be good to go for a natural delivery. However, if the baby is big... they'll go ahead and induce at 36-37 weeks. Her other babies were both born naturally at 38 weeks.

I'm just really hoping we can convince them to not induce. It makes me sick to think that she will have to suffer as I did for no reason. I'm just praying for this to go well.

 

[Maggi315]

That level is not totally crazy, I have been over that before. Some people with type 1 diabetes are always over that. What that means is she needs tighter control.

I do think I posted on the other thread? I think it was this one. But don't freak out over that number! My highest was over 400, I felt horrible, that was when I decided to go with the insulin, I felt much, much better.