K.S. asks from Syosset, NY on June 04, 2008
Gestational Diabetes. - Syosset,NY
hello all you mamas,
i'm wondering if you can help me out with your own personal stories. a friend of mine (circa 40 y/o) is pregnant with her 4th child and has developed gestational diabetes for the first time. she does not, however, have high blood pressure. back in germany, where she's from, she's a midwife so she's accustomed to birthing babies naturally, at home, at birthing centers, the whole gamut. she's been in the USA for all of 1 year and speaks enough english to get by but not enough to communicate effectively with her OB. and she knows little about maneuvering through our medical system/ hospitals. the one thing she knows is that birthing via abdominal surgery is common practice where we live (the north shore of long island) and she is appalled by the practice. now, her OB is pressing her to have a c-section pre due-date. my understanding is that the main reason for doing so in the absence of preeclampsia, is concern of a large baby (which makes birth injury a possibility). given that this is her 4th child, not her 1st, her body is familiar with and will easily adjust to birth (all her children were birthed with midwives vaginally). passing a larger than average baby should be a non-issue for her.
another risk, respiratory distress syndrome, as i understand it is actually exacerbated by performing a scheduled c-section... as the lungs are the last thing to develop and they may develop more slowly in fetuses of diabetic mothers. she understands from her own experience that labor and natural delivery prepare the lungs for functioning outside the uterus so again, she doesn't understand why her OB is recommending the surgery.
i would like my friend to be as informed as possible so as to be able to make the choices that are best for her and her baby. that includes learning from other mamas, so i would love you to share with me your personal experiences with gestational diabetes, the type of care you had, how you finally birthed your baby, how large your baby was (and at what week) so that i may relay this all to her. she's feeling very much at the mercy of, what she calls, a screwed up medical system but doesn't know what else to do given that this is where she is. she is seriously considering having her baby back home in germany just to avoid the illogical and uncompassionate care she is encountering here. thanks in advance! and if you don't feel like sharing your stories to the world feel free to email me personally.
So What Happened?™
thank you so much for sharing so generously. i forwarded your responses on to my friend who was emboldened to address the issues with her OB. in the end, she decided to leave her OB's practice and to find a midwife to birth her instead (she didn't know that in order to be delivered by a midwife she'd have to hire one... apparently, in germany, midwives are the norm in hospitals and ob's only come in when there's a true crisis and surgery is needed). will update you in a few months when baby arrives!
L.S. answers from New York on June 05, 2008
First of all- have her find another OB. I had gestational diabetes with my first pregnancy, and all was fine. I controlled it completely by diet and exercise and amazing support from my dr's, family and friends. If I were her I would check with a nutritionist too. Also, my ob/gyn had an outside company (Matria) monitor my levels and teach me what to do. I had to call them daily to give my blood levels, and they truly helped me thru the rough days. Unfortunately my ob is no longer practicing in the area.
good luck to her.
K.K. answers from New York on June 05, 2008
I had GD with my 4th - now 4 months old. My first three were c-sections (first due to high BP and the others scheduled thereafter) so the 4th naturally was too. HOWEVER, I know many moms with GD who delivered vaginally. They monitored me very closely, especially third trimester for signs of macrosomia (big baby). My son was 8lbs 12 ozs and was fine - signs of macrosomia are rapid growth, especially around the midsection. If this is evident, or the mother's GD is not in control, they sometimes like to take the baby early so that he/she doesn't start to produce their own insulin making them born with low blood sugar and a higher risk of developing juvenille diabetes. So I think that is the issue, more so than your friends ability to deliver a "big baby". If her GD is in control and the baby is developing normally, she should be fine to go to term and deliver vaginally. However, if not, there could be some potential dangers for the baby as well as problems in the future so she shouldn't totally write off a c-section. She should bring someone with her to her OB visits that is fluent in English and her native tongue so she feels comfortable. Good Luck!
M.L. answers from New York on June 04, 2008
I had gestational diabetes when pregannat with my daughter - it was on the mild side and was watched through finger pricks a few times daily and watching my diet...My OBGYN sent me to the center for diabetes in manhassett, part of the NorthShore Hospital...the building was right on Northern Boulevard....I was never told not to deliver vaginally.etc...I think your friend she go have a second opinion - and meet with a diabetes nutrician counselor....
PS I delvered my daughter vaginally - she was a month early at 5lbs 8ounces - but no complications - she was just ready to come into this world! good luck
K.F. answers from New York on June 05, 2008
I had gestational diabetes and managed it through diet, walking for 10 minutes after meals and spreading out my carb intake throughout the day to avoid surges. i tested my sugar in the morning and after meals and had to have small amounts of injectible insulin at bedtime to keep my sugars down for the morning. I was told early on that I would be induced at 39 weeks since there is a greater risk for large babies and stillbirth. I was very disturbed about hearing this news but happy to report that the pregnancy was easy, was induced with petossin at 39 weeks and gave birth to a very healthy 6 lb 13 ounce boy (hardly a large baby!). baby did not have high sugars and mine returned to normal post baby. please wish your friend luck. i'm also suprised to hear that C-section was recommended. perhaps your friend can bring an interpreter to her next appt or contact an interpreting service to help interpret via phone with her OB.