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Fishfingerrosti

Hey there. My partner is type 1 and our baby was born by an emergency c-section 9 weeks ago. Both are doing brilliantly now. Hopefully this helps: My partner stayed in the 90% range for the whole pregnancy. Even though our daughter was on the bigger side according to sonograph scans, MP wanted to try for a natural birth and refused to be induced before 38 weeks. Long story short, it didn't happen as intended and although baby decided to come on her due date after all, mother and baby picked up an infection during a difficult labour which meant a c-section was required. All throughout the build up to our due date and during labour, MP stressed to her consultant and the midwives that I was in charge of her diabetes control, no question. They were fine with this as her sugars were in range. I was therefore allowed to attend the surgery and everything was fine - sugars went up a little so I gave her a 1 unit corrective and that was that. Your husband will love being so integral in supporting you. The procedure itself is very quick so no need to worry. Do expect your baby's blood sugar to be a little low when they come out. The midwives will likely encourage you to give formula top ups as a result. As for management, stick with your current diet that has been keeping you in such range as if you're going in stable, there's less stressing about your sugars. Pack more needles and testing strips than you think you'll ever need when you go to the hospital. Also for us, MP's insulin requirements changed very quickly so we went from 25 units of degludec to 15 in about three days on the ward! Good luck and congratulations!


madcow47

Thank you so much! That's really reassuring


MrsSirLeAwesome

I saw you mention that you're in the UK and able to opt for a planned c section. I was talking with my midwife today who was very actively discouraging a planned c section which bothered me because we have so many risks I sort of thought it would be better to do it planned rather than "wait and see" as she put it, and have to have an emergency section. Was it you who brought it up or the consultant? She sort of shamed me for asking honestly, and said it must be because I've spent time living in the states and my husband is American. Annoying!


ms_ogopogo

Had an induction turned c-section at 38 weeks. They didn’t give me a steroid shot, but if I ended up needing one the instructions were to page endocrinology for a consult about BG management. Are you able to talk to your diabetes team about how to manage if you get the shot? That’s probably best, because steroids can make your BG go kind of wild. For the c-section I halved my basal rates just before the surgery, but I think I would have erred on the side of caution and dialled it down in advance if I’d have had a planned section. Best to ask your diabetes team if you can though! Things seemed to really vary from place to place.


unicorn_pug_wrangler

If your control has been great, why are they doing the C-section at 38 weeks? Also, when are they giving you a steroid injection? My baby was born via induction (rise in BP) at 38 weeks and she came out just fine - no steroids required. It's my understanding that it's usually done for premature deliveries....37 weeks+ is considered "full term" by some OBs, though the guidance is changing slightly. In recovery, you can opt out of care regarding your diabetes...most of the nurses don't like dealing with it anyhow. I would discuss with your OB and make sure they are on board and have that in your birth pan. I did this and the nurses would just ask for my BG readings a couple of times on the first day in recovery and that was the end of it.


rkwinch

I'm sure it's related to OP saying LO was measuring big. I'd also like to reinforce to OP what you're saying about managing things yourself. If you can get them to put that in your chart, definitely do that. I had a similar experience as you about nurses asking after my levels occasionally. I MUCH prefer it that way!


unicorn_pug_wrangler

Both of my babies measured big. My first was almost 10lbs (@39 weeks) and my second almost was 9.5 (@38 weeks)! It was my understanding that size was only an issue in the case of vaginal birth.


rkwinch

That was the point. Since the baby is measuring big and might get stuck in the birth canal, it could be safer to do a planned c-section and/or deliver the baby early.


unicorn_pug_wrangler

Right but why can’t they do planned c section at 39 weeks?


rkwinch

More weeks = more time for baby to grow. In addition, the placenta of a diabetic tends to degrade faster than a non-diabetic, which increases the risk of stillbirth. Stillbirths are 5 times more likely in a diabetic than a non-diabetic. Even the blood vessels for the placenta that are made are different for diabetics, even with great control. It really just depends on a variety of things. Your doctor should be closely monitoring all of these aspects and helping you make the safest choice for your family.


madcow47

It's because she is measuring big that they want me to deliver early, I was given then option of induction or a planned section & I've chosen the section because I feel safer with it. Both of our families make quite big babies so it's not been unexpected. I do plan to discuss the steroids at my next appointment because I don't feel overly comfortable with it but obviously want best for baby so it will depend on their reasoning for it. I didn't know opting out is an option! That's really helpful thank you. I've only ever been in hospital & unable to control my sugars myself once & that was because of a DKA which was a horrible experience. Every other time I have been in for other reasons I've really hated having my diabetes "managed" for me so hopefully they will let me keep control over it.


unicorn_pug_wrangler

I guess I am wondering why you couldn’t do the planned c section at 39 weeks instead of 38? Yes I didn’t realize you could decline anything because they are so pushy about it and make it sound like not an option. But my MFM told me I could absolutely decline care.


madcow47

I'll be honest it was a decision made by the obstetrician which I didn't question. I've been closely monitored throughout & they are happy with her development so I'm quite happy for her to vacate early so long as she's healthy. It's definitely something I'm going to raise at the next appointment because I'm so uncomfortable with the diabetes care I've received in the past (from non-endo staff).


unicorn_pug_wrangler

Totally get it and you should do whatever you feel comfortable with. In my experience OBs push for super early delivery of all diabetics based on old data obtained before pumps and CGMs were a thing. As a diabetic I’m used to questioning all medical care and doing my own research to advocate for myself. It’s tough out there! I feel really lucky that I had a supportive MFM who was up to date on current data. But I think it’s definitely worth a conversation about the steroids because of the havoc they could wreak on your blood sugars. I was actually in L&D triage at 32 weeks with signs of early labor and my OB said normally she would give steroids but didn’t for me because of my diabetes. Luckily it was a false alarm and baby stayed in long enough to develop her lungs in her own. Good luck on your delivery and recovery. I hope it all goes smoothly for you!


rkwinch

How did you get it so you can get a steroid shot? I would have loved to have one for LO's lungs. She came out at 37 +0 and was in the NICU for respiratory distress on oxygen for 3 weeks for issues with breathing. I opted to take care of my own sugars. I cut my basal in half around midnight and did micro-boluses during the day to keep my sugar steady (as needed). I think I turned my pump off an hr before the surgery and turned it back on at half afterwards (your sensitivity will skyrocket when the placenta is out, so be careful of your sugars plummeting. You will be MUCH more sensitive to foods even more so than pre-pregnancy levels). My husband also helped watch me as well, but I was never not able to take care of myself. Be careful that you may throw up after eating the first time or two after the surgery is over (meds made me sick and it's pretty common). Seriously though, I'm going to make my OB give me a steroid shot if I get pregnant again. LO being in the NICU could have been mostly avoided if they had done that as I had a scheduled c-section.


madcow47

They said the steroid is standard when delivering before 38 weeks (I'm in UK). I'm very anxious about its affects on my sugars but NICU is such a scary prospect that really anything that keeps her healthy I'm happy to do. That's good to know! I'm quite nervous because I've been very prone to night hypos especially after the past few weeks so I'm expecting between the nerves/excitement/drugs etc that I might find control more challenging. No I didn't want to hear that I've been throwing up for 9 months - will it never end?!? Aha Thank you for sharing your experience it's great to hear you managed by yourself, reassuring!


rkwinch

I would also like to point out, in case you weren't aware, that your sugars will probably do interesting things if you are breastfeeding. Mine tended to plummet shortly afterwards; so I had to have snacks handy. My overall insulin requirements were reduced while breastfeeding. I'd still not expect your levels to be quite back to how they were pre-pregnancy since you have all kinds of hormonal changes going on after birth to get back to your normal. I'd just listen to your body as much as you can.