Delivery: Women And Diabetes
As your due date nears, your doctors will study your health and that of your growing baby. Then, you and the team will discuss the best time and method for delivery. To determine the safest time and method to deliver your baby, your health care team will examine a variety of factors: The team will also study your babys size and movements, his or her heart-rate pattern and the amount of amniotic fluid in the uterus. Your labor may start on its own, or you may decide to have labor induced or have a planned cesarean section (C-section). During a cesarean birth, an incision is made through the abdomen and uterus, through which the baby is removed. Because of the surgery, your recovery time may be longer than if you delivered your baby vaginally. No matter how you deliver your baby, your doctors will be working during labor and delivery to keep your blood glucose level under control. At the start of active labor, your insulin needs will drop. You will most likely not need any insulin during labor and for 24 to 72 hours after delivery. Your blood glucose will be checked frequently (probably every few hours) and your insulin and glucose regimen will be tailored to your needs during that time. To help you prepare for labor, many hospitals and other organizations offer classes (such as lamaze) to help you have a smooth delivery. They teach you what to expect during delivery, techniques to improve delivery and to relieve pain during labor, and how to care for your baby after birth. Because of the care needed for both mom and baby during and after delivery, home births are not advised for women with diabetes. Its important to have a partner or coach helping you throughout the labor and delivery process. This can be a spouse, parents, relative, or friend. Having a support system w Continue reading >>
Labour And Birth With Type 1 Or 2 Diabetes
Your birth experience may be different to the one that you had expected, and this can be hard to come to terms with. Finding out what might happen could help you feel mentally prepared for what may lie ahead. It can help to remember that although the birth itself is important, it is just one step in the journey towards having your baby. Where to give birth with type 1 or 2 diabetes If you have diabetes, it is recommended that you give birth in a hospital with the support of a consultant-led maternity team. It is not unusual for babies of mothers with diabetes to be larger than normal, which could lead to birth difficulties such as shoulder dystocia (in which the baby’s shoulder gets stuck during the birth). This means that options such as home birth are unlikely to be recommended. When to give birth with type 1 or 2 diabetes You will be advised to give birth early if you have diabetes. This is to reduce the risk of stillbirth. It is recommended by NICE that women with type 1 or type 2 diabetes and no other complications should give birth between 37 weeks and 38 weeks +6 days – either by being induced or having a planned caesarean. If you have any complications that pose a risk to you or the baby, you might be offered an even earlier delivery. 'I had always been aware that I would be on the ward for high-risk cases. I am so grateful to be pregnant, I’m not going to complain about stuff like that. If there is an issue, I would rather be ready for it.' Svenja, mum-to-be How to give birth with type 1 or 2 diabetes As the recommendation is to give birth by 38+6 weeks, you are likely to be offered an induction or a caesarean section. Diabetes is not in itself a reason that you cannot have vaginal birth. Unless there are other complications there is no reason this should Continue reading >>
- Guest Post: Giving Birth to Violet as a Woman with Type 1 Diabetes (Part 1)
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
- New type of diabetes discovered - Could YOU be showing symptoms of type 1.5 NOT type 2?
C-sections Vs. Natural Birth In Diabetic Moms
Childbirth and diabetes were once considered mutually exclusive. Thankfully, those days are over. But aiming for a healthy baby — and an uncomplicated birth — when you're living with diabetes is still a very tall order. It can be scary. And no one really wants to have a C-section, right? (I sure didn't, x3). Today, D-author and fellow mother of three Amy Stockwell Mercer joins us once more for a special report on new research providing insight into the precise effects of the Big D during childbirth. Special to the 'Mine by Amy Stockwell Mercer The myth that women with diabetes can't have babies is almost extinct. Shelby's premature death in the movie Steel Magnolias has slowly been replaced by images of healthy, vibrant women like former Miss America Nicole Johnson and fellow D-blogger Kerri Morrone Sparling as they navigate diabetes, pregnancy and motherhood. We've come a long way in understanding the importance of prenatal care for women with diabetes and as a result, more women are having healthy babies than ever before. However, 45%-70% of these pregnancies result in cesarean births and until now, no one could explain why. Researchers at the University of Liverpool have recently discovered that women with diabetes have "impaired uterine contractility." That means that even if we push for hours, some of us may never succeed. This groundbreaking research is based on 2010 United Kingdom government statistics, which show a high induction of labor rate (39%) and a high C-section rate (67%) in women with type 1 and type 2 diabetes (compared to 21% of the general maternal population). "We need to think about the enormously high C-section rate rather than just accepting it," says co-author Dr. Susan Wray. "As scientists we asked the question, could it be that these wome Continue reading >>
Type 1 Diabetic Being Induced Soon
Are any of you type 1 Diabetics? I am and im being induced on the 8th. This is my first baby so I am very nervous! Anyone have any good tips on keeping calm and speeding things up? I'm type 2, and was induced 2 weeks early... Emily's birth ended in emergency c-section as she was getting distressed and I wasn't dilating quick enough, so from waters to birth was only 11hrs. I'd had 2 pessaries, and was getting really bad prostin pains, so midwife recommended a bath. I got back to my bed after the bath, felt a pop and then my waters broke without intervention! Was immediately moved to delivery suite, but in the 11hrs of labour, I only got to 4cm dilated. Because of the diabetes and induction, I ended up with a sliding scale drip, glucose, saline and syntocinon drip, baby was monitored with a clip on her head, and a catheter because I ended up with an epidural. Therefore I couldn't keep moving and hadn't been all that active, so I suggest you stay active as long as you can as it'll help things along... Hope that helps, happy to answer any other questions you might have... x How long did you stay in hospital for and how did you find the c section? I'm a type 1 and I was induced with DS1 5 years ago (my first baby). They induced me, then broke my waters, but by 5.30pm I still wasn't dilated enough. Baby then moved his head to the wrong position, my BP shot up and baby's heart rate dipped, so he was born via emergency c-section that evening. My advice would be .... take some magazines, snacks and drinks - it could be a long wait (but SOOOO worth it!). All the best hunny, I'm sure you'll be just fine. Had first pessary 11am on thursday, gave birth at 7.24am Friday, came home 10am Sunday. The c-section was fine. So much better than I thought it'd be. Done in an hour, up and abo Continue reading >>
Complications Beyond 39 Weeks Pregnancy ? Type 1 Diabetic
Labor, Delivery + After With Type 1 Diabetes
WRITTEN BY: Pamela Hoffman, MPH Editor’s Note: If you are pregnant and have Type 1, take this survey on Glu and help field research for future generations of mothers. Can I just pat you on the back for a bit, Mama? You are doing an amazing job with your pregnancy! You have assembled a medical team you trust to guide you throughout the remainder of your pregnancy, courageously navigated the fluctuating blood sugars and hormones that come along with the first and second trimesters, and you’re now waddling around with the best of them! Your baby is so lucky to have a mother who loves him or her so much that she is striving to keep both of you as healthy as possible. You are going to be a great mom! No guilt allowed here – you are doing your best! You cannot wait to meet your new bundle of joy, but you might be feeling anxious about what to expect when your water breaks or your OB/GYN announces “it’s time.” We want to share some tips to help you better prepare for your labor and delivery, as well as offer some advice for taking care of you and your new baby upon arriving home. Manage stress Don’t let the stresses of managing your Type 1 take away from the joys of your pregnancy. Relish in those baby kicks, proudly share your ultrasound photos far and wide, schedule that maternity photo shoot and take time to enjoy life’s little luxuries before your baby arrives. Create your birth plan Discuss your birth plan with your OB/GYN and endocrinologist. Ask how your medical team will approach your diabetes management during your time in the hospital. Make your personal desires known and be your own advocate. Your team will help you develop a plan for how to handle your changing insulin needs on the day of delivery and the days after. Most women will need to reduce t Continue reading >>
Would Love To Hear Some Type 1 Diabetic Birth Stories...
How did you deliver? What was the reason? C-section due to breech baby Were you induced? No, but it was planned. I did not go into labor on my own. Were you able to breast feed if wanted to? Yes. The planned c-section was a piece of cake for me. I was able to nurse within in a hour of having him and he was in our room the whole hospital stay. They checked his blood sugar every few hours for the first 2 days, but there was no NICU stay since all were in an acceptable range. This time around, I'm hoping to VBAC, so I hope a few respond with stories about vaginal birth. Also, keep in mind that baby's weight is an estimate through ultrasound. Baby might not be as big as he/she is currently measuring (or could be bigger), so don't let them push you into a c-section based on baby's size if you really don't want one. It's more than possible to give birth vaginally even with a larger baby. I hope things work out the way you want them to. Good luck! Thank you all in advance for sharing your stories!!! I had a c/s for pre-eclampsia at 35w0d. We skipped induction, as MFM didn't think I, nor baby, would tolerate labor. Baby was 4 lbs, 10.5 oz at birth, which was pretty close to growth estimate on u/s the week before. I do wear a pump but was put on an IV insulin drip. I had to cut my basals in half while on the drip. DS spent about 28 hours in NICU for hypoglycemia. He had an IV for hypoglycemia while in NICU. I tried to BF but DS never got it. Definitely not my birth plan but DS and I both did well. He was able to come home with us, which was important to us. I EP, and so I'm glad to be able to give DS BM, no matter how he gets it. Good luck! Diagnosis over the past 3 years of doing IF treatments: PCOS, mild endo, MTHFR, Factor II mutation, APAS & autoimmune ovarian failure. 3 cy Continue reading >>
Pregnancy Tracker: 31 weeks, 3 days Size of the Baby: Crown to rump length is over 11 inches** Biggest Obstacle:** Scheduling all my doctor’s appointments. During the latter stages of pregnancy, people start discussing their “birth plans.” Decisions have to be made about everything from whether you want an epidural or not, if you’re going to deliver in a birth center or Labor and Delivery, to what type of relaxation and breathing techniques you want to employ. Especially for first-time mothers, these options and decisions can seem overwhelming. It’s difficult to know what you’ll want until you’ve actually experienced the pain of child birth! For mothers-to-be with preexisting diabetes, the choices are different and somewhat limited. I, for example, don’t have the luxury of choosing a birth center for my delivery. High-risk pregnancies require constant fetal monitoring, which is done in Labor and Delivery. For high-risk moms, other factors have to be considered such as potential complications that may be addressed by inducing labor early. Today I had an appointment with my main OB. He’d been gone for several weeks, during which I met with his partner. Both doctors are awesome, but they take somewhat different approaches. A few weeks ago, my secondary doc mentioned that they’d probably induce labor for me at 38 to 39 weeks. She explained that type 1 diabetics have a slightly higher risk of still birth than the average. This risk only increases the longer you stay pregnant, thus some doctors choose to take the baby early. We’re talking a very small risk, which largely is based on your level of blood glucose control throughout your pregnancy. I wasn’t thrilled about the idea of being induced, since it does increase your chance of needing a cesarean, Continue reading >>
Diabetes In Pregnancy: Management From Preconception To The Postnatal Period
See other NICE guidance for NICE information for the public on care for women and their babies during labour (intrapartum care), induction of labour and caesarean section. You should be advised to have your baby in a hospital that has special facilities to care for sick babies 24 hours a day, in case these are needed. During your pregnancy (and especially in the last 3 months), your care team should explain about your options for giving birth. This should include information about the benefits and risks of having your labour induced compared with letting the pregnancy carry on, and of having a 'normal' (vaginal) birth compared with a caesarean section. This is especially important if you are having a large baby. If you have had a caesarean section before, you may still be able to have a vaginal birth this time. If you have certain health problems (such as being very overweight or having spinal nerve‑related problems such as sciatica), you may be advised to see an anaesthetist to talk about the best method of pain relief during the birth. Timing of the birth is important, because if your pregnancy carries on for too long this may increase the chance of problems for you and/or your baby. You should be advised to have your labour induced, or a caesarean section if this is the best option for you, during week 37 or week 38 of pregnancy. You may be advised to have your baby earlier than this if there are complications (such as high blood pressure or a slowing down of your baby's growth). You should be advised to have your labour induced, or a caesarean section if this is the best option for you, before 41 weeks of pregnancy if you have not had your baby by this time. You may be advised to have your baby earlier than this if there are complications (such as high blood press Continue reading >>
Being Induced Because Type 1 Diabetic - Can I Have A C-section?
I am 17 weeks pregnant and have type 1 diabetes. The hospital (St Thomas in London) have told me I must be induced at 38 weeks - which I understand the reasons why. However I have requested an elective c-section which they have refused. Does anyone have a similar experience. I am scared about being induced and having a long difficult labour resulting in intervention (highly likely I hear) and would prefer to have a c-section - at least I can mentally prepare for that and know what will happen. Any advice? Ask St Thomas's what their rates of failed inductions for first timers are - or you may find this information on the internet. You're right that early inductions have a higher rate of intervention, and specifically emergency c-section, and for first time mothers the rate is significantly higher. At my local hospital the rate of failed inductions for first births is 50%. However, some early inductions proceed smoothly with no problems, and the problem is you just won't know how yours will go until it happens. My SIL had an induction at 36 weeks for pre-eclampsia, and it was a totally straightforward natural birth taking 8 hours in total - which most women would prefer to a c-section. I have no experience of arguing for a c-section on your grounds, so don't know how likely it is that St Thomas's will grant your request (not very likely, I would have thought). All I can suggest is that you do as much research as possible so you know all the risks and likely outcome, whichever way things turn out. I'm a type 1 and had my ds at St Mary's (where they let you go up to 39 weeks before induction). I was told that they preferred to do it this way rather than an elective because firstly there is a chance that you may deliver vaginally (which is usually better for both you and th Continue reading >>
Pregnant Type 1 Being Induced Next Week: Can You Give Me Any Advice??
Pregnant TYPE 1 being induced next week: can you give me any advice?? Pregnant TYPE 1 being induced next week: can you give me any advice?? Well I've just come back from the doctors and he is inducing me next week. 15.01.09. My HBA1C is 6.4 and I've felt really healthy throughout the entire pregnancy. My sugars have been monitored every two days by my educator and they have been stable. Unfortunately, my ultrasound results show my baby's abdominal circumference to be at 40 weeks when I am 38 weeks and this is making the doctors decision to induce me next week. This is my first baby and I would love any advice for a successful vaginal delivery!!! If you have been induced with type 1 can you please tell me your story!!! How were your sugar levels, insulin doses, how long did it take, what pain medication did you use, any advise on natural pain relief??? etc etc D.D. Family T1 since May 2006 Metformin, Humalog and Lantus Can't help with advice on the birth as I wasn't diabetic when I had my kids,but would just like to wish you good luck and hope all goes well.Let us know when baby arrives. Last edited by Nixo; 1/09/09 at 05:18 AM. Reason: Typo Good luck first of all!! I had my girl in 2000 when I had diabetes for exactly 10 years. I was induced at 38 weeks, though babygirl wasn't that big yet, but my blood pressure was rising. First of all, have you discussed who's in charge of your diabetes. I did, however, once they put me on an insulin and separate glucose drip, that control was out of my hands, and that's terrible, I'd meassured a low BS, I told the nurse to lower the insulin drip (at one point I demanded they turn it off, because I was working so hard, I didn't really need the insulin), she said she had to go ask the, wait for it, OB-gyn...... who was of course worki Continue reading >>
- Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study
- 'She's feeling terrible': Pregnant Danielle Lloyd 'has been forced to clear her schedule after being left bed-ridden with gestational diabetes'
- How Low Can You Go? Expert Advice On Low Carb Diets and Diabetes
Gestational Diabetes And Induction Of Labour – What You Should Know
Gestational Diabetes and Induction Gestational diabetes (GD) was once a relatively rare condition, occurring in about 4% of pregnancies. In recent years, the rate of women developing GD has doubled, and experts believe the incidence of the disease will keep increasing. Most women with GD are told by their care providers they will need to be induced before their due date, destroying their hopes for a natural and intervention free birth. Having GD can have a big impact on mothers’ and babies’ health during pregnancy, but does it really need to change how we give birth? What Is Gestational Diabetes? Gestational diabetes is a condition that only occurs during pregnancy. Certain pregnancy hormones interfere with your body’s ability to use insulin. Insulin converts blood sugar into usable energy, and if this doesn’t happen, blood sugar levels rise. Insulin resistance can cause high blood glucose levels and can eventually lead to gestational diabetes. Some women will have symptoms of GD, while others will have none. Many women can manage the condition without treatment other than dietary and exercise changes. Around 20% of women will need insulin injections. So for many women, well managed diabetes means they can still have healthy babies and normal births. Induction Of Labour Many care providers routinely recommend that women with gestational diabetes be induced around 38-39 weeks. The most common reasons given for induction at this gestation are to prevent stillbirth, and to prevent babies growing too large for vaginal birth. However, the evidence related to induction for women with GD comes from the review of one trial, which looked at 200 women who had either GD, Type 1 or Type 2 diabetes. The World Health Organization states this evidence for induction before 41 w Continue reading >>
Early Induction Of Type 1 Diabetes
Department of Diabetes & Immunology, St Bartholomew's Hospital, London, UK Correspondence: Professor David Leslie, Department of Diabetes and Immunology, St Bartholomews Hospital, London EC1A 7BE, UK E-mail: [email protected] Keywords: Type 1 diabetes, environment, autoantibodies, pregnancy This article has been cited by other articles in PMC. Type 1 diabetes is the second most common chronic childhood illness, after asthma, in Europe and North America. The disease is due to destruction of the insulin secreting (cells of the pancreatic islets of Langerhans [ 1 ]. At the clinical onset of type 1 diabetes about 80% of islets contain no (cells and the islets may be infiltrated with mononuclear cells [ 2 ]. Mononuclear cell infiltration is not a consistent feature, but includes macrophages and T lymphocytes with lymphocytes predominating and CD8 positive cells being most prevalent [ 1 ]. It is thought that the destructive process is mediated directly or indirectly by these immune effector cells. In the years before the clinical onset of type 1 diabetes, immune and metabolic changes can be detected in peripheral blood [ 3 ]. Since the nature, intensity, extent and persistence of these immune changes distinguishes individuals who develop diabetes from those who do not, these changes can predict type 1 diabetes [ 4 ]. The long prediabetic period and the potential for prediction have led to attempts to prevent clinical disease. But for how long is this prediabetic period and when are the immune changes which lead to diabetes induced? In this issue of Clinical and Experimental Immunology, Mikhail Knip and his colleagues seek evidence that the process may be induced in utero [ 5 ]. Antibodies have been identified against a number of antigens in patients with newly diagn Continue reading >>
Timing Of Delivery In Women With Diabetes In Pregnancy
Timing of delivery in women with diabetes in pregnancy 1Maternal Fetal Medicine St Michaels Hospital, Toronto, Ontario, Canada 2University of Toronto, Toronto, Ontario, Canada 1Maternal Fetal Medicine St Michaels Hospital, Toronto, Ontario, Canada 2University of Toronto, Toronto, Ontario, Canada 1Maternal Fetal Medicine St Michaels Hospital, Toronto, Ontario, Canada 2University of Toronto, Toronto, Ontario, Canada Copyright The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav The incidence of both gestational and pre-gestational diabetes is increasing worldwide. The main cause of this increase is likely the concomitant increase in the incidence of global obesity, but in the case of gestational diabetes, changes in the diagnostic criteria are also a contributing factor. The adverse outcomes associated with pre-gestational diabetes are well known and have led clinicians to implement various strategies that include increased fetal surveillance and induction of labour at various gestational ages. In many cases these same strategies have been applied in clinical practice also to women with gestational diabetes despite there being differences in the type and magnitude of perinatal complications associated with this diagnosis. Despite the widespread application of these clinical practices, there is a paucity of quality data in the medical literature to guide the clinician in choosing a strategy for fetal surveillance and timing of delivery in both gestational diabetes and pre-gestational diabetes pregnancies. In the following review, we will discuss the rationale and consequences of planned delivery in gestational diabetes and pre-gestational diabetes, the evidence supporting different strategies for delivery and finally highlight future targets Continue reading >>
- Timing of Delivery in Gestational Diabetes Mellitus: Need for Person-Centered, Shared Decision-Making
- Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study
- Timing Luck And A Bit Of Diabetes
Pregnancy Was Hard But Worth Every Moment
Save for later My pregnancy was without doubt the hardest thing I've ever done, but worth every minute to have baby James safe in my arms. My control wasn't as good as it should have been when we started trying for a baby, and I hadn't seen a diabetes consultant for years. Instead I just attended check ups at my GP surgery. To be honest I didn't fully realise the risks involved with having a baby as a diabetic, although I did know that diabetics have a tendency to have larger babies. It was during one of these check ups that I mentioned that my husband and I wanted to start a family, and the practice nurse told me I should see a diabetes consultant urgently. At that point I was already a few days' pregnant - although I didn't know it yet. I was worried about miscarriage Thankfully we found that I was pregnant very early on, and I was seen by a consultant the following week. I'd read up on what effects diabetes can have on pregnancy and I felt quite stupid and irresponsible for not having taken better care of my sugar levels before. I wanted this baby so much but was really worried that I would have a miscarriage, or that the baby would have some kind of abnormality. I was determined to get my blood sugar levels to the lowest levels I could, and started testing at least 10 times a day. I was really struggling to get the balance right, giving myself corrective injections to bring the levels down, and having hypos every single day. Hormones during pregnancy interfere with blood sugar levels. That coupled with losing hypo awareness meant I had a lot of severe hypos and we had to call an ambulance out on a couple of occasions. Ten weeks into my pregnancy I had a hypo at work where I ended up fitting at my desk. I hadn't wanted to tell my colleagues that I was pregnant until Continue reading >>