Saturday, 13 September 2014

An uncomplicated pregnancy except...

All the worry I'm facing at the moment about gestational diabetes, all the complications associated with that, have really taken up most of my thinking lately. I've been reading about it voraciously, too. And what I've been finding has been extremely helpful in bringing me back from the brink of panic, where I was last week.

I'm grateful I had the glucose tolerance test that discovered my gestational diabetes. Because of it, I've been very careful about my diet in the weeks since. Gestational diabetes can cause complications because:

  • the baby can grow too large
  • sugar spikes in the mother can 'age' the placenta prematurely, causing it to deteriorate in function towards the end of pregnancy
  • the baby can be born with too much insulin (as he/she was having to compensate for mother's sugar highs)

Well, in my case -

  • I know baby's perfectly sized because of weekly ultrasounds
  • Baby's amniotic fluid is perfectly adequate too, not too much or too little
  • At the moment, with weekly checks, placenta function and blood flow in the cord are perfect
  • I have no sugar spikes because I control my sugars well through diet.

Which leads me to question whether any of the risks above are things I should really worry about. Unlike a mother with pre-existing diabetes, my risks are already lower; and the only large study I have been able to find that compared mothers with well-controlled GD to mothers without GD found that 4 in 10,000 women without GD had stillbirths, versus 5 in 10,000 with GD. That's one more, which does matter, but even if my baby was stillborn it would only be 20% likely be caused by GD!

How I feel. Backed into a corner
filled with fear.
Am I willing to risk my baby's life because I don't want to be induced? No, absolutely not.

But unless the doctor I'm seeing next week can give me a good reason why I am actually at risk, I will ask them a few questions...

  • Placental failure, which was thrown at me at the last appointment: how quickly does it happen, if it happens? Is it like kidney failure, or heart failure, which doesn't mean function stops - only that it deteriorates, which can be picked up in good time? 
  • Can we agree that from Week 38, I can be monitored regularly - daily if necessary? 
  • If we reach 40 weeks and baby still hasn't made their appearance, I understand risks actually do rise and I would agree to an induction then.

So that's my battle plan for next week. My preference, however - if you're the praying sort, please pray this for me - is that baby will just decide to come naturally. Before Week 38 if possible, so I don't have to go through all the above. It's nerve-wracking to negotiate with medics as a non-medic who has no way of knowing what risks are truly worrying and where the medics are just trying to cover their backs against litigation. I feel very, very out of my depth. All I want is for baby to be well...

By the way, full term (37 weeks) is this Tuesday. Baby would be very welcome to show up right then.

No comments:

Post a Comment

Thanks so much for sharing!