New here (with this pregnancy) Introductions, vent, and questions

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morel_baby's picture
Joined: 03/04/07
Posts: 194
New here (with this pregnancy) Introductions, vent, and questions

I'm currently in my third pregnancy. I'm seeing a MW, but I'm considered high risk because of GD. I had it with my last two pregnancies as well, but before my numbers were controlled with diet and exercise. This time I was unable to stabilize my fasting numbers so I'm a low dose medication before bed.

With my first two pregnancies I had low intervention care, and a medication free, spontaneous labor and delivery at 40.5 weeks and 40.3 weeks.

This time because of the medication they want me to start twice weekly appointments at 32 weeks, with a NST on Tuesdays and an U/S on Fridays. I'm having a very difficult time swallowing this fact. I understand that I'm high risk, but I feel like those interventions are a little over the top. The made me go in for an U/S two weeks ago, and my baby was normal sized, I always measure normally, and my numbers have been really good and controlled.

The MW also said that the doctors that oversee them want me induced at 39 weeks. I told her that I wasn't ok with that happening, and she said that we'd try to figure out a way to avoid it. I also told her that I felt the extra appointments were unnecessary, and she indicated that she agreed. One of the appointments during the week will be with the MW, the other will be with the doctor team. I asked her how the doctors are, and she basically said that I should be ok as long as I continue standing up for myself and taking what the say with a grain of salt.

I'm really into low intervention care unless I absolutely need interventions. I'm also not feeling comfortable with have 8+ U/S between now and delivery. I understand that there are risks involved with GD, especially on medication, but I'm feeling very frustrated.

I'm really not sure of what to do. I thought about telling them that I'd meet them somewhere in the middle and compromise. That I would go to weekly appointments for now, and then when I would normally start weekly appointments switch to twice weekly.

Does anyone have any other suggestions and support? The hospital is also 45 minutes away, and all of these extra appointments will be a hardship for my family. I am willing to do whatever I have to to keep my baby safe, but this feels over the top and unnecessary. Thoughts?

Spacers's picture
Joined: 12/29/03
Posts: 4103

Oh, this is always a tough one. Insulin does NOT cross the placenta, so even though it helps you maintain YOUR blood sugar, it does nothing to help baby maintain his. So the extra monitoring does make sense. Sadly, it sounds like your midwives are too closely tied with the OBs who "oversee" them, and that's not a good thing; if the MW does something against what the OB suggests, she risks losing his support and professional oversight.

Here's what I would do. Suggest a Biophysical profile be done weekly, that basically combines an NST and a detailed ultrasound, in conjunction with your regular weekly appointments, which saves you a weekly trip to the hospital but also gives you a good picture of how baby is doing. After 36 or 37 weeks, agree to a BPP separate from your weekly appointment, but try to get it done closer to home so you don't have a 1.5-hour round trip.

As for inducing at 39 weeks, that's a tricky one. You have a history of going a bit longer than 40 weeks, but both of those pregnancies you were able to control your blood sugar, which helped control your babies' weights. That's not the case this time. I would watch baby's weight in the BPPs over the last weeks and see if he's staying the normal range or not, and make my decision with real information. One problem with GD mom babies is that baby puts on the weight around the middle, which is not the norm, and which can create problems with birth. A "normal" baby at 9 pounds and a "GD mom" baby at 9 pounds look very different, and not in a way that makes birth easier. There are a LOT of things your midwife can help you do beginning at week 38 to help things progress naturally but quicker & sooner. But there's no need for them if you & baby are both doing fine.

tanismom's picture
Joined: 11/07/06
Posts: 717

Hey! Welcome to this board! It's always fun towards the end of my pregnancies to see who from my birth board hops over here Smile

I don't have much to add to Stacey's advice, but I will add my support and love! I definitely agree with finding out if there's a place closer to home that you can do the BPP, traveling is so hard! Also, remember that it's your body and your baby. "they made me..." needs to be deleted from your vocabulary! If you feel that what you're being told is not right, don't go. Or go home.
I wish I had known I could do that with my first baby. At her office at 36 weeks the dr told me she was worried about low fluid, maybe my water had broken and I hadn't noticed and her plan was to admit me to the hospital (next door), break my water and see what happens. My gut told me that dehydration was a much more likely cause for low fluid than unnoticed SROM, and that I was better off going home, drinking a ton, lying down and seeing if the ctrx stopped. But I was stuck on this feeling of "the dr. said..." so I went.
Go with your gut! (inform your gut as much as possible... but in the end, go with it!)

morel_baby's picture
Joined: 03/04/07
Posts: 194

They want me to come in for a NST every Tuesday, and an U/S every Friday. I'm not ok with the NST, but I'm not ok with having 8 more u/s for this pregnancy. I know that they're considered safe, but what if they're not safe in excess? I should probably just be happy to see my baby weekly, but it feels like the OBs are trying to impose all of their crappy interventions onto me.

Joined: 01/03/06
Posts: 302

I can relate to not wanting so many interventions. Now that I'm 35 this pregnancy they suddenly want to do NSTs and Ultrasounds every week from 36 weeks on. It sounds like you have more to consider with the GD. The risks to you and baby may be higher than the risks of too many u/s. It's worth considering that these early interventions will help you push the case that induction at 39 weeks is not necessary. You have a better argument for continuing past 39 weeks if you've been having the NSTs and u/s regularly that show everthing looks great. I would at least see if they will let you combine the NST and Ultrasound visits to the same day once a week and look at upping the frequency after 36 weeks. If not I agree with seeing if there is somewhere you can go closer to your home for the NST.

Clarkton's picture
Joined: 01/07/08
Posts: 1972

Yeah, I'm in the same boat as Molly. Since I'm 36 doc wanted to start NST's alternating with BPP's weekly since 32 wks :eek: Can you say overkill, much? I'm a bit more compliant than some and have gone along with it. I probably should put my foot down more. I have always found my doc to be reasonable and not one to use scare tactics even though he does like to have the data so I have agreed. :/

I think PP's have given some great advice and ideas. I agree you have more reason for a bit more intervention given your situation. Sorry you are having to deal with it. Sad I hope you can find an acceptable solution. KUP on how things go. Smile