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Type1 full term pregnancy no induction

Discussion in 'Type 1 Diabetes' started by CL85, May 1, 2020.

  1. CL85

    CL85 · Member

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    Hi everyone,
    I am nearly 30 weeks pregnant and my obstetrician has informed me I will be induced early due to being type 1. No information, no thorough discussion. I do not feel like I have been asked to give informed consent. She has very poor interpersonal and patient centred skills, and every interaction I have had with her I have left disappointed. So, I have done a lot of my own reading and research to inform my judgement and decision before agreeing to it either way. I may also request a second opinion. I appreciate induction reduces the chance of still birth in type 1 mothers but when you look at the stats, it is actually a very small percentage chance anyway. When considering the entire potential process, risks, complications and overall potential trauma of inducements (if it isn’t straight forward), I am weighing up if it’s worth it. Further to that I don’t want to be spending any unnecessary time in hospital due to the Covid situ. Inducement could mean being in several days, something which is a risk in itself. I am fit, healthy, have very good control A1C currently 39 and no further comorbidities. First growth scan was normal on all levels. I am struggling to see the benefit of putting myself through inducement, which could have a higher risk of needing a c section if it doesn’t work. I would prefer the at least try the process of a natural birth and for baby to come when he is ready, even if it does end up with some form of intervention, at least it’s intervention when required, rather than intervention ‘in case.’ I was hoping to find other people who have taken this approach and it would be great to hear your experiences. Have you opted to let birth come naturally, and declined inducement? How did it go? Can anyone out there help? Thank you!
     
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  2. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Sorry . Have had 3 kids but followed conventional advice though I do know of others who were allowed to get to 37-38 weeks.
    I think it is your choice but should be informed by discussion with someone your trust and it is valid to ask for a 2nd opinion but also be flexible to the idea that things might change e.g. blood sugars going up and abnormal growth or baby being in a bad position for a normal delivery.
    Also you could ask about the CoVid risks so that you are not swayed by what may be irrational fears of getting infected.
    I hope you enjoy your last trimester and can get some answers.
     
  3. CL85

    CL85 · Member

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    Thanks Nicole, yes you certainly raise valid points, I agree nothing is fixed either way, I still have a bit to go and so I need to be prepared for changes that may be out of my hands. Just struggling with a lack of information from the obstetrician regarding choosing inducement and weighing up risks either way. I don’t feel empowered to make a decision and it feels they are just telling me it will happen. Would you mind if I ask, by following conventional advice, do you mean you had 3 inducements? I would be just as interested to hear of your experiences around this if you are happy to share. Were they all successful in inducing labour or did any result in c-section? Did you have to have a syntocinon drip? What was that like? I hear it can lead to a lot more painful contractions and more chance of epidural? Were you fully informed of the process from the start? Anything you’d be happy to share would be helpful either way. Many thanks x




     
  4. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Hi.
    I had a c section because I got pre eclampsia at 34 weeks (one of those things that is more common with type 1). Therefore I was not allowed an induction for 2 and 3 and had to have c sections.
    I've only got anecdotal experience of inductions so I would suggest making a list of pros and cons that you can ask a midwife; the midwifes can be nervous of dealing with non standard pregnancies but should be able to talk to you about the different types of drugs they would use and the likely success rate e.g how many resulted in a natural delivery compared to a non induced labour? Average durations of labour etc. The only thing I'd say is that with an induction you will be booked in at a time when a consultant is on hand as opposed to possibly not having access to that specialist should they be needed.
    If I was doing it again, i would go for a natural birth because it helps the baby to develop a great immunity system (c section babies are more likely to have allergies and less diverse gut michobiome). Also heard that natural birth hurts quite a bit...You don't get any medals either way but as you say it is best to be empowered by having your questions answered.
     
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  5. CL85

    CL85 · Member

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    Thanks for sharing this, much appreciated! X


     
  6. Rose22

    Rose22 Type 1 · Well-Known Member

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    I think what you’ve written here is your case in point. You seem to be clear in your reasons, give these to the consultant and agree a plan together. You have choices, and more control than it seems. They will always go by the book as it’s in the interest of safety of you and your baby.
    I have experience of refusing an induction... ten years ago very fit and had controlled by gestational diabetes by diet alone. All my birth choices went out the window and I was told I was being booked in for an induction. I said no thanks... something that was met with horror. The midwife took out a calendar and said I’m booking you in anyways, she’d reluctantly let it be for a few days after my due date. I went into labour on my due date. (Day before saw midwife & had a sweep) With my second I had an elective c section. I gave my reasons to the consultant. If you present why clearly they often plan with you, I found. As it was up to me..yet they pushed one way clearly. If you want another way just need to say & why. My consultant then went and discussed with another and come ack saying ok you seem very determined, we will do that. All my growth scans showed baby to be bigger than they actually where. But I was grateful for all the checks along the way. My c section was booked in at 38 weeks, as they wanted the baby to be in as long as possible.
    Good luck with pushing for the birth plan you want, and the more in control you feel the better.
    Sorry should add first birth I wasn’t type 1 only gestational and was natural delivery. Second I was insulin controlled and they wanted me to do natural & induction. I chose elective c section. End result was choosing what was the safest way to bring my baby into the world, only you can choose that with the information you have, and go by that at the time.
     
    #6 Rose22, May 1, 2020 at 7:45 PM
    Last edited: May 1, 2020
  7. CL85

    CL85 · Member

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    Thanks Rose, I agree it is so important to fight for your preferences and reassuring to hear they worked with you. I feel it is such a shame that women are often pushed into decisions about birth without a true detailed discussion and full information. It’s not a one size fits all, and they are supposed to assist you in making a decision that’s right for you. At the moment it just feels like it ‘my may or the highway when I speak to the obs. No opportunity to ask questions. She never asks how I feel about anything, just makes statements and tells me what’s happening. She even got my health condition wrong at one stage, insisting I was type 2 not 1 - I obviously complained about this. I always come away from conversations with her feeling awful, so I am doing lots of my own research so I can support my arguments and decisions when I discuss this with her next. Not what you’d expect from services that are supposed to deliver ‘women centred care.’ Thanks again
     
  8. CharlottePatten

    CharlottePatten Type 1 · Member

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    Hello, I know this is an old post and hope all went well for you in what ever your decision was I'm currently pregnant with my second, with my first I had the same situation you are talking about, just going to an appointment and my consultant just stating right I'm booking you in for an induction without explaining anything to me. I left my appointment feeling very confused that day. So I did alot of research of my own. I actually ended up going in early as my son fetal movement had reduced. When I went in my son was showing signs of distress and I ended up having an emergency c section, if I haven't have gone in when I did, he wouldn't be here today, I had a calcified placenta, my son was born hypoglycaemia and severe jaundice and ended up in NICU for 9 days. I believe that every pregnancy with diabetes is different and you have a choice to refuse an induction but if you do all I will advice you is that you need to just keep a good record of fetal movement as that's the warnings you get but this is the same for a women without diabetes. There's many women that have complications in pregnancy with diabetes but then there's many that don't, same goes for normal pregnancies too. I'm currently 25 weeks pregnant and I'm looking to do a vbac with this pregnancy and know the research done on inductions done at 37-38 weeks and this time I will be asking many more questions and not going to leave my final appointment until I get them all, I don't want an induction at all but need more medical information before I agree to anything. Hope this helps good luck
     
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