Thursday, January 12, 2012

Weaker Contractions in Type I Diabetic Women?

My cousin forwarded this article to me, about why women with Type I Diabetes may have more c-sections. It certainly provides a provocative physiological hypothesis about women with diabetes - that their uterine muscles are not as strong - but I also have a few other thoughts about it.

My pushing experience with my first son actually seems to anecdotally confirm the hypothesis. My contractions were extremely spread out - never closer together than 4 minutes. In fact, after I had been pushing for 2.5 hours, my contractions were STILL sometimes 7 minutes apart. Fortunately, my doctor didn't seem perturbed by it, suggested a little bit of pitocin, and we got the job done vaginally. I always chalked it up to being a first-time mom who was scared to death of having a baby.

But with my second son, I was induced with pitocin to begin with. Contractions didn't get very intense until after they broke my water. I asked the nurse to turn the pitocin off after they broke my water and I felt like I had NO REST in between contractions. I finished dilating about 2 hours after the pitocin was turned off, and then he came flying out in 20 minutes! I actually have no idea how close together or far apart they were, but they were intense. And his rapid exit surely says something about the effectiveness of my uterine muscles.

So was it the difference between a first-time mom and a second-time mom? Or was it that I needed the pitocin to assist me? Perhaps the pitocin was actually still working by the time I pushed my second son out, but my impression is that it doesn't stay in your system quite that long.

Without knowing a lot about the science of contractile intensity of uterine muscles, my greatest question about this new science would be: are induced labors more likely to be affected? That is, if you induce labor at 39 weeks, are you more likely to find that you suffer from ineffective contractions? It seems like a no-brainer to say "yes," but I actually have zero science to back that up. It's just an intuition, but it does seem like a pretty reasonable one. Oh, and not anecdotally applicable in my situation either, since my first labor (the spontaneously-begun one) had weak contractions and my second labor (the induced one) had normal contractions.

My other question would be, could pitocin be used to augment labor that has already begun, rather than jumping to a c-section? I mean, I'm as afraid of pitocin as the next lady, but I guess since it's been used to such positive effect in both my labors, my position on it has softened somewhat. And particularly when it means avoiding a c-section, I'd be all for it.

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