Tuesday, December 11, 2012

The Longest, But Most Informative, Post Ever

***Republished today, originally published May 12, 2010***
Because this is a popular post and because I'm hoping (cough) to start blogging again, I thought republishing this article might be a helpful way to start.  I've missed blogging, three children do take a bit of minding, but I think there may be time to squeeze some writing in, I'm hoping to share with you about baby #3 over the next months.  Please always feel free to email us your questions as well. Jenn

I wrote this article a couple of months ago... I'm thinking at this point it's not going to be used for its intended purpose and wanted to share it here, with you. Enjoy, it's the abridged version of the entire blog!

My name is Jenn, I’ve had type one diabetes for 15 years and I wanted to change how doctors look at diabetic birth.

“It doesn’t have to be that way.”

This was my only thought after delivering my son in a St Louis hospital after 2 and ½ hours of pushing, labor that stalled with an epidural administered at 8cm, a vacuum-assisted delivery, a 4-hour wait to hold my baby because he had to be taken to special care nursery for slow breathing, my baby given formula without my knowledge, supplemental formula every 2 hours there after for hypoglycemia, and a son who despite everything I did over the following weeks was never able to latch and breastfeed. I was frustrated, where did everything go wrong, why wasn’t anyone asking me how I wanted to care for my son, why wasn’t I getting to be his mommy, why did I feel so unable to care for him when they sent us home?

Now, I had a healthy, beautiful 8lbs 9oz baby boy - who had nothing wrong with him. And folks might say, “Isn’t that enough for you, lady?” Absolutely, but he walked away with a mother who now had a lot wrong with her...

I am a woman. For my entire life, I’ve never felt different than any other woman. That is, until I got pregnant. I was diagnosed with type one diabetes at age 12, pursued a career in nutrition, married a wonderful man, played sports, danced, traveled the world, worked in hospitals, and kept other people’s children, but then I got pregnant. And this was the first time in my life that I was treated differently because of my diabetes. At least, this was the first time I was aware of it.

My diabetes absolutely did require special monitoring to ensure my baby’s well-being,
but when it came time to push, was I really all that different from other women? All I wanted was a natural labor and delivery. I don’t know why I cared so much about this. Was it because it was the “in” thing to do, or was it because I didn’t like drugs? Was it because my mom had done it that way? I’m not sure.

I knew after giving birth to my son that I wished I had done it my way. I now believed natural birth was best. I believed that natural birth would have given me the confidence to care for my son. I wished I didn’t have the pain of an awful tear from a vacuum-assisted delivery. And I wished my doctor had listened to me and been honest, saying, “I don’t know how to do it that way.”

It wasn’t me. I could have done it my way. It wasn’t even my diabetes. It was my medical team. They didn’t know how to deliver babies without intervention; they were high risk specialists trained for the worst-case scenario. I am so grateful for the prenatal care I received from this team; however, I needed them to know I’m not an impending medical disaster. I can birth my children, I can care for them when they are born, I can be normal!

With my second child, the goal was not to pretend that I didn’t have diabetes. I wanted to give birth without regrets about how my baby came into the world. I wanted to show my doctors that diabetic women can give birth. I wanted to breastfeed my baby. I wanted to have confidence in my ability to care for a child. And I wanted to avoid the awful post-partum depression I’d experienced with my son.

This time, I wasn’t going to let diabetes be my prognosis when it came to childbirth. I was a woman who wanted to have her baby naturally, and I wasn’t going to be told “no.” Sure, I might need a million doctors visits to get me to the point of birthing a baby, but when it came time to push, if we had all done our jobs for the last 9 months, I didn’t need the doctors anymore. I needed to be a woman and be left alone to birth my child.

Doctors aren’t comfortable with leaving pregnant diabetic women alone. Maybe it’s because we do have high-risk pregnancies, maybe it’s because they’ve seen all of the horrible things that can happen sometimes. But maybe it’s also because they were taught not to leave us alone.

I planned to deliver my second child at smaller, non-teaching hospital in St. Louis, although I saw the same maternal-fetal specialist throughout my second pregnancy. I had all of the same extensive testing, but I asked my maternal-fetal specialist to allow another OB to deliver my baby if all went well. I worked weeks to find an OB reputably experienced and competent in both natural deliveries and c-sections (should I have needed one emergently). I met with both doctors throughout my pregnancy. I maintained even tighter control of my blood sugars during my second pregnancy (A1C below 6.0 the entire pregnancy). I met with the neonatologist to discuss ways to prevent hypoglycemia in my baby after birth and ways to treat it that did not involve bottle-feeding. I worked with a doula on natural childbirth techniques. I studied natural induction methods and used them to make sure my baby came before the specialist’s mandated induction at 39 weeks. I was as ready for a natural birth as I could have been. And then, I went into labor on February 22, 2009 for the second time...

I labored at home from 3pm until 10pm. By then, I was begging my husband to get me to the hospital because I’d changed my mind, I wanted those drugs! We arrived at the hospital having never even toured the baby center there because I was only 36 weeks pregnant, and with a 17-month-old little boy at home, we just hadn’t gotten around to it. My best friend was with us because I wanted a woman with me, but was too ashamed to call the doula because I just knew I was going to get an epidural.

We arrived at the hospital at 11pm and I was still able to remain calm during my contractions, as I’d practiced with the Bradley Method. The staff looked at me like I wasn’t really far enough along to be there and like they were planning to send me home. My nurse checked my progress, not knowing that I was teetering on the edge of begging her for an epidural and then announced that I was 7cm dilated. I told her of my internal struggle...my strong desire, possibly even need, to have this child naturally – a desire that was warring with the reality of how intense the contractions were. Being experienced in natural births, she calmly responded, “I think you’re doing great, honey, you can do this.” WOW! This was the opposite response of that I’d received with my son’s birth at another hospital...”Calm down, sweetie, so that we can get your epidural.” YOUR epidural – like they set it aside for me earlier that day!

I was allowed to labor off of the fetal monitor in the tub, I was allowed to move around however I needed, I was treated like every other woman who might have been in that room on a given night. My diabetes didn’t matter to them. The difference between this birth and my first: I was in charge of my labor. I wasn’t tied to drugs and stuck in the bed. I wasn’t doing what a nurse or doctor told me to because I couldn’t feel my body. I was giving birth with their help!

I told them I could manage my sugars and they let me. (For the three days leading up to the labor, my blood sugar never went above 120 and during my labor never over 100.) The nurse brought me juice when I needed it and kept my specialist updated on my progress.

Turns out choosing a hospital with a reputation for natural births made the difference for me this time. They didn’t have a set way of doing birth for high-risk pregnancies that involved induction, an epidural, or a scheduled c-section. Instead, they listened and encouraged me in the way I needed to be encouraged. My nurse and my doctor, the OB we’d asked to deliver, made the difference for me that night.

I gave birth to a 7lbs 10oz baby girl at 37 weeks gestation on Feb 23, 2009 at 3:24am. She was pink and I was the first person she saw when she opened her eyes because she was in MY arms. I made the decisions about when she would eat and when she would get her first bath, where she would sleep and who would hold her. She breastfed immediately after birth and never required any supplemental feedings (no hypoglycemia at all). She was never taken away from me. I asked for help with her if I needed it. I left the hospital the day after her birth and went home without fears of my ability to care for her. I had birthed that baby. I could do anything. It was right this time.

I share this story to let those of you who desire natural childbirth know that you can have it. You are a woman and you can birth. It takes a ton of work on your part to grow the healthiest, most normal baby you can despite having a disease that would have killed you without modern medicine. But with the right knowledge, the right medical team, a birth-attendant experienced in natural childbirth, and a little luck, you can do it. And you don’t have to wait for your second baby to prove yourself; you can do your homework the first time! A fellow type one mama in St. Louis birthed her first child naturally 11 short weeks after my story at 41 weeks gestation. (I’ve never heard of a type one going that far; her doctor was extremely supportive). The stories are hard to find, and doctors willing to work with you may be even harder to come across. But, if it’s what you want, or in my case, need, you can have it.

I wish all women (and men) with diabetes the best in having families. I never imagined in my wildest dreams that I would have two healthy children. They are an amazing blessing, no matter how they arrived into our lives. My story is one of realizing my dream to change the mold of diabetic pregnancy, and not meant to diminish the pain and hardship that having a family can be in the face of type one diabetes. Thanks for reading; I pray the information on the blog will encourage you.