My name is Lauren, and I confess that I am in imperfect diabetic. I have had type 1 diabetes for 14 years and have had varying degrees of control along the way. When my husband and I started discussing the possibility of starting our family, I got to work on two things: 1) managing my blood sugars, and 2) educating myself on pregnancy and childbirth. I learned that keeping perfect control of my sugars was, frankly, impossible. But I kept working and trying and getting closer and closer to "optimal." I also learned a great deal about the human body's natural process of giving birth. The more I read, the more determined I became to have a healthy pregnancy and a natural childbirth free from unnecessary medical interventions. I firmly believed that type 1 diabetes and natural birth were not mutually exclusive. It took A LOT of work and preparation, but in the end, I had my first baby, a healthy little boy, in a natural unmedicated birth. I hope that my story can be an encouragement to others!
On January 10, I was 38 weeks and 6 days pregnant. I had been feeling the pressure from doctors for weeks to set an induction date, because they prefer type 1 diabetic moms to deliver by 38 or 39 weeks at the latest. I had maintained optimal control throughout the entire pregnancy (A1C’s between 4.9 and 5.8) and had no pre-existing complications from the diabetes. After much research, reflection, and agonizing, I was prepared to go to 40 weeks or longer before resorting to induction. Fortunately, whether as a result of our “natural” induction attempts or just plain luck, we didn’t have to!
At about 11:00 pm on January 10th I began to feel some minor contractions. I had not experienced any Braxton-Hicks contractions prior to this and had declined a vaginal exam at my 38 week appointment, so I did not think that labor was imminent. By 11:45 the contractions were about 5 minutes apart. The pain was still very manageable, so I wasn’t sure that it was actually labor. We called the doula and continued through another hour of contractions. By 12:45 contractions were 4-5 minutes apart and beginning to get more intense, though still manageable. At this point we called the doula again and asked her to come to the apartment because we thought this might be it! My husband threw together his overnight bag and some other hospital necessities (we sure did wait until the last minute!) and before I knew it, the doula had arrived.
By 1:30 am the contractions were growing more and more intense. I labored in a variety of positions but had a difficult time finding one that helped me to relax. Eventually I found that the only position that gave any relief was a sort of modified child’s pose, sitting on the floor with knees apart, toes together, and leaning forward. It was not one of the practiced poses from our Bradley class, but it worked! I went back and forth periodically between this child’s pose and a side-lying position for the next 6 hours, taking each contraction one at a time. My husband laid beside me on the bed, helping me to breathe and relax, and assuring me that I was doing great. Our doula sat on the floor beside the bed, timing contractions, encouraging me, and occasionally massaging my lower back. I want to emphasize how important it was that we prepared for the labor using the Bradley Method. It truly did help me to endure this time laboring at home, one contraction at a time. I never felt “out of control” even though I did feel pain. In reflection, I believe that preparing with Bradley helped me to be more responsive to my husband’s and doula’s suggestions to help me relax, make low guttural noises, breathe, and so on.
Throughout this entire time laboring at home, my husband and I also managed my blood sugars. By the grace of God, my sugars stayed in tight control throughout, between about 90 and 130. I wore my insulin pump and used both my continuous glucose monitor and hourly finger sticks to keep things steady. Although I thought that I would want to eat and drink during labor, it was surprisingly difficult (I was not interested in food), so my blood sugars really never needed to contend with that. Other than a few bites of toast and a ton of water, I didn’t put much in my system.
At about 7:30 am, I remember hearing my husband and doula discussing going to the hospital. I wanted to wait longer, as I didn’t know how dilated I was at the time. I was terrified of overzealous hospital doctors and nurses taking control of the birth and pushing interventions on me simply because I have type 1 diabetes. By 8:30 am, I remember my doula looking me in the eyes between contractions and saying, “Lauren, after this next contraction, we are going to start bringing bags downstairs to go to the hospital. It’s time.” This was the wakeup call I needed. If the doula says it’s time to go, then it’s time to go!
The 45 minute drive to the hospital in LA traffic was horrendous. I labored in the car and cried because I just wanted to get there as quickly as possible so that I could get out and move. Of course we finally made it, and when we were checking in, I had two contractions back to back. I fell to my knees both times and literally could not complete the paperwork. Two nurses - absolute angels - walked me back to a triage room, helped me out of my nightgown, into a hospital gown, and onto the bed in seconds flat. At this point, things seemed to happen really quickly. They attached the electronic fetal monitor and finished asking me admission questions between contractions. These contractions were incredibly intense, and I basically lost all focus on relaxation and breathing. I just made low vocalizations and gripped the bed handle for dear life. At one point the handles were rattling, and I actually thought, “Oh my God, I think I’m going to break the hospital bed!” Thankfully, I did not. When the nurses had their fetal monitor strip, they tested my blood glucose (it had crept up to 154), and they measured me, and gave me the best news I had heard all day: I was at 8 centimeters! I knew from Bradley classes that 8-10 usually went very quickly, so I knew things would be happening fast. They immediately wheeled me to a labor and delivery room, where they put in an IV for antibiotics, since I was GBS positive. My OB was not at the hospital yet, so for a few minutes I actually had a midwife helping me labor. Very soon after, my OB arrived and took over.
It felt like no time before I was 9 ¾ centimeters. However, 9 ¾ to 10 felt like an eternity. I felt the need to use the restroom, so I shuffled to the bathroom and immediately felt the intense urge to push. When I said this, everyone in the hospital room yelled, “Don’t push! Breathe through it!” so I tried to breathe as I willed my way back to the hospital bed. The doctor measured me again, and I was still 9 ¾. Not good. It felt impossible not to push. I tried to contain it for a couple more contractions, then knew that I had to push no matter what they said. Fortunately at that moment, my OB said that I could push whenever I was ready! Hallelujah!
It was a relief to finally push with each contraction. However I quickly realized that pushing was incredibly painful and difficult. The nurses, OB, and doula all told me that I was doing an amazing job and pushing very effectively. Yay! They helped me to hold my knees back, pull my elbows up, and put my chin down. I kept pushing, knowing that each time my baby was getting lower and lower. I gave every push my all, using every bit of energy and force that I could muster. My guttural noises turned to grunts and screams. Finally I knew that my baby was almost there when I heard my husband’s encouragement go from general (“You can do it! Keep going!”) to very excited and specific (“Oh my God! His head is right there! You’re pushing his head out!”) It gave me that last bit of energy that I didn’t know I had. I felt the baby crowning, and my OB told me to “half push” several times. These “half pushes” were unbelievably painful, but thankfully they saved me from tearing too badly. So I half pushed until I felt the baby’s head slide out. One more push for the rest of his tiny body, and at 10:41 am, my son was born! I was completely overcome by the flood of emotion. I was crying when they put him on my chest. It was the most incredible moment of my life.
My little boy was born completely healthy in a high-risk, unmedicated hospital birth. He weighed 6 pounds 14 ounces and was 20.5 inches long. Even his blood glucose was perfect - 83! I could not have asked for a better birth experience. Everyone, from the doula to the nurses and OB, were so supportive. My husband was my rock throughout the entire experience. It really went better than I could have ever hoped. I feel incredibly lucky that things turned out this way, since I know that even those who prepare and do everything “right” don’t necessarily have the experience that they want. I am extremely lucky and blessed to have my beautiful baby boy!