2nd pregnancy tips? Refusing induction?

[Type1of25years+]

Hello,
Wondering if any T1s have any tips for managing tight control for pregnancy with a one year old running around?! It’s so much harder this time! Planning IVF soon so trying to get ready but so hard to do fixed meal times!
Also…. Has anyone refused induction and gone to natural labour? I think induction caused us so many issues, especially feeding problems, I think induction is unnecessary when your control is all in range and trying to decide if I’m brave enough to refuse this time… I went to 38.5 last time…
Many thanks for any advice

 

[Inka]

Hi @Type1of25years+ I have three children. Yes, it’s harder when you’re going for a second or third pregnancy. My tip would be to reduce unnecessary things where you can - simplify lots! As your little one gets older, you could also consider a morning or two of nursery care. I sent mine for a few hours a week and I felt it helped me physically and mentally as well as being good for them.

As for refusing induction, yes, it’s tempting. I react poorly to the induction drip. I really did think very hard about things but I couldn’t do it. Why? Because if anything had gone wrong, I’d have never forgiven myself. My control was excellent but that’s not the only issue. Our placentas age faster than people without diabetes, so our placenta is actually two weeks ahead, meaning a 38 wk Type 1 pregnancy is equivalent to a non-diabetic 40wk one. I read and read every study I could find, and I couldn’t take the increased risk even if it was small. To delay and then lose my baby? Not a choice I could consider. The recommendations are there for a reason. One of my babies was an uninduced birth and yes it was nice, but that was chance rather than my decision.

 

[Type1of25years+]

Hi @Type1of25years+ I have three children. Yes, it’s harder when you’re going for a second or third pregnancy. My tip would be to reduce unnecessary things where you can - simplify lots! As your little one gets older, you could also consider a morning or two of nursery care. I sent mine for a few hours a week and I felt it helped me physically and mentally as well as being good for them.

As for refusing induction, yes, it’s tempting. I react poorly to the induction drip. I really did think very hard about things but I couldn’t do it. Why? Because if anything had gone wrong, I’d have never forgiven myself. My control was excellent but that’s not the only issue. Our placentas age faster than people without diabetes, so our placenta is actually two weeks ahead, meaning a 38 wk Type 1 pregnancy is equivalent to a non-diabetic 40wk one. I read and read every study I could find, and I couldn’t take the increased risk even if it was small. To delay and then lose my baby? Not a choice I could consider. The recommendations are there for a reason. One of my babies was an uninduced birth and yes it was nice, but that was chance rather than my decision.

Thank you, so helpful to read. Do you know from your research that the placenta is older for well-controlled type 1 diabetics as well? I just don’t feel the research has caught up with CGMs and well-controlled diabetics in pregnancy as I’m not sure it was ever possible to be fully well-controlled before CGMs?! Can’t help but feel like it’s just “induce them because we always have!” My son and I had so many problems following induction that I am dreading another potential six months of feeding hell, no sleep and recovery

 

[Inka]

@Type1of25years+ I don’t remember the most recent research I read, but I did ask my consultant and she said it was to do with the effect of having diabetes for any length of time rather than just high blood sugar. All my pregnancy HbA1Cs were excellent but she said they weren’t sure of the reason for the additional placenta ageing but it still applied even with excellent control.

Don’t say if it’s private but what problems did you and your son have after induction? I don’t react properly to the induction drugs, which makes it a very painful and lengthy process, but after the delivery things were ok. I had both the softening pessary thing and the induction drip because the softening thing did nothing.

 

[Type1of25years+]

@Type1of25years+ I don’t remember the most recent research I read, but I did ask my consultant and she said it was to do with the effect of having diabetes for any length of time rather than just high blood sugar. All my pregnancy HbA1Cs were excellent but she said they weren’t sure of the reason for the additional placenta ageing but it still applied even with excellent control.

Don’t say if it’s private but what problems did you and your son have after induction? I don’t react properly to the induction drugs, which makes it a very painful and lengthy process, but after the delivery things were ok. I had both the softening pessary thing and the induction drip because the softening thing did nothing.

Thank you, that’s really helpful to know. Nobody’s ever really given me a reason other than “it increases the risk of stillborn” and nobody can answer from what rate to what new rate and whether that includes all types of diabetics, including those less able to be tightly controlled. The medical profession is so scared of diabetic births because of a huge famous case that I’m sceptical if it’s still right to induce us when well-controlled, weighing up the effects of induction. I had the pessary (did nothing) and then the evil (!) drop too and it made his heart rate suddenly drop so it was emergency get him out… poor boy had two sets of forceps marks on his head, every nurse called him “battered” and he never fed well until I finally took him to a chiropractor. I was in and out of the feeding clinics and pumping at 3am etc just to keep him on breastmilk and I think the not feeding well or gaining weight led to not sleeping well - he was awake 1-2 hours for 6 months until we did sleep training! It was brutal. I would give anything to have a natural birth and avoid all that. (Sorry, brain dump!) I think like you I am not brave enough to refuse induction because of the weight of that but was just curious if others are starting to maybe.

 

[Inka]

I had the ventouse for one of my births @Type1of25years+ Baby’s head wasn't tucked down so he wasn’t coming out. The ventouse made his head look a bit funny for a day or two but it had no lasting effects. I wrote “No forceps unless an emergency and no other option” in my Birth Plan so I didn’t have to explain or answer questions in labour. People are sometimes dismissive of Birth Plans but they make things easier IMO. I also put “No Epidural”, etc, which meant they didn’t keep asking me.

Try not to worry about the birth. Every birth is different. Some are harder, some are easier and some are harder in some ways but easier in others.

Because of the effect of the drip on your son’s heart-rate, I’d be asking some questions about that so you can get some reassurance. You can ask for a birth de-briefing where they go over events with you and why things happened and what are the options for future births. Having a good obstetrician is very comforting.

I don’t think there’ll be a reduction in inductions. The risk is proven - a placenta two weeks older, therefore potentially beginning to fail at 38wks rather than 40wks. The exact day can be negotiated but even that’s a balance. Babies of women with diabetes are also more likely to have breathing problems after birth, so it’s a balance between getting them out to reduce the risk of stillbirth but not getting them out too early to give their lungs a chance to mature.

I completely understand your feelings. I think talking about them is key. Don’t worry. You did everything right, even down to getting a chiropractor, so you’re clearly very on the ball and a great mum 🙂 Take each day as it comes, and best of luck xx

 

[Leadinglights]

I remember my daughter took her son to the chiropractor as he was breach and was born by C- section but always laid awkwardly.
Every birth is different and sometimes things have to be done that wouldn't necessarily be your choice but is the best option. Of my other daughters 3 babies, 2 were emergency C- Sections at 6 weeks premature and the other a natural birth which took longer to recover from in terms of discomfort than the C-sections.
I hope all goes well for your IVF plan and you have a birth plan which you are comfortable with when it happens.

 

[Type1of25years+]

Thank you both. If we’re lucky enough to get there I think sadly it’ll be another induction but hopefully with a better six months after. I do wish they’d start collating more data to help us make our own better decisions though - for example they wanted to induce me a week earlier based on the ridiculous NHS scan date and we said no because it was IVF and we knew the exact date the egg went in!! Poor boy would’ve been so premature! Which they then agreed made sense!! But I’m sure other IVF parents wouldn’t think of this. And a week difference could be a natural birth for several women, which is worth it. Anyone, I could write an essay on it all! Thank you for your thoughts, really helpful and you’ve reminded me I’m going to ask for a recap 🙂 xx

 

[Thebearcametoo]

Birth plans are often a juggle of ‘if this happens then we do this and if we can wait a bit then we wait’. It’s worth having in in-depth conversation with your midwife and consultant about the options and the reasons why things are done and how much you can wait and see at each point. It may be that you opt for a C-section instead of induction if you want to avoid forceps. Your options aren’t just induce or natural birth. I tried a home birth with both of mine (non diabetic) but ended up with c-sections for both but the difference was night and day between the one with induction drip vs the one without.

Feeding issues can be common after forceps delivery but even without every baby is different. You now know where and how to get support if you have problems with feeding and will be able to access support more quickly if there are any problems.

It can worth having a birth afterthoughts appointment where you go over your notes with a trained midwife so you can discuss how and why things happened with your last birth.

Good luck with your pregnancy journey.