"Type 1 diabetes and pregnancy"

I had my baby in December and have been a type 1 diabetic for as long as I can remember. I understand that managing diabetes during pregnancy is challenging. However, I felt unprepared due to the lack of a comprehensive birth plan.

At my 36-week appointment, I was 36 weeks and 5 days along. During this visit, both my diabetic specialist and consultant examined me. The consultant performed an ultrasound and noted that my baby was measuring large—a common occurrence in type 1 diabetes pregnancies. He immediately recommended a cesarean section (C-section), which I was hesitant about and expressed my concerns. Despite this, I felt pressured and as though I had no alternative.

Previously, at my 32-week appointment, a doctor had also observed the baby’s large size but mentioned the possibility of induction at 37 weeks to facilitate a natural birth. In contrast, during the 36-week appointment, he other doctor dismissed induction as an option. They emphasized potential complications of a vaginal delivery, such as shoulder dystocia, which could necessitate pushing the baby back into the birth canal or even fracturing the baby’s bones. This doctors explanations were overwhelmingly negative, instilling fear rather than providing balanced information.

When I inquired about induction at 37 weeks, I felt this same doctor asserted their medical authority, insisting that a C-section was the superior choice. I became emotional, feeling stripped of any real choice. I found the response I received was dismissive; they went on to question why I was upset about a C-section, noting that many women prefer them nowadays.

This lack of empathy was disheartening. As a first-time mother, I had hoped to experience natural childbirth, including labour contractions. I was open to a C-section if complications arose during labor, but I wanted the opportunity to try for a natural birth. The prospect of a planned C-section made me feel disconnected from the birthing experience, and even now, I sometimes struggle with feelings of inadequacy as a mother.

During this consultation, while I was visibly upset, I feel he doctor pressured me for a decision regarding the C-section. I was given only an n hour to decide, leaving me feeling cornered. Reluctantly, I agreed to the C-section but requested it be scheduled at 37 or 38 weeks due to breathing difficulties and previous episodes of reduced fetal movements, which had caused me significant anxiety. Yet again the doctor dismissed my concerns, stating that delivering before 39 weeks via C-section was unsafe and refused to consider an earlier date.

I couldn’t help but wonder if the consultant’s insistence on a C-section was influenced by personal biases, especially since the other doctors had been more supportive of induction and natural birth options. It seemed as though the doctor had made the decision for me, disregarding the fact that many women successfully deliver large babies naturally. Once the C-section was scheduled, there was little discussion about my preferences for the procedure. Unlike others I’ve heard of, I wasn’t offered options like having my partner cut the umbilical cord or choosing music during the surgery. In my overwhelmed state, I forgot to ask about these details.

Despite these challenges, I am grateful to the nurses and surgical team who performed the delivery; they exceeded my expectations and provided excellent care. However, the consultant’s refusal to consider a natural birth still weighs heavily on my mind.

Post-surgery, my experience was less than ideal. Being bedridden for the first day, my partner took on all newborn care tasks, including feeding, burping, and diaper changes, as I was immobile. When he left for the night, I realized I hadn’t been taught how to burp the baby or how tight to fasten a diaper. Feeling in my legs returned around 9 or 10 p.m., but my partner had to leave by 10:30 p.m., leaving little time for him to guide me. Having never held a newborn before, I was in significant pain and lacked basic caregiving knowledge. Throughout the night, my baby was unsettled for about five hours. Despite ringing the call bell for assistance, the midwife who responded dismissed my concerns, stating the baby would settle eventually, and left without offering help. Later, when I needed to use the bathroom, I took my crying baby with me and asked the staff to hold her briefly. They burped her during this time, realizing she had been uncomfortable, which finally allowed me to rest around 6 a.m.

Additionally, during my recovery, the doctor who had insisted on the C-section visited me and remarked that they had told me i would have a big baby? These comments felt smug and insensitive, especially considering my baby weighed 9.10 lbs at 39 weeks.

Throughout my pregnancy, I found it challenging not having a consistent consultant or midwife. Despite fortnightly visits, I often saw different professionals, each offering varying advice. Initially, I was assigned different diabetic specialists, requiring me to repeatedly explain my medical history. I requested continuity of care with a specific doctor to build rapport and ensure they understood my case. However, even towards the end of my pregnancy, I sometimes had to see other doctors who made minimal adjustments to my insulin regimen, necessitating follow-up appointments with my preferred specialist.

This lack of continuity and the feeling of being unheard added significant stress to my pregnancy journey.