Labor, Delivery, and Diabetes

So, I’ll try to keep this short. But we know that won’t happen. Nor will I withhold any details. I figure my story isn’t the typical “mom with diabetes” tome, so I might as well let y’all know what went down.

Let’s start on Monday, October 27th – right before M and I went to bed. In less than 24 hours, I was going to be admitted and induced because my docs couldn’t let me progress any further in the pregnancy, even though there was no indication that something was wrong. However – diabetes and stuff. But, at nearly 41 weeks pregnant, I was pretty much done giving myself insane amounts of insulin for meager meals and feeling like an emotional hot air balloon. I still cried before bed, mourning the fact that M and I weren’t going to be a twosome anymore and that our lives would be upside down for the next 18+ years. But, let’s face it – we needed that change. And I think we were more than ready for it. (Ask me that question now…)

At around 11:30 pm, I started battling heartburn really bad. Typical for me at this stage of the game. Except this felt like stomach acid was rising out of my throat with every minute. I ended up losing my dinner and whatever else was in my stomach at the moment, but I felt a bit better post-puke. Back to sleep I went after another quick BG check.

Then, at around 1:30 am, my water broke. But not just broke… more like a dam ruptured. I heard a very loud “pop” and, as my NST nurse predicted, out pours a ton of fluid. So, of course, I panic and run to the bathroom, waking up M in the process. I’m not really sure how I’m supposed to pack or anything because it seems that the fluid just won’t quit. M begins loading up the car while I jump in the shower. Or at least try to. My mind is racing because there was meconium in the fluid, so I feel like my time is limited.

I pop out of the shower and try to keep a calm head. But, here come contractions. Crap – that was fast. I’m going to have this kid in my hallway! Better change my infusion set. (Wait – what?)

Yeah – the plan was to change out my infusion set and go in with a fresh batch of insulin before heading into L&D for the induction. So my pump was nearly on empty and about 2 days old. I didn’t actually think I would need to change out my pump site while having contractions. 1st labor achievement unlocked.

M and I got on the road around 2 am. I continued to have fairly strong contractions in the car at around 2-5 minutes apart. (Yeah, that escalated quickly.) I called my parents (yes, at 2 am) to let them know the scoop and tried to focus on the fact that we weren’t going to be stuck in traffic on the way to the hospital. (Hooray?) Upon arrival, I stumbled out of the car with a small bag and slowly walked up to L&D while M parked the car. (I love my hospital, but not the parking situation.)

I checked in with the nurses station and waited for the triage nurse to take me in back for an exam. I start having contractions again as we’re walking back, but they insisted I still stand on a scale and try to pee in a dixie cup. (DEAR GOD, WHY!?) Yeah, the dixie cup wasn’t going to happen. Vitals taken, monitors hooked up, and contractions are still happening and getting worse. One of the residents I saw in the clinic quite often happens to be on-duty for the evening (yay familiar faces!) and lets me know that I’m already 4 cm dilated. Hooray! Give me the damn epidural. (M: Jen are you sure you want to do that now? Me: YES, damnit!) For the record, I wanted to progress naturally and med free up until about the half way point. Since I was being admitted nearly at that point already, I figured what the hell? I’m going to want to try and sleep for the rest of the evening.

Epidural was placed, monitors were hooked up and I was sitting fairly comfortable. The neat thing about my hospital is that when monitors are hooked up, the results are broadcast to all of the nurses stations on the L&D floor. This comes in handy if there is a problem with mom or baby. Turns out my birthing suite would be a popular joint for the evening. Sometime after the epidural was placed, E’s heart rate was getting hard to track on the monitors. The resident asked if they could place an internal monitor on her head – I was numb from the waist down, so might as well. E’s heart rate didn’t pick up, even after finding it on the monitor. Suddenly, I’m being pushed to my side, being given oxygen and a shot in my arm, and there are about 20 people in my room. Da fuq? E’s heart rate recovers, but I’m asked to stay on oxygen for a while to keep her stable. And then try to sleep and stuff. But I’ll need to wake up every hour to test my blood sugar.

Blood sugar-wise, the resident had me lower my pump basal rates to about 25% of what I had been taking in the 3rd trimester. It seemed a bit dramatic, but I figured they had their reasons. Labor is like running a marathon, and I didn’t need to be dropping low if I couldn’t eat anything. Turns out the basal reductions were a bit too much as I averaged around 140 mg/dl for most of the labor process. The residents didn’t really like that and kept asking me to correct with insulin on-board, but I had to explain what a terrible idea that would be to stack insulin without food being served. They generally agreed with my judgment, but justifying my choices every hour on the hour got annoying.

Morning arrived and the nursing/resident staff changed. The hospital delivered breakfast (chicken broth… ugh), which I couldn’t eat because I started feeling really nauseated. Blood sugars were still staying put at around 140, despite corrections, and now the staff wanted results every half hour instead of an hour. I’m not sure what this was supposed to achieve since I don’t tend to see corrections work until after about an hour. Add that I haven’t eaten anything substantial since, well, Monday’s afternoon snack, I was sleep deprived, and dehydrated… no wonder my blood sugars were being so stubborn!

E kept things interesting by having another heart rate decel at around 10:30 am… right as my mom was walking into my birthing suite. Awkward. More oxygen and side-lying for me as M runs out to get my mom back out to the lobby. I guess the memo about M being the only person allowed in my birthing suite during labor didn’t get communicated to all staff.

At around noon, I get checked again – I’m nearly 10 cm and 100% effaced! Woo hoo! Except, E is still sitting high and I’m not quite complete enough to start pushing. So the resident asks that I sit tight and labor down. We get a few practice pushes in, but it’s still pretty early to start things for real. So we wait. Again. Even with the epidural, there was a lot of pressure from the contractions. I’m also uncomfortable and really, really thirsty, and really just wanted to get the show on the road.

Another resident came in around 1:30 pm to examine E’s placement because there was concern she was facing sunny side up. (Face up, rather than face down.) After a failed attempt to try and grab E’s face, I started cramping up really bad. Like, split me in half bad. Where the hell was my epidural and why wasn’t it working? Naturally, E’s heart rate drops because I’m in a panic. Even with oxygen placed, I can’t breathe deep enough to stabilize her. So the resident says “Okay, Jen, we need to take you to the OR.” Cue ugly cry, more panic and another 20 people in my birthing suite. I hear M off to the side reassuring me he’s still nearby. Monitors are disconnected and I’m being wheeled off to the OR. En route, the anesthesiologist is giving me a massive dose of pain killers to prep my lower half for surgery, which kills the pain I was experiencing. But I’m still uneasy, to say the least. This wasn’t part of the plan. This isn’t what I wanted. I was so close!

E’s heart rate stabilizes in the OR, which doesn’t mean surgery yet. M joins me in the OR decked out in scrubs. The chief OBs aren’t optimistic because they still aren’t sure how E is facing. I was ultrasounded and examined again by multiple people (glad I’m not shy in that regard) and they decide to let me try practice pushing again to see if E’s heart rate can handle it. Nevermind that I’m completely numb from the rib cage down and the docs are all asking me to push. (Or in my mind, pretend to.) No dice. E is too high in the birth canal and her heart rate continues to drop after pushing. So – C Section it is.

E came out screaming at 2:01 pm. I saw her briefly before they rushed her off to NCIU. M followed her while they stitched me back up and wheeled me off to recovery. One of the chief residents informed me that this would have been a C Section delivery anyway as E’s cord was sitting right by her head. If I had pushed her out, the cord would have compressed all the way down the birth canal. Scary to think about now, so I’ve come to terms with how she was delivered. But I didn’t get to see her for a good four hours. The NCIU team wanted to keep her under observation because my A1C before delivery was one tenth of a point over what they want their pregnant diabetics to be sitting at prior to delivery. (Sigh.) Plus – there was the whole meconium thing.

I get transferred to my hospital room after about an hour in recovery. I was feeling pretty awful, nauseated, but still hungry and fighting the high blood sugars I was having during surgery. I decided to switch my basal back to my pre-pregnancy rates because I didn’t feel like the labor doses were sufficient enough. However, explaining my reasoning to the nursing staff was a pain in the ass; especially when they needed to record EVERY dose my pump dispenses upon every hour. I know this was just a way to cover their behinds because I was manning my own device, but the hourly checks while trying to recover from surgery didn’t allow much sleep. Plus E was delivered to my hospital room at around 7:30 pm that night. And I still couldn’t walk… and still hadn’t eaten anything all day. (Or when I tried, I threw it up.)

I’m not sure how the three of us survived night one. I’m pretty sure the pediatric staff asked if we wanted to give our daughter her first bath… at 1:30 in the morning. (Nope!) I was woken up again around 3 am to see if I could stand up. (I couldn’t.) My blood sugars finally started to regulate a bit and the night time resident finally said stop checking hourly. And by morning, I was allowed to have my first real meal in over 24 hours. (And I kept it down.) My feet and legs were about three times their normal size from all of the fluids and surgery, but somehow I managed to start walking around with assistance. And then eventually on my own. This made it a bit easier to tend to E and give M a break. We had visits from the grandparents here and there.

We were finally discharged on Friday at around 4:30 pm – which allowed us to sit in traffic… in the rain… on Halloween. Luckily, E slept through all the traffic. We’ve been surviving ever since. (With lots of coffee.)

Congrats on making it through this wall of text! Here is a photo for your trouble.

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8 thoughts on “Labor, Delivery, and Diabetes

  1. Scott E says:

    Wow Jen, what a saga! (you had me glued to every word of this post). I’ve said it before, but I’ll say it again — I am absolutely in awe of everything a woman with diabetes deals with during pregnancy and childbirth. It sounds like your medical gang had a pretty sharp eye on things, even though it may have seemed like chaos, and that everything decision and action was the right one.

    And she’s beautiful.

  2. fifteenwaitfifteen says:

    The end result makes it all worth it, right?? She is BEAUTIFUL and you did a fantastic job brewing her for that long and managing your diabetes so well! CONGRATULATIONS!! (and coming from another T1 Mom who had to have a c-section….it seemed so scary and not-really-what-I-wanted at the time, but having a healthy baby (and healthy me) was the end goal and that was all that mattered. Our c-sections are our stories, and end up being only a few moments in the grand scheme of the wonderful lives we created!!!!

  3. Maria M says:

    What a cutie!! 😀 sorry you had to go through so much to get her out – what a story!! (I may have cried a little reading it). But you and all the other t1d mamas give us wannabe/soontobe t1d mommas lots of hope and inspiration!! ❤ thank you for sharing

  4. gogogone says:

    Your story is a lot like mine..water breaking in the night, long labor and subsequent C-Section. (type 1 and labor:very challenging) Hope you’re healing up well and enjoying your beautiful baby and congrats!

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