Too much going on. Too many thoughts on my mind. Where to start.
First, Gestational Diabetes and VBAC. It seems I have been talking about GD since 11 wks pregnancy. I was tested for GD early on, at 11 wks and failed the 1 hour test because of the stupid gum I ate. Passed the 3 hour GTT with flying colors. After 20 weeks I switched OB practices because of previous practice's policies on GD and VBAC. They informed me if I get diabetes that has to be controlled by medication, I will not be allowed to go beyond 39 wks. If I don't have it or don't need medication, I may go up to 40 wks but no further because I'm VBAC. I switched to Dr. A. who was quite sympathetic and proclaimed a different viewpoint. He, you see, is mother friendly. He doesn't like to section and is not like other doctors. He has the lowest c-section rate in the area. He would let me go beyond 40wks and take a wait and watch approach. It was better than what I had so I switched. I wasn't entirely sure about him so I kept looking for a more supportive doctor. I found him through ICAN website, Dr. T. I met with Dr. T who agreed to be my backup doctor in case Dr. A pulls a fast one on me at the last minute. I also hired a midwife to be with me during labor.
Things were fine until last week, when I failed my 1 hour glycola again and had to take the 3 hour GTT. The numbers -
Fasting - 82 (less than 95)
1 Hour - 190 (less than 180) - Failed
2 Hour - 153 (less than 155)
3 Hour - 131 (less than 140)
I failed ONE part of the test. Dr A says my numbers are high and I have failed the test. From everything I've read and the literature I have from the lab, to fail, I have to either have the fasting bloodsugar higher than 95 (it isn't) or, 2 readings high (only one is). I feel an uphill battle coming up. He wants to meet with me this week and I said fine. I am going tomorrow with DH to hear what he wants to say. I feel he is too intent on diagnosing me with GD because it gives him more reasons to induce me early. From whatever I've read, inducing VBACs is bad. The chance of uterine rupture increases at least 2 fold. I made clear to him early on, I do not want to be induced. He promised me more than 40wks and I am keen on making him keep his promise. If I get diagnosed, that is one strike against me and one point in his favor. Ironically, I am still in the same situation as I was before switching.
The only reason why I don't want to switch too soon to Dr. T is that he is far from home (but closer from my work than current practice). The hospital he goes to is also far from home and going there during rush hour can take up to 1 hour. We have an alternate route which we can take in a emergency and that should take about 20 minutes. I really love this doctor and like this option but DH is saying it's too soon to make this decision. He is our backup plan and it is not time for that yet.
Nursery - I have been planning the nursery most of the pregnancy. At first, I was going to do a robin egg blue with a black&white theme. This was before we found the baby was a girl. I've never wanted a pink nursery. Then, I got attached to a sunshine yellow nursery. I was going to make the bedding out of Michael Miller fabric. I have the fabric but didn't start it yet. I was going to paint a song bird and a swirly tree branch on one wall.
Now, however, I have completely changed my mind and am going with a nice deep teal color. The nursery will be in the sitting room adjoining the master bedroom and it works with the color scheme. I have ordered some butterfly decals from etsy. I just can not wait for it all to be done. The bedding now will not be Michael Miller fabric as it no longer works with the new color scheme. Now I want a white, fancy, frilly bedding. Haven't started looking yet. Better do that now!
30wks today
Delivery options
I had a detailed discussion with one of the providers at the OB practice. It was sort of what I expected. She tried to scare me with the worst case scenarios. Here is the gist of it -
They don't let their GD patients to go beyond 40 wks in any scenario. They don't let their GD patients who have to use medication to control it beyond 39 weeks. Also, they're ok with VBAC as long as you go into labor before 40 wks. Again, you can't go beyond 40 wks for VBAC. I'm pretty sure I'll get GD later because of my own history with it and my family history. The doctor suggested I check with the maternal fetal specialist in a few weeks and get on Metformin. I don't want to be on medication without any reason, I'm very anti-pills but I'll do this if this means skipping GD this time around. The risk with GD is premature aging of the placenta. I don't know how much risk is there but she kept switching between premature placenta aging and uterine rupture risks. When I asked her about monitoring the aging of placenta on u/s (as I know this is what my previous doctor did), she brought up uterine rupture scenario. Argh. So according to this practice policies, I am just a perfect candidate for a scheduled C though she didn't utter those words, I got that impression.
The plan now is to ditch this practice. They are not VBAC friendly (which I suspected to begin with) and they're also not in favor of GD patients going overdue. I have talked to a friend whose OB seems in favor of VBAC. Good thing they take my insurance! I'm going to talk to the practice next week or so.
Another lead I have is I've contacted someone from ICAN website who is a birth doula. Since we have not experienced this before and are not familiar with what kind of scare tactics the doctor/nurses/hospital staff might throw at us at the last minute to pressure us into a repeat-C, it is a good idea to have someone experienced. I just hope she calls me and it all works out. She will also have some other VBAC friendly doctor recommendations I'm sure. Fingers crossed!!
