December 14, 2005
permalink 35 weeks - still feeling good

Well it's 36 degrees celsius here today and I'm 35 weeks pregnant, but I feel positively spritely compared to how I felt at this stage with my last pregnancy.

When I saw my docs last week my blood pressure was still good (130/80) and there was only the mildest of oedema (no more than most women experience). I don't think this has changed but it will be interesting to see what happens at my doctors appointments tomorrow. Last week my protein had gone up to .96g per day, but this was still at least three times less than it was this time last pregnancy. I had put on a bit of weight (now up to 62kg) but this is only 10kg so far this pregnancy which is pretty good and doesn't necessarily indicate oedema. Yes, it will be interesting to see how I go tomorrow.

I do feel a bit guilty about my blood sugar control. My last HbA1C was 6.4. I've had 6.3, 5.7, 5.9, 6.5, 6.1 and 6.4 this pregnancy. But last pregnancy I think I ranged from 4.9 to 6.3. So my sugars are a bit higher. Partly this is due to the hectic nature of looking after a toddler. But partly this is also due to me being quite preoccupied with getting things done. I suppose if I was only concentrating on my diabetes and the pregnancy it's possible I could have got even lower bsls. It would have been nice to have kept the Hba1Cs under 6.0 (non-diabetic range). My doctor tells me not to worry, it won't harm bub at this stage. The baby appears to be spot on normal size and doing well. Getting the control as tight as possible just before the delivery though will be a worthy goal, he says, as this will reduce the likelihood of my baby having hypoglycemia in the early days.

I had intended to start expressing breastmilk today but have been a bit lazy (busy) on that front. I hope I can collect some colostrum in advance though as it will help to keep bub's blood sugars up in the first couple of days, especially if I am unable to feed from the breast straight away.

NB It's common for babies of diabetic mothers to have low blood sugar straight after birth and important to keep their blood sugar levels normal to prevent any damage to the brain occuring. This can often be done via breastmilk feeds (colostrum) but sometimes it's necessary to give extra food (via expressed breastmilk, formula or intravenous glucose drip). After my first child was born, she was almost immediately fed formula. I was upset about this because I wanted to breastfeed and preferred her not to be given formula. This time I was determined that my child would not be fed cow's milk formula if at all possible. So was keen to take in a supply of my own expressed breast milk and to have some Neocate on hand (formula which contains only amino acids) to help keep my baby's blood sugar up if needed. I was also happy for the paediatrician to give my baby a glucose IV infustion if necessary. What I wanted most of all, was for my baby to be well enough and my medical team to be supportive enough, for me to be able to keep my baby with me rather than having him taken to special care.

In terms of steroids, I have decided not to have them unless my ob strongly encourages me to when I see her when she returns from overseas (five days before the booked caesar). I've decided this mostly because my endo, whom I trust more than anyone, really thinks it's unnecessary.

Other reasons are that I prefer to avoid a drug if I can, I don't like the idea of having to spend up to three extra days in hospital hooked up to a drip (for insulin, as steroids can cause a huge increase in insulin requirements), and the fact that if it was to be done it would have to be done in the days before bub's birth and I don't really trust 'the system' to keep my blood sugars under control by drip (therefore risking hypos in the newborn).

Quite frankly I also hate being 'at the mercy of nurses' (although many of them are excellent), I also hate the thought of being away from my two year old daughter any longer than is necessary, and basically I think I'd rather get other things done at that time than be admitted to hospital if possible. Having said all this, I would do it in a flash if I knew in advance my baby had a high chance of requiring days of oxygen after the birth due to immature lungs or retained fetal lung fluid.

Both my endo and my former ob (whom I'm now seeing) seem to think I'm much better having the baby at 37 weeks, when I've been booked in, rather than trying to push it to 38. The fact that the two of them will be around that week and on leave when I am at 38 weeks is an important factor to consider. But on the other hand I feel wierd too having my wee one extracted this early.

Perhaps I should just count myself lucky.

Posted by patton at December 14, 2005 07:21 PM
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