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how much of this is "scare tactic" and how much is "real"? Also, any ideas on how to make sure things STAY good with blood pressures and things like that?
Im a little freaked out and not as confident about going natural after today's appt...not sure if it's the "knowing too much" camp from being a doctor myself or what.
background: I have GD and am on a tiny bit (4 units regular per day) of insulin to keep it under control. Because of this, I have twice weekly appts for NSTs.
I had my 35 week appt today, my blood pressure was up (146/86) but came down on recheck 10 minutes later (130/82). I also have trace protein, but she doesnt yet want me to do a 24 hour collection or anything, I personally think the b/p issue was most likely due to 1) working nights the last 4 nights and 2) freaking out about being late to the appt b/c of getting out of work late. We'll see, Im afraid of pre-eclampsia. My life gets less stressful now (6 more clinic days and one more bad day - Saturday in the PICU for 12 hours) and after next tues, stress from work will be virtually nonexistant.
Brayden's measuring spot-on, NST was good, she thinks my glucoses are good, and we sent off the group B strep screen. She did say today that I have a narrow pubic arch which can be associated with a pelvis type that doesnt do as well with vaginal deliveries. (anybody have literature on this? Ive been looking but not finding much aside from basic anatomy). She said she couldnt tell if I had much space posteriorly or not but that it would be a wait and see thing. Apparantly, my cervix is now closed/thick/high and way posterior, so hopefully my b/p fixes itself because I dont think an induction would go very well at this point (which I would only consent to if pre-eclampsia rears its ugly head).
She also said that while I can push in any position I want, for the actual delivery, she (or her partners) would pretty much 100% insist that I be on my back b/c Brayden is a "diabetic baby". She said this was so they could relieve shoulder dystocia more easily. (Correct me if Im wrong, but isnt that one of the WORST positions for this???)
Me: 29, DH 35, SD 15, DS born 6/9/2008, 3 kittys, Riddle , Mittens and Tiger.
The pelvic thing is a bunch of crap to put it bluntly. Has she measured your pelvic inlet? CPD is extremely rare, and only diagnosable AFTER delivery - and first got being diagnosed when rickets was common (a couple hundred years ago lol). Now, rickets is also virtually nonexistent particularly in our culture with our nutrition and working conditions.
Furthermore, true measurement of the pelvic inlet is determined by xray and even then isnt indicative. Your pelvis changes during labor and moreso during the birth itself. Add to that, the babys head molds, making both the baby's size & the pelvic inlet prior to labor minor issues if even issues at all.
Now - HER experience may be different, I'm going to assume her experience involves medicated moms who dont get to move during labor to bring the baby down and into a good position & she probably also expects moms to push laying on their back. In that case, your pelvic size isnt the issue, its the position. You can have more than enough room in every direction & your pelvis will be smaller & more difficlt for a baby to navigate through when gravity is narrowing it & youre laying on it.
As for the BP - yours is barely borderline & the fact that it came down tells me your theory is probably very accurate. True Pre-E BP doesnt come down no matter what you do. You could stnad on your head & it still wouldnt come down.
either way, since it is borderline & there are traces of protein, the true reason behind it is likely diet. Increase your protein significantly (75 - 100 grams of protein) & follow the brewer diet for pg: http://www.blueribbonbaby.org
The Tom Brewer pg diet has been shown to prevent & even reverse "pre-E". In studies, women who dont follow the recommended amount of protein have about a 40% occurance of pre-e. Women who do follow it - ZERO percent occurance in the study.
Its significant. I had pre-e with my first, never was told why or how to reverse it, prevent it, handle it, etc. Just an "oh well guess well probably induce you" (which they did - I was threatened with a cesarean, ended up with an epidural, and had a pretty ugly episiotomy against my wishes). Second time around, I followed the diet, had zero problems whatsoever. (And a natural home water birth I might add!).
Hi Star, I don't know much about Pre-E or GD but I do know that pushing on your back is the worst position and there is tons of research out there to back this. I have no idea why your having GD would make a difference in the pushing stage and that sounds to me like a way to get you to do what's convenient for them. I would say if you feel most comfortable pushing in a different position (and I'm guessing you will) then just refuse to lay down on your back. You should see our thread here on "What if..."
Good luck to you! I so hope you get the birth experience you want. Try to stay strong and listen to your body. You can do this! *HUGS*
I don't know too much aside from what has been mentioned, I had very very high protein in my urine for the last few months of my pregnancy, they too didn't tell me how to change that (and I saw midwives) but my Doula did. I ate protein until my ears bled and although it didn't get too much better, it didn't get worse either.
Squatting is fantastic for opening your hips up wider. I personally can't squat for squat, but if you can start practicing now it may help you. Next time I will start practicing as soon as I get pregnant.
best of luck! try not to let it all get to you, just keep educating yourself and that will be your best defense against things spiraling out of your control when the time comes. Talk to your Dr ahead of time and let him/her know that you are not one that is going to get bullied into doing things their way.
I would suggest you switch doctors. Your doc is giving you false information and scare tactics now. How do you think labor will go?
Take charge of your own care. If you stay with this doctor you can't expect a good outcome.[/b]
Oh trust me, I have been. I started in with birth plansat my appts at 18 weeks and it's taken me awhile to be comfortable with the plans I have. Im fighting the "Star-as-pediatrician" vs "Star wanting NCB" battle, and I think Im pretty much at a good place with it - Im not going to the big hospital I work at where I trust all the neonatologists, etc, but the OB side is very "factory-like". Im not comfortable delivering at a place without neonatology support, so that rules out birth centers, and the hospital I will be delivering at has the neos that I know and love covering there 24-7.
SOME of it is *me* freaking out, not her. Unfortunately, I suffer from the "knowing too much" bug. She barely mentioned my b/p, for example, just that she agreed w/my theory that it is likely work related.
This group is actually really accomodating for pretty much everything in my (very detailed) birth plan, including
-eating/drinking during labor
-maintaining mobility/using balls/chairs/etc
-using the jaccuzzi (no waterbirth per the hospital, though).
-having my doula
-no induction until 41 weeks (even with GDM, as long as everything else is ok)
it's really just the actual baby coming out part that they want me on my back, apparantly, I can push however I want up to that point.
and yes, most of their patients do get epidurals, etc, but they do also have some NCB experience.
I have one good article about it so far (showing all-4s and shoulder dystocia stats), I just need more backup, kwim? (preferably randomized, controlled studies in reputable journals).
Me: 29, DH 35, SD 15, DS born 6/9/2008, 3 kittys, Riddle , Mittens and Tiger.
Sorry I don't have much to add.
Just wanted to say that my bp was a little on the high side for my last few weeks of my pregnancy and it didn't affect anything.
Also wanted to encourage you that you can do this!
If you are happy/comfortable with everything else, then I would be asking your OB to provide you with some information/evidence as to why you need to be on your back to deliver this baby.
If you are allowed to 'push' in other positions, what happens if baby delivers very quickly whilst you are pushing in these positions? I deliver VERY fast. Pushing = baby out.
I have delivered all 4 of my babies on my back, but strangely enough have NEVER been told to deliver that way. It is honestly just the position that my body puts itself into. I think that everyone is different, & that you have to deliver in the most comfortable position for you