The good news and the bad news

I debated posting this before a diagnosis, but figured what the heck.  Might as well "journal" how I'm feeling at this point.  Also, the font is being wonky for me.  Sorry 'bout that for all of you reading it at the actual site.




Our prenatal appointment did not go how I thought it would.  We had some good news as well as some bad news, but we're trying to stay positive.  First, the good news.

The birth center midwives usually take one week off per month so that they are not on call 24/7/365.  We didn't know when Stephanie (our head midwife) would be taking her vacation in November, and it of course made me a little bit nervous.  I want MY midwife at the birth.  Period.  The good news is that she is not scheduled for any births in September, so rather than taking week-long vacations she is going to take the entire month off and thus will be on-call for all of November.  Whew!  Now there's only a very slim chance of her missing my birth (either if baby comes too fast for her to arrive, or if her other client (only one other, yes!) that is due in November happens to be delivering at the same time as me.  Unlikely.  

The other bit of good news was that our birth team is changing.  Normally this would not be a good thing, but they messed up the scheduling for our junior midwife and she will no longer be on our team.  Instead, we'll have a CNM (certified nurse midwife) as well as the student midwife that has been present at our appointments as our backup team.  Stephanie is still the head midwife on our team, of course.  She is a CPM or Certified Professional Midwife (only legal in 27 states... I'm rolling my eyes at the other 23 states.)  The difference between her and a CNM is a CNM attends nursing school first, then midwifery school.  I'm excited to have two really knowledgeable women on my team, as well as a student.  I haven't met the CNM yet, but I am sort of glad she'll be replacing our previous junior midwife... I just didn't click with her.  Nothing wrong with her- but personality-wise I didn't feel a connection. I hope I connect better with this new midwife!

I suppose the other good news is the usual- baby is growing well (though I am measuring a bit small, yet still within the normal range) and the heartbeat was good.  His position was LOA which is a really good head-down position!  I'm excited that he's in position, though I know he could flip multiple times still.  At least he knows how to get there ;-)

So, the bad news.  I had my glucose tolerance test (to test for gestational diabetes) at our appointment and got an abnormal result.  I'll have to retest on Tuesday with a 3-hour GTT (the standard test is a 1 hr GTT, mine was an alternative 2hr test after a carb-heavy meal.)  I'm totally bummed about this.  My glucose reading wasn't super high, just borderline, so I'm hoping that I'll pass the test on Tuesday.  However, I'm not feeling optimistic about it.  I just have a bad feeling based on some "symptoms" I've had, and yet I also have some positive signs that would indicate I don't have GD (specifically I am measuring small.)  I had two unusual urinalyses (I had glucose in urine) at months 4 and 6 which would be a risk factor....  So I guess I just have to wait and see.

It's been a rough couple of days since my first test.  I feel like a failure, even though I haven't yet been diagnosed.  I think anyone who knows me knows that I have a very healthy diet- limited processed foods, no soda or sugary drinks, I cook at home from scratch much of the time, and I am a vegetarian.  Intellectually, I know there is nothing I could have done to cause or prevent GD (it is not a lifestyle disease- more on that later) but I still can't shake the feelings of failure.  I think it's because many people hear "gestational diabetes" and think that it IS a lifestyle disease- that it is caused by poor diet or unhealthy lifestyle choices.  But while that is sometimes true for plain ole' diabetes, it is not at all true for GD.  It's all about the placenta and pancreas' ability to work together well during the stress of pregnancy to produce the right amount of insulin at the right time.  


Obviously, I'm hoping that I don't have GD.  It's hard waiting for a diagnosis, and I'm really not looking forward to the retest (15 hours of fasting.  Ugh.)  This was a bump in the road that I was not at all prepared for, and it is pretty disheartening.  

I'll be sure to update as soon as I know more.






More details:


Here is some more info that I dug up for those who are unfamiliar with gestational diabetes. 


During pregnancy, hormones made in the placentawork to shift nutrients from the mother to the baby, and also to prevent the mother from developing low blood sugar.  The hormones work by stopping the actions of insulin- which is to regulate blood sugar.  As pregnancy continues, the hormones lead to higher blood sugar levels in the mother, so the pancreas works to produce more insulin (2-3 times as much) to overcome this.  However, if the pancreas cannot produce enough insulin blood sugar levels will rise, resulting in gestational diabetes.

The following factors increase a mother's risk of developing GD during pregnancy:
- Being overweight
- Being a member of a high-risk ethnic group (hispanic, black, native american, or asian.)
- Having sugar in your urine
- Impaired glucose tolerance (high blood sugar levels but not high enough to be considered diabetes)
- Family history of diabetes
- Previously large babies (>9lbs)
- Having GD with a previous pregnancy
- Having too much amniotic fluid (polyhydroamnios)
- Previously giving birth to a stillborn baby


It is important to note that many women who develop gestational diabetes have no known risk factors.

GD is managed by monitoring blood sugar levels 4x a day, monitoring urine for ketones, following specific dietary guidelines, monitoring weight gain, taking insulin (if necessary), and controlling high blood pressure.


Gestational diabetes does increase the risk of other pregnancy complications such as preeclampsia, large birth weight, and high blood pressure, as well as jaundice and hypoglycemia in the infant after birth.  However, well-controlled GD reduces the risk of those complications.  There is, however, still an increased risk for both the mother and infant of developing diabetes later in life.