Rachel joined the Homebirth UK email group and posted when she was diagnosed with gestational diabetes 8 weeks before her third baby was due. Rachel has described her discussions with obstetricians and midwives in some detail, rather than emphasising the birth itself, in the hope that this will help other women in the same situation.
Sorry this will be a bit of a long one because I want to include all the pre-labour advice I was given.
My first child was born in hospital and I had a pretty horrible time and was determined I would have a home birth next time round. I gave birth to my second son, Aidan, at home weighing 8lb 9oz and had a wonderful midwife who looked after me during pregnancy and delivered him. I was advised by consultants not to have hb because he was so big I was at risk of shoulders getting stuck. Thankfully I ignored them!
Third time around I had the same midwife looking after me and all was going well until I reached about 32 weeks and had glucose in my urine. I was therefore sent for GTT and I failed it with a level of 8.3 and here started the problems and "advice".
I was immediately placed under consultant care and at my first appt at hospital I was given a glucose testing kit and told to keep sugar levels below 5.5 in the morning and below 8 in the evening. I was told by a Registrar that I was not "allowed" a home birth and told me I was at risk of a bigger baby, increased bleeding and high blood pressure. I would also be placing baby under great risk because it may become hypoglycaemic and would need to be in hospital to have its blood sugar levels checked.
When I questioned her rationale (yes I dared to question her authority!) she could not give me any reasons for saying I was a increased risk of high blood pressure, all she kept repeating was that medicine is not an exact science and that she can not give me reasons. She told me that the baby was big and when I pointed out that she could not tell me the baby was big, she hadn't examined me, she hadn't looked at my notes and I had a small bump, she got quite cross with me! I left this appointment feeling very angry and told her I would see the main man the following week.
The next appointment I demanded to see the consultant and he told me that the baby was very big (it was measuring on the 97th centile) and I was at increased risk of ending up with a c section (60% risk!) there was an increased risk of mortality if I went over my due dates, they told me I would be induced at least 1 week early, there was no way they would "allow" me to go over my dates.
He told me I would be putting myself and baby at risk if I continued to want a home birth. He clearly could not understand that the thought of going to hospital was not doing anything for my stress levels. I eventually accepted his advice and agreed I would have a hospital birth.
I then continued to monitor my blood sugars etc and did my research. The pregnancy continued and I became more and more stressed out by the thought of a hospital birth to the point that I was having nightmares. My midwife had told me that,on arrival at hospital, I would be placed into the high tech room where they would probably encourage me to have an epidural because they would automatically place me on electronic monitoring and because I was "diabetic" I would be unlikely to deliver the baby naturally.
The next appointment with the consultant I was 38+5 and the Cons re-scanned me. The growth had evened out and baby wasn't looking too huge after all. Bearing in mind it was only 18 months since I'd had my second son, who was on the big side, I wasn't too worried anyway. I decided to question the consultant as I was still hoping I could have my homebirth. I explained that I had only put 1 stone on throughout my pregnancy, I did not have a big bump, I did not possess the true risk factors of a diabetic, no family history, I am white and I am not overweight. I had already had a large baby and my blood sugar levels were controlled, I had only gone over the limits set once. He would not, however, depart from his original advice and would not support a homebirth.
He did inform me thought that I was not really "gestational diabetic" I was more "glucose tolerance impaired". He then told me he would see me in 2 weeks time - by then I would be 40+5 - so a complete change then in policy.
The Friday before my due dates I had a long chat to my midwife and repeated all the things that I had told the consultant and she agreed to support me and put me back on the homebirth list - hooray - the weight on my shoulders eased. I got some great support from various homebirth websites.
I didn't tell anyone except my husband that I was now staying at home because I didn't want to have to justify my decision.
On my due date of 10th April at 2.30am my waters went whilst in bed and the contractions started pretty much straight away. I telephoned the hospital and they sent a midwife out who stayed all day.
The labour was pretty bad this time compared to the previous two as it was far more painful and I kept being sick. The second stage was very quick - two pushes and he was out. He eventually arrived at 11.50am weighing 7lb 13oz and I turned to find out the baby's sex - I did not want to be told. To my surprise he cried immediately - the other 2 had been quiet straight away.
I had a natural third stage and no stitches. Baby fed straight away and the midwives didn't bother to take his blood sugar levels (I was quite pleased as I didn't want this done anyway but given that this was a reason for me having to be in hospital seems pretty stupid)
Ciaran Luke has had no problems and I am presuming my 'gestational diabetes' has gone.
The long story hopefully gives anyone out there the confidence to question the consultants and listen to what your body is telling you. I have twice ignored consultants' advice and whilst I accept that there are some instances that mums should listen and go to hospital, these were not those times.
I went to the GP for my 6 week postnatal check and as he didn't mention it I asked if I should have a repeat GT test - he asked me why?!!!
I pointed out I had been under the care of the consultant and was being treated for gestational diabetes - he told me that my GTT in March was perfectly normal - it was 8.3 - apparently the WHO state between 8.9 and 12 is cause for concern - ie I would be borderline at these levels! He had marked on my records that the result was normal so if it was just down to him I would never have been referred to hospital care.
I asked him why the Cons had felt it necessary to put me through 8 weeks of hell for no reason and he started to back-track and said well perhaps they have changed the levels and perhaps the Cons has had previous experience of borderline woman having problems.
I am absolutely livid that they caused me so much stress and made me quite ill towards the end of the pregnancy - I agreed to sweeps even though I had made my mind up not to have them this time as they are pointless - I was so stressed I was having nightmares about hospital.
If any women want to contact me, I'm more than glad to assist. People helped me and I am more than happy to return the favour.
rachelsmith @ blueyonder.co.uk
Home Birth Stories
Gestational Diabetes - women who've been diagnosed with excess sugar in their urine, or 'failed'a Glucose Tolerance Test (GTT).
Big babies and homebirth
The Third Stage of Labour - what are your options, and the pros and cons of each?
Homebirth UK email group
Home Birth Reference Page