Wednesday, 19 December 2012
Boys boys it's a sweet thing
I'm taking a break from ranting about feminism to begin ranting about pregnancy and labour again!
I'm almost 28 weeks pregnant and have just discovered that I have gestational diabetes.
If you're not aware, the amount of glucose in your blood is controlled by insulin, a hormone. During pregnancy, 5/100 women have higher levels of glucose in their blood and their body cannot produce enough insulin, so the level of glucose rises.
I am not obese, do not have a genetic pre-disposition towards diabetes and am told that there is nothing that has "caused" this, it just sometimes happens. I won't suffer any symptoms, and indeed would never have even known that I had it, had I not been given a glucose tolerance test just to check. They estimate that a lot of women develop gestational diabetes and never know any different.
The glucose tolerance test involves fasting from midnight (water is allowed) and then having your blood taken at 8:30am. You drink a glucose drink and then 2 hours later your blood is taken again. Ideally you should measure 7.5 but I measured around 10 which meant that I definitely had gestational diabetes.
Ordinarily gestational diabetes can be controlled with diet alone, but I was sent to the diabetes clinic today where I met with a dietician (who established that I have an excellent diet) and then handed me over to a nurse who explained that I am to keep a 7 day food diary and check my blood sugar with a finger-prick kit 4 times a day. I have to measure my blood sugar when I wake up in the morning, then an hour after breakfast, an hour after lunch and an hour after dinner. If I'm eating all the right things for a week and yet my blood sugar is still above 7.5, then I will need to be put on insulin for the remainder of my pregnancy.
I also met with an obstetrician who explained a lot of things that I already knew - such as gestational diabetes makes the likelihood of: macrosomia (essentially developing a giant baby) very high, the likelihood of developing preecclampsia (an extremely serious, life-threatening blood pressure disorder which can cause seizures, strokes, multiple organ failure and death for the pregnant woman or child) very high and the likelihood of having a stillborn child, or a child with respiratory problems very high.
She also explained that I am to be booked in for an induced labour at 38 weeks.
Now here comes my rant. As you all know from my previous blog on labour preferences, I believe in natural labour without interventions unless they are medically necessary. Since the dawn of time, women have given birth without fear or pain relief - if you are fit and healthy in body and mind and allow nature and gravity to take its course then you will be able to birth and breastfeed your child without issue.
The position you adopt (upright or on all fours) can make your labour progress faster and with minimal discomfort. Look at animals or women in other cultures - no muss, no fuss.
The depiction of labour in the Western media as being a huge, dramatic and traumatic ordeal with lots of blood and screaming and agony is only a reality because we make it so. Yes some births absolutely require medical intervention and medical intervention saves lives... but for the most part, I think the education we receive about labour and breastfeeding in this country is absolutely shocking.
Whether you choose to breast or bottle feed is absolutely your own business, but for a person who wishes to breastfeed, there are a lot of technical issues that can prevent this from being possible. The major impact of most birth interventions such as inductions, pain relief, c-sections and the skin-to-skin bonding factor after birth make breastfeeding extremely challenging, if not impossible. And for women who are able to breastfeed, but told by a midwife or health visitor that their baby is losing weight and they should discontinue feeding... many of them are completely unaware that the IV fluids they are given during labour cause the baby to weigh much heavier than it actually is, and that their baby is not losing weight and there is nothing whatsoever wrong with their breast milk.
I will have an ultrasound scan every 2 weeks between now and the birth to monitor the growth of Starchild.
At 38 weeks, if I have not gone into labour naturally (37 weeks+ is considered full term, and I would never wish for a premature baby, but in this case if he's measuring higher than his gestational age, this is a very sensible thing for me to wish for so that I can have the birth experience that I want!), then I will go to hospital for a membrane sweep and to have my waters broken for me.
The ideal (but highly unlikely) situation is that my body will say "OOOH! NOW I NEED TO GO INTO LABOUR!" and things will progress naturally. If so, then I will be the happiest woman in the world.
If not, once the waters are broken there is no going back because it presents a risk of infection and foetal distress, so I will be given pitocin and IV fluids to induce my labour artificially. I will be hooked up to a monitor and asked to lay down on a bed - the least effective position to labour in for most women - which will make the likelihood of me not coping with the pain that they are essentially causing me to endure and needing an epidural to be very high.
If my body doesn't respond then I’ll have to have a c-section.
The implications of being given IV fluids (aside from artificially increasing the birth weight of the baby) are that my nipples will be distorted and Starchild won't be able to latch on and feed, that Starchild will be stuffed full of fluids and won't be interested in latching on and feeding... and then that sets the entire process up for failure. If by some miracle I am able to express colostrum prior to being induced, then I can at least give him this so if my milk then doesn't come in and I can't breastfeed, then he still gets that boost to his immune system.
The implications of being given an epidural are that the baby will be too drugged to be capable of feeding.
The implications of a c-section are that my body will not recognise that labour has taken place, and my milk will not come in, or that the baby is disrupted by not recognising that labour has taken place and possibly not given adequate skin-to-skin bonding afterwards that will encourage him to latch on and feed.
Procedures I challenged, with no satisfactory explanation from the NHS Obstetrician for why they were enforcing them:
Why would I still be induced at 38 weeks if the baby is not measuring too big for his gestational age?
Why would I be given IV fluids if petocin is not necessary and I am not actually dehydrated?
Why do they recommend that women lay down on the monitor to make it easier for them to examine me when they admitted that it was absolutely unnecessary for me to not be in an upright position?
From here, despite there being a metric fuckton to worry about, I aim to cease worrying.
It seems that there is nothing I can do to change the situation I am in, and I certainly can't improve matters by worrying about it. I am going to continue with my research and do everything I can to ensure that I minimise interventions without putting myself or Starchild at risk. So think positive thoughts people, and for goodness sake don't listen to everything the NHS tell you. Take responsibility for your body and understand the impact that the different processes and procedures will have. There is a huge difference between procedure that is convenient for the people caring for you, and interventions that are legitimately necessary.
Ziggy played guitarrrrrraaaaarrrrraaaarrrrrr.
Title: Sweet Thing by David Bowie