Questioni just want to no how nessesery a c section is if u have type 1 diabetes an if natural childbirth is possible
AnswerA c-section is not necessary at all just for diabetes. Indications for a c-section include preeclampsia, placenta previa, placental abruption, cord prolapse, uterine rupture, true cephalopelvic disproportion (only in cases where the pelvis has been fractured or the mother suffers from rickets), transverse lie, uterine infection, active herpes, and fetal distress. Conditions that do not require a c-section are diabetes, postdates pregnancy, ultrasound diagnosis of big baby, low amniotic fluid at term, slow labor (usually labeled "failure to progress" or "CPD"), water being broken for more than 24 hours, breech baby, and history of prior c-section.
The most important thing you can do is to keep very, very strict control of your sugars. Check yourself 12 times a day if you need to; I know it's not fun, I've done it myself, but if that's what it takes, you do it. All of the problems and complications that cause doctors to think of diabetes as needing a c-section stem from uncontrolled blood sugar. High blood sugars in the mother lead to macrosomia (very big babies), placenta deterioration, and severe hypoglycemia in the newborn, and can lead to diabetes later in life for your baby. But if you can keep your blood sugars under tight control, and you can prove this to your doctor with a record of tests, there is absolutely no reason for you to be treated any differently than any non-diabetic mother.
Check out the Brewer diet at www.blueribbonbaby.org. This diet can prevent preeclampsia, which is its biggest claim to fame, but it is also an excellent diabetic diet. Modify it if you need to, but make sure you get in 2 eggs and a minimum of 80g of protein every day; this is the most important part for preventing preeclampsia.
You should know that controlling your blood sugar will be more difficult during pregnancy. The growing fetus will affect your body's utilization of glucose and insulin. During the first trimester, you will have a tendency to require less insulin. During the third trimester, you will need more. This is why it is so important to do many fingersticks, every day. Maintaining tight control during pregnancy will require constant readjustment of your diet and your insulin doses. Keep in close contact with your endocrinologist. Ask if metformin (Glucophage) is a possibility for you; this medication is safe during pregnancy and may help stabilize your sugar and minimize the effect of pregnancy.
Natural childbirth is definitely possible. You may have difficulty finding a midwife, since diabetes generally places you in the "high risk" category, but if you're interested, check around. You might find one willing to take you on as long as your sugars are under control. If not, and you're in the hospital, remember that the doctors work for you, not you for them. They are providing you a service, and you always have the right to decline interventions. Make sure you eat during labor, to keep up your energy and stabilize your blood sugars. Don't allow an automatic IV, and be leary of accepting any pitocin or even an epidural. Any intervention that you get has the potential to interfere with your blood sugar, and when you're running a marathon (that is what labor and birth are to your body), this can affect your ability to finish. Do your research ahead of time so you will be prepared, and make sure that anything your doctor does besides stand aside and watch is absolutely medically necessary, not just protocol or impatience.
Good luck!
