Choosing a Good Obstetrician When You Have Type One Diabetesfeatured
There are some definite benefits to being pregnant the second time around… One of the big ones is knowing what to look for in a good OB (obstetrician).
What I’ve learned is the result of literally choosing unwisely and not being an advocate for myself when preggo with Golden Top.
Here are the top 5 things to look for in an OB:
1. Ask about their Experience with Type One Diabetes
It may seem obvious but you really should know whether you’re OB has past experience with type one. A diabetes nurse told me this with Golden Top, but I didn’t take it seriously.
I did ask but I was okay with his wishy-washy answer of: “yeah, I have some but that’s why I’ll send you to see an endo at the hospital.”
Translation: I don’t need to know much about your diabetes, that’s someone else’s job.
If you hear something like that, then you may have an OB from the dark ages.
Why is this so important if you’re seeing an endo at the hospital?
Here’s the difference:
With my first OB I was told: “Because you have diabetes you will be induced by 38 weeks.”
With my current OB, yes a different one this time around, he said on the first visit (after reviewing in detail my endo reports and A1Cs):
“You’re blood sugars are excellent, there’s no reason that you couldn’t go to 39 or 40 weeks.”
This was a HUGE relief!
I have a serious pet peeve with health care providers who like to shove all people with diabetes into one big statistic… And usually it ain’t a pretty one…
You know who I mean – the doctors who scorn at an A1C of 6.5%…
Do you have any clue what it takes to get an A1C of 6.5? No. So be quiet.
And one last point…
Make sure they understand the difference between type one, type two, and gestational diabetes. These are unique diseases with unique challenges. The more your OB understand this, the better and more specific they can take care of you.
2. Inquire into whether you can use an Insulin Pump during Delivery
I delivered in a prehistoric hospital with my first babe… Using an insulin pump during delivery was out of the question.
Because the endo said so.
No judgement towards you if you want to use an IV during delivery. I was reassured with the thought of having a nurse do my diabetes work for me while I, well… labored.
I pictured myself on a bit of a diabetes vacation (but with really crummy weather, since my son was born in the middle of a snowy February).
In reality though, I was frustrated many a times during the labour by not having management of my sugars.
And I should’ve trusted my instinct since my sugar sky rocketed up to 11 mmol/l (198 mg/dl) by the end of the delivery, mostly because my sugars were only monitored every 4 hours. (Yeah… crazy, right?)
I’ve now learned that many hospitals check every hour during active labor.
The other downside with the IV, was that it really restricted my movement… and I truly believe it’s better for the progression of labour to be able to move around.
My current OB is a-okay with me using a pump. In fact, he kinda looked at me like… What else would you do? Loving this OB.
3. Do some Background Checks on your OB :)
Everyone does it now a days, so no guilty conscience.
Look up your OB on sites like Rate your MD.
I instantly ruled out OBs by looking up reviews. I didn’t wait for my family doctor to tell me who’d be delivering this baby…. I told her. And she was completely cool with this, I saved her time actually.
A funny fact: I looked up and reviewed every OB at the hospital I’m delivering at… Psstttt… There were some really badly reviewed OBs out there. So glad I won’t be with one of them :)
4. Look into Wireless Monitoring
This point has more to do with the hospital you’re delivering in.
Check to see if they have wireless monitoring of the baby. This allows you to be able to walk around while they still are able to keep track of baby.
If the hospital doesn’t have this, then just be aware that, because you will be labelled as “high risk”, they will want you connected to a monitor that will require you to be immobilized in bed.
I hated that.
I wanted to walk around and use good positioning to encourage labor and baby positioning. Instead, I was confined to a bed. And no surprise, Golden Top’s head was tilted, making delivery harder.
At my current hospital, they’re invested in wireless monitoring. I will be able to have a bath, walk the floors and use a birthing ball. All of which will encourage a more efficient and effective labor.
5. Consider having a Midwife in a Supportive Role
Few women in Canada know that our healthcare system allows a high risk mother to be paired with an OB for primary care and a Midwife in a supportive role.
I discovered this late in my first pregnancy after being rejected by one Midwife practice, because I was too “high risk”.
Thankfully, I discovered a local Midwife clinic that has the following motto: Every women deserves a Midwife.
The model of care and accessibility of midwives is different from an OB.
I can call my midwife at anytime of the day with urgent concerns. My appointments are 30 minutes and very patient-centred… so I can ask the midwife all the questions I don’t have answered by the OB.
What kind of pain management options are there?
What kind of things can I do to encourage labor without the need for induction?
My midwife was even more helpful after Golden Top was born. She came right to the hospital and to our home to help with breastfeeding and to check on my adjustment to motherhood.
When I was diagnosed with mastitis 6 weeks after our son was born, I was seen on Easter Monday and given antibiotics by my midwife, when everything else was closed.
Women with type one diabetes are denied enough when pregnant. I cannot tell you how many times I’ve had to resist desserts and even healthy carbohydrate option – like a big bowl of fruit – because it wasn’t best at that moment.
But we should not be declined supportive and holistic care just because we have a crummy disease, we never chose.
Pregnant with Type One Diabetes?
Have any other tips to share about choosing a good OB?
I look forward to learning from you in the comments below!