About 3 weeks ago, I went through the fun glucose tolerance and challenge tests and found out that I do have gestational diabetes again. I have been following the diet and exercise regime that I did with Evelyn pretty much to the T with this one - but my glucose readings have been all over the place. Which likely explains the baby growing so quickly. Late last week, my endocrinologist put me on an insulin pill to help control my blood sugar. Hopefully that will help bring my numbers back into the ranges that they should be.
At my appointment with my OB today, other than confirming that I'm carrying a sweet little chubbers, I've been labeled as high-risk because of the largeness of the baby and having to be on insulin to control my GD. I learned that blood sugar is toxic to the placenta (which is crazy, because it's the placenta that develops GD in pregnant women). The problem with this is that if your blood sugar is not controlled, it basically kills the placenta and the baby can not get the oxygen that she needs. Because of these, I now will go in for weekly tests to be sure my placenta is healthy enough to sustain the baby in utero. The main test is a biophysical profile, which can take anywhere from 15 minutes to an hour depending on how the baby responds. A biophysical profile (BPP) begins as an ultrasound where they measure the baby's heart rate, activity level, breathing movements, muscle tone, and the amount of amniotic fluid. Each of these 5 indices are rated on a scale from 0-2 to give a number from 0-10 indicative of the baby's well-being. A normal score is between 8-10, between 6-8 requires a non-stress test to follow-up the BPP results, and anything below 6 basically is an alarm to induce soon for the baby's health.
I will go in every week until 39 weeks to complete this test. Thanks to ObamaCare, I can not induce before 39 weeks unless there is a medical necessity. As my OB put it, apparently he went to medical school in his free time and knows more than I do. If my score drops to the non-normal level, that would be reason to induce earlier than 39 weeks.
The hardest part of this for me is that my risk for a cesarean is pretty high now, and that's something I really do not want to do. I am hopeful that now that we are controlling my blood sugar with the insulin, that her growth will level-off a little and allow me to still deliver vaginally. If she sticks to the half a pound a week plan from here to 39 weeks, I'll be right at the 9.5 pounds that my OB says is where she will start to consider cesarean a necessity for the safety of the baby. I'm praying that she will slow some and stay in the 8 pound range on the ultrasound measure (which was totally off for Evelyn...she measured 9.5 pounds the day before I delivered, and was 8.5). They will measure her every two weeks during the BPP test.
All-in-all I am needing peace, mostly over the cesarean issue. While it won't be the best experience ever, I can join the "I delivered a 10 pound baby club", and I am happy that my OB has one of the lowest cesarean rates in our area. Praying that I will experience God's peace and remember the authority I have, in Christ, to remind my body what it was designed to do. There are times when my faith is strong, but also time when I am fearful.
On the up-side, I get to see our sweet girl every week from now until I deliver!
Here are some specific things I am praying for, I'd love for you to join me:
- No cesarean
- Safe, vaginal, delivery (I'm not opposed to using an epidural if needed)
- That my gestational diabetes will stay under control
- That baby girl will slow her growth enough to allow me to deliver vaginally
- That my placenta will stay healthy and provide the oxygen that she needs while she finishes cooking those internal organs of hers
- Peace of mind - resulting from a deeper knowledge of God and His provision
- My doctor, Dr. Nowitzky, that she will have wisdom to know what care is best