By: Nicole Johnson
On January 7, 2006, I gave birth to a beautiful baby girl named Ava Grace Baker. She was 8.4 pounds and 20.25 inches long. It took 30 hours, but it was worth every moment. Well, almost every moment.
The downside: I am no longer making my own insulin. The upside: I have learned more than I could have ever imagined about health advocacy, the power of the patient’s voice and the value of education. I also learned, again, that with diabetes anything is possible if you are in good control.
‘Scared Out of My Mind’
To say that I was anxious about the delivery would be an understatement. I was scared out of my mind. Even though I had read scores of books about the process, I still didn’t quite know what to expect, and in reality, nothing could have totally prepared me for the experience.
I was most concerned about how my diabetes would be managed and if the little one I was carrying would be safe from severe hypoglycemia upon birth.
The labor started easily enough. My water broke at around 1:00 a.m., during a routine trip to the bathroom. To be honest, I wasn’t even sure it was my water breaking. There weren’t any contractions or any other signals that delivery was close. My husband and I concluded that we would be best served trying to get a little rest and going to the hospital in the morning.
But within hours we were on our way—nervous, excited, antsy.
Keeping the Pump On
The first few hours at the hospital went smoothly. Check-in was a breeze. Confirmation of labor—easy. Monitoring—everything looked good, and I was even dilated a little. The hospital staff thought that I might have the baby by early evening.
The greatest gift of the labor process came in those first few hours when my obstetrician suggested that I keep wearing my pump. He said, “It has worked for you for nine months, lets just keep at it.” I was shocked. I had been prepared for an IV drip of regular insulin and glucose. The hospital had forewarned me that their protocol was to control the diabetes through an IV, not with a pump. I had fought for months for the opportunity to be a part of the decision-making process, sometimes hitting a brick wall. Now that gentle advocacy was paying off. My husband and I could hardly believe our ears. We simply agreed, “Makes sense to us!”
A few hours later, my doctor returned during a routine glucose check and said to the nursing staff, “Why are you using the hospital meter to test her blood sugar? Why not just let her use her meter? It has worked well for her for nine months.” Again, my husband and I were shocked.
Again, we agreed. I had been checking my blood glucose hourly with my meter, anyway, and had been reporting the numbers to the care team. I didn’t like having only two-hour glucose readings, as was the hospital protocol.
What I Learned
Hours came and went. An epidural was administered. Blood glucose levels were monitored. Basal rates were lowered. Food was withheld. Through it all, my diabetes control was perfect and the hospital experience, a dream. My glucose never went above 132; the baby’s blood glucose was 88 at birth. Although the labor took 30 hours, it seemed like moments, and our reward was the beautiful baby girl wrapped in blankets, lying on my chest at 6:29 a.m.
When the process began—nine months earlier—I didn’t know what to think. As the pounds piled on and the baby grew, I was terrified. At times the intensity of my diabetes care overwhelmed me: an average of 12 glucose checks a day and more than double the amount of insulin I used before pregnancy. I worried about every little thing and was convinced that my diabetes was somehow going to harm this little girl. But I pressed on, worked hard, learned much and demonstrated my capability to my healthcare team. It all paid off.
Today, we know that Ava has the lowest-risk gene for getting type 1 diabetes. (Her genetic makeup was looked at for the TRIGR study on breastfeeding and type 1, which we participated in.) And I have a pregnancy success story, something I wasn’t sure was possible.
It is all a blessing beyond measure, and now there is one more reason to fight for every moment I can suck out of this life.
Nicole’s Numbers During Labor
|January 6, 2006|
|12:30 pm||75 mg/dl|
|1:30 pm||50 mg/dl|
|2:30 pm||95 mg/dl|
|3:30 pm||132 mg/dl|
|5:00 pm||98 mg/dl|
|6:30 pm||75 mg/dl|
|7:15 pm||105 mg/dl|
|8:15 pm||88 mg/dl|
|9:15 pm||68 mg/dl|
|10:15 pm||67 mg/dl|
|10:45 pm||72 mg/dl|
|January 7, 2006|
|12:00 am||76 mg/dl|
|12:30 am||80 mg/dl|
|1:30 am||85 mg/dl|
|2:30 am||89 mg/dl|
|3:30 am||93 mg/dl|
|4:30 am||91 mg/dl|
|5:30 am||95 mg/dl|
|6:30 am (Delivery)||119 mg/dl|
|9:30 am||130 mg/dl|