A Complicated Process: T1D and My Emergency C-Section
A lot to go over
There aren’t enough words in the world to cover everything about my diabetes and my pregnancy all in one go so I thought it best to write about one of the most important parts: the birth of my beautiful baby boy.
Nine months after the birth of my child, I’ve realized that for me, one of the key parts to giving birth with diabetes is control. This comes in many different forms: controlling your diabetes throughout your pregnancy, trying to control the variables in your labor, knowing when to let someone else be in control and keeping your cool when your control over the situation goes out of the window.
As part of my diabetes care, I was induced at 38 weeks. I knew that the process might be a long one, up to 10 days to bring my baby into the world. In reality, it took two!
During those two days, I had my blood sugar levels checked by the midwives every few hours. As the number would appear, they would often hold the testing machine towards me with a questioning look and say “Is that OK?” It was at this point that I knew that unlike my diabetes related antenatal appointments, I was the expert here and I had to take control of the situation. As the ensuing hours went on, I was in more and more pain and struggling to fully concentrate on my diabetes. After several hot baths and lots of support from my partner, Matt, I found a midwife and explained that I felt something wasn’t right. The usual ‘first time mum’ conversation followed; lots of talk about it being ‘normal’ and once I was dilated enough I’d be on my way to the labour ward. After a lengthy discussion about my diabetes and the pain being too much to handle, the midwife agreed to examine me. As we went to a private room, Matt and I had no idea what the next few hours would hold.
Change of plans
Cut to 30 minutes later, I was surrounded by two midwives, a student midwife and a doctor. My baby was footling breech and I had just signed the consent papers for an emergency C-section. My wonderful best friend is a doctor and a few days before I went into the hospital he had talked me through what to expect if I needed an emergency C-section. What followed from the moment the doctor confirmed the C-section was needed was the scariest twelve minutes of my life. Matt was rushed off into another room to change into scrubs and grab some clothes for the baby (which were still in the boot of the car!) and his phone to take pictures and most importantly my Libre remote to check my blood sugar (BG). I was lifted onto a wheelchair and rushed to the lift. When in the lift to the operating theatre, a midwife took our “last picture” of just the two of us. I look back at that photo now and see sheer terror in my eyes. The control I had planned to have over the birth of my baby, including the discussions I wanted to have about my birth plan, sliding insulin scales, change in basal rates after the birth, weren’t going to happen.
As I was wheeled down the corridor to the operating theatre, the anesthesiologist met me at the door. I was helped onto the operating table, and everyone had to stop while I had my last painful contraction and the spinal was administered. As they were laying me down, the incredibly quick two minute conversation about my diabetes was had. They taped my insulin pump next to my head and Matt had the remote to check my BG on my Libre. I asked whether they were going to put me on a sliding scale, whether there was an endocrine specialist in the room (there were about 20 people) and how they were going to check my blood sugar throughout. I was met with somewhat of a blank look and it was quickly decided that Matt would be checking my BG throughout the section, we were keeping my insulin pump on and in all honesty, I think all of us were just keeping our fingers crossed.
Around 15 minutes later at 2:20am, our beautiful little boy, Thomas Robert Clipson was born weighing 7lbs 15oz. Perfect in every way.
The nitty gritty
What people don’t discuss about C-sections is that getting the baby out is the quick part. After that, the doctors spent over an hour putting me back together again. I couldn’t have skin to skin straight away because the curtain was up to my chin as they needed as much space as possible to maneuver Thomas into the right position. I was also still acutely aware, as my little boy was placed next to my head, that I still had to be in control of my diabetes. Matt had to juggle holding a new born baby and scanning my Libre and as soon as the placenta was delivered, I had to instruct them how to change my basal profile back to my pre-pregnancy basal rate on my pump. I look back at this point of the delivery and I feel a little sadness. I couldn’t see my little boy properly, I couldn’t hold him, I couldn’t bond with him as I had planned. All of that was completely out of my control.
Eventually, the C-section was finished. I finally got to hold my baby boy and that moment that everyone talks about, when you see your baby and you fall completely head over heels in love, happened.
I have very few criticisms about the care I received on that day, quite the opposite in fact. The midwives, nurses and doctors were lovely and caring and both the midwife who had first realized Thomas was breech and the student midwife who was observing came to see me when they had finished their shift. The student midwife even came into the C-section with us and kept a running commentary for Matt to let him know what was happening and took our phones to take pictures of Thomas when he was first born. The anesthesiologist chatted to me throughout the whole operation, even when I was making no sense, just to keep me calm. Medical professionals have an already increasingly difficult job and in emergency situations like that, cannot be expected to be experts in every condition known to mankind.
My little boy didn’t come into the world as I had originally planned. There were times when my control of the situation went out the window and there were times that I felt like the only one in control. For other women with type 1 diabetes (T1D) who might be thinking about having a child, my advice would be to educate yourself as much as you can, prepare for the unexpected and sleep—because you won’t get much after the baby is born!
Learn more about pregnancy and diabetes.