This afternoon I had my much anticipated OB appointment. A couple of weeks ago I was reluctant to go, but I was pleasantly surprised. I've had this biased and unfavorable opinion of OBs based on nothing at all, just what I've heard about American OBs. What is the difference? Well, this is Canada so while some practices may be similar I am, ultimately, in a different country and our OBs (and hospitals) are likely to practice a little differently as well (i.e. different policies/protocol on c-sections). I don't know why I've had it in my head that all OBs practice like pretentious, old school doctors from the 50's who ride on this high horse declaring, "I'm the doctor so what I say goes!". My OB is young, apparently boho in style, and has a pleasant bedside manner. She was not all what I expected. If I saw her on the street in passing the last thing I would ever think she does for a living is practice as an MD, let alone an OBGYN. So I'm pleased with her to say the least and she made it clear that she knows that her involvement is only due to the fact that my midwives' college requires it. She said everything is fine and she'll just be taking a back seat. I'm still in the hands of midwives.
The appointment was pretty straight forward. I met with a resident first who collected history and asked about my blood sugar numbers and how much insulin I'm taking. Neither of them seemed concerned in the least. I'm sure the amount of insulin I'm taking is minimal compared to some women they've seen. She checked my weight, blood pressure (kind of high 135/82 or something like that, but that's also typical for end of third trimester), fundal height (36 cm. One cm ahead, but considered normal), and my personal favorite, urine. Man, will I ever be glad to never pee in a cup or on a dipstick again for a long time. Anyway I checked out just fine. Everything was normal. The resident said that my referring midwife is the very same who delivered her own baby. I thought it was a little ironic that an OB resident had a midwife deliver her baby. Small world, anyway.
After all that my I met with my actual OB, the boho chick
I liked her right off the bat. She said some very important things that I needed to hear. It is very apparent now after three weeks of being on insulin that my diabetes is in fact getting worse as time goes on and that insulin is very necessary. However she said it's a sign that the placenta is growing and working properly since it's the hormones from the placenta that are causing the GD in the first place and making it worse. So in way, it's good that I need insulin and that my dosage seems to always be increasing. She also said that even though induction would be seriously considered so that I don't go past my due date, I'm still calling the shots for my delivery and there is no reason for me to not have a normal vaginal birth. She believes I'm in good hands at my midwifery.
I asked her about the induction thing and I told her straight up that I wasn't into having an IV induction with Oxytocin. She said I can decline an induction and wait to go naturally and during that time I would have to go for NSTs to keep an eye on the baby and make sure she's okay. She said there are other things that can be done to encourage labor to start like sweeping of the membranes and such, which I am all game for. I will try anything to avoid an IV induction, which can make labor more painful, longer and lead to a higher risk of C-section. So I'm happy with her answer. I'm not going to be forced to do anything, but I need to keep my own head in the game to keep my baby girl safe. Her safety is the most important thing and I can't let my own stubbornness get in the way of that.
The other thing I asked her about was her position. It's suspected that she's breech still. OB said that normally babies are in a head down position by now, but there are things that can be done to try to help her flip if she doesn't. It's not uncommon for babies, even first timers, to wait until the last minute so there is still time. My ultrasound on Friday will give everyone involved a solid answer which way she's sitting. It would be a great surprise to find out she is in fact head down and I've been seeing her bum bulging this whole time. If I find out she's head down I'm going out that very same day and buying a birthing ball so I can help her drop. If she is breech then I'll have to wait and see what my midwife says at my next appointment. I think, out of all of this, anything were to send me in for a c-section it would be her breech position rather than the fact that I'm diabetic. But I think in that regard I can still wait for labor to start naturally rather than scheduling it. At least my body and baby would be telling me it's time rather than removing her when it's not. At least that's how I would prefer it to go. Scheduling a C-section would only make me more nervous I think. I don't need to know when her birthday is going to be.
Anyway, peace of mind has been achieved. I feel so much better. Now I'm just looking forward to my ultrasound. I'll get to find out how big she is, how much she weighs, what position she's in, how my amniotic fluid levels are doing, and how much hair she's got. I really want to know the last one for no particular reason other than curiosity, lol.
I'm realizing that I'm panicking for no reason. With a new perspective put on my GD, I'm just going to relax. I want to enjoy these last weeks, rest up, get some gentle exercise to prepare myself, and, the hardest of all, exercise some patience. I'm in good hands.