04 Feb
Meeting with the Midwife: Appointment 4
Appointment number 4 was my one-hour glucose screening gestational diabetes test, a huge deal for me because really high numbers could mean a transfer out of Sarah’s care and the end of my home birth hopes. I spent hours reading up online on all kinds of opinions surrounding what could be done to achieve the best results possible. It wasn’t about cheating the test, it was about staying away from the edge if I was tiptoeing close to it. If I really had gestational diabetes and the baby was at risk I don’t think there is anything I can do to avoid a hospital birth, and at that point I wouldn’t want to. If baby isn’t processing insulin properly s/he needs medical care. But I do think that diet can have mild effect on test results and so for the weeks leading up to the test I worked extra hard to limit my carbs, which actually felt really nice after a Christmas season of indulgence. In the days before I went on extra long walks to burn off as much sucrose (or is it glucose? I always mix the two up) as possible and drank water like it was going out of style. I’ll never know whether or not my actions made a difference on the test results but the intense focus on diet, exercise, and hydration definitely had a positive influence on some of my overall habits so I’m glad I did it.
The night before the test I grabbed a few nuts each time I got up to go to the bathroom, in hopes that it would keep my levels from spiking when I ate breakfast in the morning. For breakfast ate 4 whole eggs and 2 slices of bacon (no dairy), and then right at 9:30 am I measured out a glass of apple juice equivalent to 50 grams of sugar (my math skills are so bad I had to have TH do the calculations for me!) and downed it right before I walked out the door. My drive to the birth center was about 30 minutes, my appointment was about 30, and at 10:30 am she got the needle out and drew my blood. One reason I love Sarah? She *rocks* at drawing blood. The needle she uses is tiny, she gets the vein on the first try every time, and she’s lightning fast. I got a bit dizzy after it was over so it was a good thing I had a Larabar in my purse. Though I hate having my blood drawn I don’t usually get lightheaded like that. Another anomaly I can chalk up to the strange state known as pregnancy?
My appointment was on a Thursday and on Friday evening I texted her to find out if she knew the results yet. Her reply of “All is well” made my weekend! And it meant I could make my friend a birthday cake (that Clementine cake I posted last week) without feeling guilty that baby and I were struggling with each fingerful of batter I grabbed. Now that I’ve passed the gauntlet I let myself have some toast with my eggs in the morning, or a bowl of cereal. It feels like quite an indulgence after days and days of only bacon and eggs!
Pregnancy overall has still been really easy for me, so I didn’t have much else to talk about. I mentioned the redness in my legs in an earlier post, which I thought was a rash, but a doctor friend of mine took a look and unofficially diagnosed it as vascular changes from being pregnant, possibly from my uterus pressing on my pelvic vessels. If I elevate my legs, two minutes after putting them up my awful looking stumps turn fair and smooth once again. It’s really amazing actually! I have some swelling in my calves/feet each night but I’m still wearing my engagement ring so it hasn’t extended to my upper body at all. My blood pressure is still looking great, 97/70 and baby’s heart was thumping firmly at 144 bpm. I used the little strip to test all of my different levels and my consistently elevated leukocytes have Sarah a little worried. I’m going to pick up some cranberry pills and try to increase my water intake even more. I feel like I always have a mug in hand and straw to my lips already!
The most exciting thing about this appointment? My weight gain has slowed. FINALLY. My average has been close to 2 lbs/week throughout my pregnancy, but in the three weeks between appointment 3 and appointment 4 I only gained 3 lbs, and my home scale confirms that I’ve stayed at a similar pace since then. Early in my pregnancy I went through periods where I felt sick if I wasn’t eating constantly (or what felt like constantly) so I know my caloric intake has naturally decreased. My diet hasn’t changed although I have been working to make time spent walking a regular occurrence during my week.
I still haven’t had the Rhogam shot because That Husband still hasn’t had time to get his blood tested. Sarah was fine with me choosing to delay it, or not even get it at all if that’s what we want. If TH tests RH-Positive I’m going to get the shot for sure, but I don’t want it otherwise. I hope he can get the time to have his blood drawn within the next week. After that, my last big hurdle is pre-ecclampsia. As long as my blood pressure stays in an acceptable range I should be able to welcome baby into the world in our living room come April!
Also:
I'm a farm-raised almost-crunchy stroller-pushing picture-taking lifestyle-blog-writing gastronomy-obsessed divine-seeking thrift-store-combing cheese-inhaling pavement-pounding laughter-sprinkling lover of individuality and taking chances.
Always great to hear good news!
It’s funny how many little things change with your body and what it can do when you’re pregnant - you get so “used to” being pregnant after awhile that you forget *that’s* why you can’t walk through Costco without collapsing, where normally (when not pregnant) you don’t even worry about that!
1I’m so glad that “All is Well”! What a great feeling! I’m glad that you mentioned the RH test because I was thinking of that and wondered if he had done that. I hope you don’t have to get the shot. Sounds like this has been a great month for you. : )
2YAY! I can only imagine how excited you were to get those results! I’m curious about the rhogam, do they make a mercury free version now? Are they all mercury free or do you have to specifically request it?
Jenna Reply:
February 12th, 2010 at 6:50 pm
So far I’ve been able to figure out that the FDA realized that mercury is a bad, bad idea for babies and so Thimerasol has been removed from everything except the seasonal flu shot. BUT they still have to use some type of preservative for those multi-dose vials, and that’s what I’ll be asking about with all shots. We want single dose, even if we have to pay for it ourselves.
Here’s hoping TH has a Rh negative blood type as well! My hubby has an Rh positive blood type, so I had to get the shot. But it’s really not a big deal. I’m very much for natural birth and natural living and so on and so forth, but I am grateful for the Rhogam shot- 40 years ago women with negative blood types suffered a lot more miscarriages and stillbirths than we do now.
4So I’ll only say this with caution and a deep breath because it’s something so close and dear to our family: get the shot if you don’t know. My dear MIL suffered needlessly through 9 miscarriages and my husband was cheated as an only child due to his sister’s stillbirth… all because this shot didn’t exist. She had no way of knowing this was the case and can only be thankful that women today have the choice not to live through the suffering that she did.
5I love these posts because the pregnancy appointments are a complete mystery to me. Its nice to get a preview with your entries.
Are you going to give us a “here’s where the magic will happen” post with pictures of your living room? I am so curious what will be done to “prepare” the space! Will you have certain music playing at home?
Jenna Reply:
February 12th, 2010 at 6:53 pm
I do want to give a “home tour” before baby comes anyway (because I’d like to have a record of the different spaces we lived in over our life!) so you will certainly see our space from that. I’m still trying to decide if I’m a candle person or not, and I’ll have music playing but probably through my speakers as I tend to like to play it really loud when I like to focus (like when I exercise).
Congrats on the positive appointment!
7Do you think trying to trick the test into giving you the results you want is a little dangerous? Maybe I’m not fully understanding the way the test works (I’ve never been pregnant before)? It seems to me that you would want to continue eating how you normally eat so that you get an honest result? You mentioned that after a week of good eating you went back to carbs again. Do you feel this was the best choice to make for the baby or are you so concerned about having the baby at home you’re making dangerous choices?
Tabby Reply:
February 4th, 2010 at 1:41 pm
I hope I’m not overstepping bounds here, but this was more than rude. I have GD. (I was only slightly overweight, worked out and ate right, so it was a big shock.). To say that eating bread and some desserts is a dangerous choice, shows you don’t understand this. First, the GD diet includes carbs and some sugar as this is how your body gets energy. I have to eat some form of carbs (45g) at every meal and at least 20g for snacks. I can even have dessert as long as it fits in ( I avoid them so I won’t want them, but that is my choice). I am being treated by a midwife, and being closely monitored. There is no reason to transfer out of her care as Iong as I keep things under control and have the correct amount of weight gain.
Also, you can’t really “cheat” the test. I did the exact same things Jenna did in the weeks leading up, but mine came back positive. (Though I did take the regular test; fasting, sugar drink, then blood work and that could make a difference since other foods aide in the way your body uses the sugar.)
it comes down to this; if her midwife is monitoring her and is not concerned, then you shouldn’t be either.
Tanne Reply:
February 4th, 2010 at 3:47 pm
Cool your heels! I was talking about it not sounding like the best idea to eat no carbs. no sugars for a week to get a good result and then resume “normal” eating again once the test was over. I’m assuming that it would be the best idea to take the test while you’re eating the same as you always do.
Tabby Reply:
February 4th, 2010 at 7:22 pm
Sorry, didn’t mean to be rude. But I had just read that after someone told me I shouldn’t be eating strawberries (really a half cup of plain strawberries, crazy people) or I was going to hurt my baby. So I was already a little frustrated.
You are correct, you should take the test eating as normal, but making a small change isn’t going to effect anything. I was eating very well before I took the test, and had been for awhile, but it didn’t matter; my body simply isn’t using its insulin correctly.
Again, sorry if I sounded rude.
Lauren Reply:
February 4th, 2010 at 4:02 pm
You can’t really “cheat” the test anyway. You consume a measured amount of sugar and then they test the amount of glucose (sugar) in your blood one hour later. If your amount is greater than 135mg/dl that means that your body not able to take the sugar in your blood (from the food that you eat) and put it where it belongs - in your cells to be broken down into energy - because your body cells are not responding to insulin. Insulin takes the sugar in your blood and carries it into your cells. High levels of sugar means insulin resistance. Either you are insulin resistant (diabetic) or you are not.
Eating carbs and then not eating carbs will eventually lower your resistance to insulin, but this is not an overnight change - it takes weeks and months.
A lot of women try to “cheat” the test by eating/not eating a certain way before, but this doesn’t really work, so if it makes you feel better to have some more control, what’s the harm?
Tanne Reply:
February 4th, 2010 at 4:08 pm
I didn’t fully understand the test. Thank you for explaining it Lauren. I apologize Jenna for sounding so harsh with my comment. I just was REALLY shocked to think you were manipulating the test.
Glad to hear that things are going well
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