26. Dear Aunty Natal, I just want some parts of this to feel normal…

It’s an interesting word, one that provokes thoughts of the majority and something that doesn’t stand out, but what exactly is normal when it comes to delivering a baby when you have Type 1 Diabetes? You’ll still be told you can choose where you have your baby and asked about what interventions you are and aren’t willing to have, you can choose between a vaginal or cesarean section delivery. There will be plenty of talk about normalising the experience as much as possible with regards to lighting and room set up and having your choice of music etc, but not many of those conversations, in my experience so far include discussions about what you, as the mum-to-be will possibly be feeling further down the line about the type of birth you’re advised to have because you have Type 1 Diabetes. If it’s something that’s weighing on your mind, then you’re of course encouraged to discuss it at any point during your pregnancy, but you might find you don’t feel sufficiently empowered or even informed to lead that discussion. For me it happened when we attended an antenatal class, ours was run by NCT but there are other options that could be on offer in your local area.

I feel that some of the decisions I made early on in my pregnancy have paid dividends in terms of allowing me some semblance of normalcy, and the ability to feel that, for the most part, my pregnancy has been about Moomin and I, not always my T1D and as a result, for the most part pregnancy has been incredible. It’s allowed me to not feel exempt from conversations with other mums to be or new mums, which before I was pregnant I feared could be the case. It’s also given me the headspace to just enjoy being pregnant, even those not so pleasant pregnancy symptoms and niggles; because my body is doing something incredible. All those times I’ve thought of my body as broken because of my T1D, I’d never paid much attention to the bits that aren’t “broken” and it’s a pretty amazing realisation. Ironically, the way I achieved this was by choosing to have my antenatal care solely with the Diabetes Ante Natal Clinic with no community midwives involved. Yes, I’ve had more appointments, but it’s less than I would have experienced if I’d had a “shared” care plan. It’s also meant I’ve avoided seeing someone who perhaps doesn’t know an awful lot about Type 1 Diabetes, it was frustrating enough at my booking in appointment where the midwife voiced many common misconeptions which held relevance to Type 2 Diabetes or Gestational Diabetes, because at that moment I’d become Mumma Bear who needed to ensure any risks to my baby were minimised, I also didn’t want to have to spend my pregnancy correcting Healthcare Professionals, I’d have to do it enough with people who knew nothing of any type of Diabetes as it was. At our NCT class in March, the course leader asked me if she should get some different snacks because “perhaps biscuits and fruit might not be very helpful in managing my BG’s?”. Firstly, I have to say how much I appreciated her asking in this way, the language she used wasn’t assuming I can’t, she was trying to accommodate me which was hugely refreshing for someone who didn’t know much about Type 1 Diabetes. I have a go-to response when people ask what I can and can’t eat:

“As long as I can access the carb content of something, or get close to guessing it, I’m able to give myself insulin to enable me to eat anything I want. With my insulin pump, I can basically make my body do what yours does.”

By the end of the course, the final part of that statement was; to my surprise, used to empower me and reduce some anxieties I was having about giving birth; “I can basically make my body do what yours does”. As you can imagine, that had a pretty profound effect on me and made me question the birth choices I had accepted as my only choice very early on in my pregnancy. My primary concern is still and always will be getting Moomin here as safely as possible, with me in one piece at the end of it too, but now I’m thinking more about the individual elements that make up the 3 stages of labour and what might be best for Moomin, Matt and I; both in those moments and in the long run. Additionally, I think I feel so lucky that I haven’t felt being pregnant with Type 1 Diabetes singled me out from any other pregnant woman, that now, as we approach the final furlong I just want to find a way to normalise those final moments of my pregnancy.

The current plan is for me to be induced somewhere between 37 and 39 weeks. I am completely ok with this, I understand the reasoning for it and that it gives Moomin the best chance of a good start in this world, and I have been comfortable with this as a plan since I pee’d on a stick in September 2017. I have also tried to remain realistic about this being a situation which cannot be controlled, and that whatever my wishes or plans, things may need to change to make sure Moomin and I get through this ok. What I became anxious and reluctant about was spending upwards of 24 hours, in the early stages of labour on a ward with 3 other mums to be nearby. No ability to climb in the bath when I want, distract myself with some Netflix binge-watching or a snooze in my own bed, to feel like I was exposed when at my most vulnerable and to be somewhat forced to share one of the most precious and profound moments I’ll ever experience as a woman; with a group of strangers who’d possibly be feeling exactly the same way. I also feared that Matt would be sent home when visiting hours came to a close and I wasn’t in active labour; we live around an hour away from the hospital and I was petrified that if things started progressing quickly, Matt wouldn’t be there when our Moomin arrived in this world. None of these had been things I’d thought about in great detail until we attended NCT. on the second day of the course, I spoke to our course leader about these concerns, mostly hoping she would know more about the hospital and could advise a little from experience. She wasn’t able to help from that perspective, but by day three she told me about some different options for induction which may be available to me. She explained that my statement “I can basically make my body do what yours does” had made her wonder why I couldn’t explore some alternatives. So, feeling empowered I had the discussions with my team, knowing the likelihood of some of what I was asking for wouldn’t be possible and therefore a little apprehensive; but armed with the mentality that “my body can do what yours does”, I plucked up the courage and began a conversation.

As expected, not all of what I was asking is possible, but I am massively reassured, my concerns have been turned into a plan and the date has been set – the weather even looks favourable. Ultimately though, I feel I’ve been able to create something that feels a little less clinical when I think ahead than it would have done if I hadn’t asked, something that still feels wonderfully scary but more comfortably so without the extraneous concerns, and not a chance Matt will miss a thing. I feel like that’s another win for normalising as much of pregnancy with T1D as possible.



Images are copyright of the Author and courtesy of Google Images.

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