Modern Health Care

I've been busting my butt managing my gestational diabetic diet and exercise regimen, only to find that I'm having sugar readings above the University of Michigan cutoff for what's acceptable. Which is around ten points lower than the Merck cutoff for GD.

Last week my diabetic counselor offered to relieve my stress by putting me on insulin. Less meal planning, more flexibility with what and when to eat. Sounds great, no?

The little detail that was not mentioned (and I don't fully blame the diabetic health care folks for not mentioning this) is that if I am on insulin my primary care provider would no longer be a midwife but a regular obstetritian.

I almost typed "a mere obstetrician." Such are my strong feelings about being cared for by a midwife. I can't tell you how important it is for me to be in the care of a woman who understands that birth is a normal event, not a medical condition to be managed.

I do believe there are plenty of wonderful OB's out there. I worked with one last year during my miscarriage. Hopefully he can consult with me soon about these slightly elevated sugar levels and what actually constitutes risk to the baby and to me.

Another interesting fact about GD and insulin use: I would not be able to deliver in the birthing center's standard rooms, but would be put on a wing with the other "high-risk" births. No birthing tubs, smaller rooms (although pretty darn nice).

Oh - lest I forget to mention that my health care provider may decide to induce labor around 39-40 weeks, and would certainly be interested in not allowing me to go beyond my due date. Due dates are an estimated figure, so I've heard. Any OB worth their salt would be interested in fetal measurement and my weight gain rather than an arbitrary date.

All of these possible interventions. Certainly not part of my birth plan.

I'm in the information gathering stage right now, having gone through the freaking out stage and then the crying stage for a couple of hours last week.

I am thankful to be so carefully monitored and managed, all said. But sometimes I wonder about the medicalization of childbirth and its connection to legal liability and the needs of insurance companies. Altogether it's a learning process, and part of what I'm learning is to think about this in the way my wonderful midwife framed it:

"I also find it helpful to remember that this is the baby's birth and this little wise one is creating these circumstances for her own particular learning. We all can do our best to shape the experiences- but she's calling the shots!"

(Already this kid's running my life...ha!)