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Vaginal Birth After Caesarean & Gestational Diabetes on 152 units of Insulin

Birth of Andreas- 28 November 2013

For this birth I desperately wanted to experience a natural birth. I am 37 years old and knew that this would probably be my last child. I had a caesarean birth with my first child, which was truly unnecessary.

My first Pregnancy & Birth

I was diagnosed with gestational diabetes halfway through my first pregnancy. Initially the diabetes was diet controlled but it was not long before I had to be on insulin to control my blood sugar. My blood sugar levels were perfectly controlled with 90 units of insulin per day towards the end of my first pregnancy and I did not have any other complications. As I reached 38 weeks the obstetrician told me that I will need to be induced because of the gestational diabetes and that my baby is too big. I trusted my care providers believing they would know best and accepted the decision to get induced.

After a few doses of gel that were applied to my cervix there were no signs of labour. My cervix did not open at all and I barely had contractions. The induction failed and I signed the consent form for a caesarean birth. Poppi, my first child, was admitted to the special care nursery straight after birth because she had low blood sugars. She was put on a Glucose drip as I refused formula. Poppi’s weight was 3780gr and nowhere near as ‘big’ as the ultrasound had predicted.

My second Pregnancy

This time round I had done a lot more research and employed an independent midwife. I was considering having a home birth. But I was diagnosed again with gestational diabetes half way through my pregnancy and started planning for a hospital birth.

Towards the end of this pregnancy I was on 152 units of Insulin per day. I reached 38 weeks and was pressured into scheduling an induction of labour with comments like ‘your baby can die’. I asked the doctor what the true statistical risk is of the baby dying but nobody was able to give me that answer.

I did put my foot down and really fought for a natural birth. I knew that an induction would be more complicated this time due to the scar on my uterus from my previous caesarean birth. I declined an induction and told the doctor that I believe in the ability of my body to give birth naturally, in my body’s own time and when my baby is ready to be born. I agreed to all the frequent monitoring that was suggested to me. The many CTG’s and ultrasounds were all normal.

41 weeks…

At 41 weeks I felt some period like pains during the day and my labour started spontaneously! I had some painful and irregular contractions for most of the day and they continued overnight. I rang my midwife overnight and she came for a visit to reassure me and to check that everything is well. My cervix was 3cm open when my midwife checked in the morning. My midwife left as my labour was not established yet. I was doing just fine and my midwife had planned to visit me again around lunchtime. But things just slowed down and because of this I told my midwife not to return yet.

I had decided to stay in my home as long as I possibly could, because I was worried that in the hospital I would not be given enough time to dilate and that this might be cause for unnecessary interventions. I was comfortable in my own environment with my midwife on ‘stand-by’ if I needed support. I was so happy that I could move around freely, without strangers trying to check up on me regularly and a CTG belt around my belly. I was wearing a TENS machine to cope with the labour pain, I was in my own world just concentrating on myself and didn’t even want to be touched or spoken to by my own husband.

IMG_0573 (2)

Established Labour & Birth

Suddenly at 5pm my waters broke and labour got a lot stronger, so strong that the contractions virtually did not stop anymore. I felt that it would not be long now before the birth. I had a sore hip, could hardly move and it was peak hour traffic so after speaking to my midwife we decided it is time to go to hospital and we called an ambulance. My midwife met us at the ambulance bay of the hospital and 10 min after arrival at the hospital I gave birth vaginally to our beautiful son Andreas Costa, an indescribable moment!

After birth the paediatric doctor checked Andreas over and everything was fine. I gave Andreas his first breastfeed very soon after the birth because I was aware that his blood sugars could drop and that he might have to go to the special care nursery. I really did not want Andreas to go to the nursery, I wanted him to stay close with me.

During my pregnancy my midwife had prepared me for the possibility that his blood sugars might drop very low because I was on so much insulin and recommended that I start expressing my own breast milk. I started expressing from 35 weeks of pregnancy and by the time he was born I had collected and frozen 200mls of my own milk! My husband took the breast milk with us to hospital. Andreas’ blood sugar levels were mostly good with breastfeeding only but I did use some of my breast milk that I expressed before birth. Andreas always stayed with me and never got admitted to the nursery. Andreas weight 3700gr.

IMG_06422 days after birth we got discharged home from the hospital and we are both doing very well. No complications – healthy boy, healthy and very happy mum!



This article has 2 comments

  1. Congratulations on a fantastic experience and such an empowering account of your decisions and birth. An inspiration to others.

  2. Thank you for your article – it’s so comforting just on 20 weeks and my fasting levels are out of control. I’m going to have a vbac and want to avoid as much intervention as possible unfortunately I don’t have a private midwife as I can’t afford it. I’m hoping to get a doula or a student midwife to support.
    Thanks for the article it is informative and comforting

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