Another Half-Way Point?

Twenty-One weeks, and this is a pretty big week. We have our standard fetal anomaly scan, to check for a host of potential developmental problems with the baby. And then next week we will also have a more detailed and specialist fetal echocardiogram, to look closely at the structure and function of Flangelina’s heart. Both of these scans are nerve wracking, because I’ve had it drummed in to me that babies born to mothers with diabetes are at increased risk of birth defects and congenital health problems. The heart scan is being performed specifically because of the increased risks associated with my type 1 diabetes and anti-convulsant medication.

Half-way thorugh this pregnancy, I’m so bonded with our baby, I honestly don’t know how I’d cope if something were to be wrong. I’m hoping that is something I don’t have to find out.

And about that half-way thing again: The half-way point of pregnancy really is ill-defined. Here I am at 21 weeks and I feel as though I’m actually properly half way now. This week marks 17 weeks since the pink line. It also is quite possibly about 17 weeks until baby Flangelina will be making their appearance in to the world, thanks to the generally accepted policy of inducing labour at 38 weeks in diabetic mothers.

I’m still not sure how I feel about the idea of being induced early. On the one hand, I don’t see much good evidence – in a scientific sense – for it.  The clearly defined risks are related to difficulties in delivery with macrosomic (big) babies and, more importantly, the placental function tending to decline faster in women with diabetes leading to an increased risk of stillbirth – a horror I can’t even begin to contemplate. The problem is, because early induction is so widespread, there is very little clinical evidence of what happens if you wait to 40 weeks, or longer, instead.  But who is going to sanction a study where diabetic mothers are encouraged to wait to 42 weeks just to see what happens? Who’d take the risk, or be able to defend it ethically?

So why am I contemplating taking just that risk with our much wanted baby? I suppose because my control has been so good that my average blood sugars across the pregnancy so far are in non-diabetic ranges. And induction itself also carries risks – most specifically an increased risk of instrumental delivery or caesarean section. And if there is one thing that I want to avoid, it’s a c-section (more on this later). If you’d asked me before I was pregnant I would have been adamant that, if my control was good and tests detected no issues with me or the baby, I’d wait to 40 weeks.

Now? Now I’m impatient. I want to meet the baby. But I also want this to be over – so I know that they’re safe. It’s hard to be told about a risk of the placenta degrading and increased rates of stillbirth among diabetics without worrying. I have a feeling that come 38 weeks I’ll be begging them to get the baby out.

17 weeks time. It feels like an eternity.

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