Third trimester: everything gets harder
After that so-called ‘glowing’ stage of pregnancy, the third trimester swiftly arrives. And if diabetes with pregnancy was difficult up to this point, then be prepared for an even steeper, uphill climb.
Let’s recap. The first trimester brought all the initial fears and anxieties about facing the next nine months. Then there were the hypos, the well-disguised hypos amid all the increased thirst, excessive weeing and general feelings of lethargy. The second trimester brought more hypos, an ever-growing bump, then the insulin requirements start to change and that frequently mentioned ‘insulin-resistance’ starts to kick in.
And now the third trimester. It seems like overnight my body has just decided to resist all current basal rates and bolus ratios of insulin. The frequent yo-yo effect of blood sugars being high then low is exhausting, especially now the bump is bigger and rounder than it’s ever been. The extra weight to carry is draining, that tiredness that plagued you in the first trimester returns with a vengeance. Hypos suddenly bring headaches that last for days and that tiredness is quadrupled as your heavier, bigger body tries to cope with episodes of low sugar and therefore no energy. And then there is the fast approaching D-day.
Labour is now a word you need to start thinking about. Type one diabetic women go no further than 38 weeks, and I recently asked my midwife about this decision. I thought it was based primarily on the findings from the 28, 31, 34 and 37 week scan. However, it would appear that this is a national standard; after 38 weeks, statistics and data has shown that the risk of stillbirth is much greater, as is a difficult labour and birth. So, women with type one diabetes do not reach 40 weeks. I’ve read that you can challenge this and discuss it, that the national health standards are guidelines to a certain extent, and individualising cases is not unheard of. The fact of the matter is, would you want to go against the grain?
The way I feel right now, the thought of being induced and having this baby earlier is music to my ears. The third trimester is incredibly hard. The shorter it is, then the better I say! I’m being asked about birth plans and whether I intend to breast feed, and whilst I have some opinion on these matters it does all seem rather superfluous to make decisions now. Who knows what will happen come week 37! I don’t feel that I am able to make these decisions; I feel that diabetes ultimately will dictate how these next few weeks will go. They are ultimately out of my hands. Yes, managing my diabetes has become an impossible task.
Type one diabetes and pregnancy is so tough. And I’m not making a fuss over nothing here. I am not one to shy away from a challenge. But this is the most challenging thing I’ve ever had to deal with, both physically and mentally. And I’ve managed my diabetes through a number of physical endurance challenges in my ten years of being diabetic. I’ve pedalled through 90 days of cycling 90km a day for a charity challenge! That was easy in comparison to this. And it’s because there is so much more at stake. There’s more than one body on the line.
One of the most frustrating aspects now is what the exterior Helen looks like in comparison to the internal one that no one can really see. Everyone keeps telling me how well I look, ‘radiant’ in fact, ‘gorgeous’, and ‘blooming’ to re-use a number of adjectives people have thrown at me. But it is like living my very own version of Oscar Wilde’s A Picture of Dorian Gray. Inside is the real portrait, scarred and hideous with all the torment brought by managing type one diabetes through pregnancy etched into my skin. And it is ugly.
Tiredness doesn’t help my strength, or my confidence, or my positivity. Instead it buddies up very nicely with doubt, anxiety and fear. I doubt my insulin pump; I’m anxious that the current state of my blood sugars are determining a terrible fate for labour and birth; and that in turn makes me more afraid than ever, especially now the birthday is closer. Again, it’s not the pregnancy side of things that affect me. It’s diabetes. I’ve been continually kicked all night and all day; the baby does not stop moving! My lower back is bothersome, my hips are sore no matter what way I sleep, and my breasts occasionally have sharp stinging pains…but none of that bothers me. In fact it’s all for a wonderful reason.
But I can’t apply the same outlook to diabetes. It is my nemesis. It was with me before pregnancy, and it will be with me after.
Yes, Type one diabetes with pregnancy is incredibly hard. And as bleak as this message is, it is the resounding one I leave you with. For now.