Because Brenden was born by C-section, Jonathan is going to be a scheduled C-section as well. This means that I really don’t need to have a full birth plan – go to the hospital, make sure I can’t feel anything, and pull out a baby is pretty much all I am taking with me. But I’m getting lots of emails about setting one up from the baby websites, and after reading through several online, here is my “perfect world” birth plan. Feel free to read the sarcasm dripping from this post:

BEFORE LABOR:
-if I show up at the hospital and I’m not truly in active labor, please allow me to return home without laughing at me. Sending some happy drugs with me would be a nice touch as well.

DURING LABOR:
– Only my doctor, nurse, husband, and anyone I deem worthy will be allowed in the room during labor. I will set a secret password and give it out as I see fit. Anyone else that does not have the secret password will be thrown out immediately.
-Unless said person without the secret password has more happy drugs. Then they can come in.
– I will have two doulas, preferably large scandinavian women named Helga or Olga. One for me, one for the baby. If the best treatment plans conflict, the doulas will arm wrestle to decide who wins.
-I will manage my pain without the use of narcotics or an epidural. My pain management techniques include inflicting pain on others, so a steady stream of strangers and a hammer will be required. Feel free to use annoying family members of other patients.
-I will be allowed to move freely during labor. Including going to the bathroom, the hallway, or Chili’s if needed.
-Only intermittent fetal monitoring will be allowed. In fact, the only fetal monitoring will be my nurse being allowed to yell “baby, baby, are you ok?” at my hoo-ha on an hourly basis.
-In order to promote a peaceful birthing environ, I request that the lights be dimmed, the other patients in labor be told to be quiet, and that a string quartet be playing in my room. Yo-Yo Ma is preferred, but if he’s busy, find someone else.
-I do not want to be induced, but the doulas will be allowed to do a “come out baby” dance and sacrifice a small animal of their choice.
-Birthing equipment I will require: a birthing ball, a rocking chair, a jacuzzi tub, a swingset, and a stripper pole.
-Before any medical intervention is done, the doulas will be allowed to do the “get better baby” dance and sacrifice a larger animal. Please provide a sheep, calf, or goat.
– If a c-section becomes medically necessary, and by medically necessary I mean I’m yelling “I’m not doing this anymore, cut the baby out now!”, please knock me out completely and wake me up when my child is going to college.

AFTER BIRTH:
-Please place my child on me as soon as possible after birth, but make sure that all that yucky white crud is removed first. Gross!
-I plan on breastfeeding, so do not give my child formula, bottles, or pacifiers while in the hospital. In fact, please remove all bottles, formula, and pacifiers from the hospital. I will provide a picture of my breasts to hang over the nursery bed so that it is all he sees.
-Please keep all family members away from our room for the first 24 hours. Please kick everyone else out of the hospital for us to promote bonding.
-We would like to room in with our child. In order to help socialization, we would also like to room in with someone else’s child as well. If this is not possible, I am willing to have my bed moved to the nursery.
-No medical treatment shall be performed upon our child. At all. Ever. If vitamin C doesn’t fix it, nothing will.
-Once the child is born, I will require an epidural. For at least the next two years.

Now, just in case you don’t know me well enough to know how silly I’m being, please know that I think it is VERY helpful to research all your options before going into labor. But those moms that get it in their head that they are going to do it ONLY THIS WAY may end up very disappointed when all is said and done because you never know what’s going to happen! Babies have a way of changing all our plans, even after they are born, so learning to go with the flow is a life long battle. Hopefully Jonathan is ok with my simple plan for this time!

Ok, some of you have been asking lots of questions about this GD stuff, so I thought I’d do a little Gestational Diabetes lesson. Before now, I didn’t really know much about Diabetes in general, except for a little I’ve learned from some friends that have a daughter with it. If you really want some great info – they have a fabulous website that I’d link to, but I don’t know how. 🙂 But you can get to it from the “Come on in, the senility is fine” link under friends on the right.

Anyway, there is a really big misconception when you hear “diabetes” that it’s all about not eating sugar. That’s a part of it, but the main thing you are trying to do is control ALL carbs you take in. Gestational diabetes occurs when your body starts putting out a lot more prego hormones than your insulin levels can handle. Insulin is what breaks down carbs into energy. The hormones from pregnancy start interfering with insulin, so your pancreas starts making more. If it can’t keep up, sometimes your pancreas will basically say “screw it, I’ll catch up with you when that darn placenta is gone” and you end up with Gestational Diabetes.

This means that you’ve got WAY too much sugar just running loose in your body, and not enough insulin to turn it into something useful. So, your body does what it can to cope – it hands all the excess over to the baby. Baby’s little pancreas can handle quite a lot, so it’s pumping insulin like crazy, turning all that extra sugar into fat, and insulin acts as a growth hormone, too, so you end up with a super chunky little linebacker of a baby if nothing is done to control the blood sugar levels.

So, most people think that means the easiest way to fix it would be to get rid of all sugar and carbs, right? Stick to an Adkins diet and you’ll be fine, right? Wrong. You still need some carbs for energy, and the baby needs A LOT of energy to grow. Cutting out all the carbs sends your body into fat burning mode, which is a little bit dangerous for the baby – when you burn fat, you make this chemical called ketones, which makes everything a little acidic. Babies don’t like acidic environments.

So, how do you control Gestational Diabetes? It has to do with the amount, timing, and type of carbs you take in. I can have 30-45 grams of carbs per meal, with 30 gram carb snacks in between. Yep, that means I’m actually eating more than before, it’s just different. Along with the carbs, you have to include protein, so that the carbs/sugar doesn’t hit your system all at once. Complicated yet? Let’s add another level. In order to help your body out, no one serving of carbs can be more than 15 grams. So, if you have to choose between a cookie that has 45 grams of carbs in it, and 3 cookies at 15 grams each, you need to go with the 3 cookies. (By the way, if anybody sees such magical cookies, let me know.)

Confused yet? Now, add in the glycemic index. This is a chart that rates foods based on how quickly your body absorbs the carbs in them. So you want to eat low glycemic index foods. For example, when picking a veggie, corn is not a good choice because it is a high glycemic index food – corn is a whole lot of sugars! But surprisingly, a sweet potato is low on the chart, so it’s a better choice!

This isn’t stuff I’ve had to memorize – I’ve got two great dieticians helping me through this process, and they’ve given me a lot of paperwork. Plus, each person is different, and their body handles things differently, so part of all this has been trial and error. For example, I’ve found that I can’t have a lot of any type of beans – that sends my blood sugar levels too high. But, a small cup of ice cream is fine if I’ve eaten a pretty high protein meal before it. Who knew?

For me, my typical day looks like this: I get up, and test for ketones. The goal is to not have any, because that means I’m not losing weight. Then I test my blood sugar with a glucose monitor (that’s the finger prick thing) to see what it did overnight. The diabetes doc wants that number to be under 90, while my OB/Gyn wants it under 105. Most of the time it is, but for a while there it started creeping up.

I eat breakfast (30 carbs and a protein) and then test 2 hours later. This number needs to be under 120. Then I have a snack. Then lunch (45 carbs), and test 2 hours later. Then a snack. Then dinner (45 carbs), and test 2 hours later. Then a snack before bed. See a pattern?

My numbers were doing fairly well, but the dinner and morning one kept creeping up, and when I could get them do go down, I was having high ketones the following morning. The docs said this was common, since the prego hormones start changing and pumping out more as you get closer to the end of pregnancy. So they put me on insulin. I actually broke down and cried in the office because I was freaked out by this, but it’s not that bad. I have two types of insulin – one fast acting, and one long acting. Both come in pens with tiny little needles that don’t even hurt. And this is giving me a little more freedom with what I eat, since I can go a little bit over and still be ok.

While all of this seems super complicated, I know in the end it will be worth it. I’m just ready for the end to be here! If you have questions, or want to see all the new gadgets I carry around with me, just ask! I don’t mind talking about any of it, and hopefully you’ve learned a bit through this post. Please continue to pray for this pregnancy, my sanity, and discipline – Christmastime is carb loaded! 🙂