I had been advised by a nurse educator, who was familiar with pumping during birth, to leave my pump on during a caesarean with the basal running at half the normal level. However my endo told me that the anaesthetist would probably want me to "turn it off" due to fear of me going "hypo" during the operation. She said she did prefer the pump to be off. So I took it off just before the operation.
My bsls rose slightly to around 8.0 or 9.0 by the end of the procedure (I tested my bsls in the recovery room). I didn't put the pump back on for some hours after the caesar, mainly due to my mind being on other things (!) and also because my endocrinologist felt I would either not need insulin at all for a couple of days or need just a small amount.
I remember that my blood sugar levels did rise considerably by the early afternoon so in retrospect I believe that I should have left my pump on, with just a very small basal.
Guidelines for pumping during labour and caesareans
I was the first person using an insulin pump to give birth at the hospital I went to, and so there were no real guidelines in place for it. 'Diabetic births' generally involved continuous insulin and glucose infusion to allow for fine tuning of blood glucose levels during birth. Important so that the baby's blood sugar levels would be stable, and less likely to be hypoglycaemic in the hours after the birth.
I mentioned to my endocrinologist early on that I wanted to stay on the pump during the birth, no matter what type of birth it ended up being. He was happy to support me but confided that he would feel more confident with being able to control my sugar levels if I was on an IV infusion.
So in many ways I had to take control of the situation myself and remember really wishing there were some published guidelines I could refer my health professionals to.Posted by M.A. at March 03, 2004 08:17 AM