# what to expect



## Akasha (Dec 17, 2012)

So. 9 and a bit weeks pregnant. 
I have had my initial appointment with the midwife at the doctors, and been booked in for the 12 week scan. 
I have been seen by my normal DSN, who filled out my other notes for higher monitoring. 

However, could any one give a hint towards what i'm expecting appointment and care. 

Thanks

*Ps. I am aware that all docs and hospitals work differently so may not get the same as others.


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## chelle2183 (Dec 17, 2012)

Hi congratulations like you say it depends where you are.

Im 22 weeks pregnant and attend an clinic run by a consultant who specialises in diabetic pregnancy. At each appt i see her, a dsn and a midwife. Ive been going since i was 6 weeks generally u get scanned at 8 weeks though i realise you are too late for this 12 weeks, 20 weeks then growth scans at their choice im going to be 28,32,34 and 36 weeks i think. Appointment wise generally every 2 weeks ive been tho it depends on how your control is??


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## chelle2183 (Dec 17, 2012)

Sorry just noticed ur hba1c so your control is good, i started round about the same but they still wanted me tighter so im 5.7 now


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## Akasha (Dec 17, 2012)

I had been trying to get my HBa1c down so that when we did start for a family in a few years time it would be easier.

My DSN said that they couldn't do much for me untill they had teh referal from the docs. Docs are as slow as snails. Plus with christmas in the way... 

I am trying to get my HBa1c down to the tighter control of between 3.5 an 5.5 pre meal and no higher then 7 after meals. Its certainly a learning curve. 
I'm managing to stay mostly below 7 with teh occasional spike.


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## chelle2183 (Dec 17, 2012)

Thats really good  i still struggle sumtimes tho im runing low just now, its hard in the 1st trimester with the sickness n hormones its easier to spike.


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## trophywench (Dec 17, 2012)

How about reminding doc?  Tell him the fact you've missed your early scan is making you anxious; say whatever you like LOL until you know for a fact everythings been done!

You should also get a retinopathy scan every trimester, may or may not get many more A1cs than usual, and are you on/have you been on high-dose folic acid?


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## Akasha (Dec 17, 2012)

Yep. Started taking the 5mg folic acid tablets the day i found out. 

Honestly, I didn't know about early scans untill mentioned above...

I nudged the Hospital on Friday as referal was sent on 6th Dec. Just the waiting game now. And with christmas looming I doubt anything is going to hapen before the new year. 

*Touch wood* No sickness. The lows are really getting me down.


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## chelle2183 (Dec 17, 2012)

Yes i trophywench you wld think id have remebered the retinal scans mines are requested at my atental clinic. My hba1c is taken once a month by my clinic.

Where in the uk are u? Im up in lanarkshire in scotland and the midwife at my doctors called while i was there and got me an appointment fot the next week (its on every monday) seems like a long time ur having to wait!

This is my 2nd and the set up of the clinic has changed a little but with my 1st i was brougt in quickly too, if theres anything i can help to answer let me know


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## Lizzzie (Dec 19, 2012)

Hi

I'm on my second and I was surprised not to get an early scan this time around. Questioned it with the midwives so much that they eventually called the consultant, who said they don't do them in my area as they don't find them useful. So areas are def different! - but always do the asking if you're not sure. The first time I asked my GP if I needed to be on folic acid 5mg he said no, but luckily he's open minded enough that when I called and asked him to check the next day, he did and then prescribed some.

However I did have a DSN available on the phone from day one, helping with my control, and visited her at least once before 1st scan.

At my clinic, I usually get scanned (well, when one's due), see a midwife, 
nutritionist, DSN and obstetrician. It's usually a lo-o-ng boring afternoon of waiting, so take a good book.


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## Monkey (Dec 19, 2012)

Get hold of the NICE guidelines for starters - they're on the NICE website - and that'll give you an idea of what's recommended.

As for what actually happens, my two pregnancies have been fairly similar. First time, I'd not been under pre-conception care so wasn't seen by the diabetes team til 12w. Scans at 12, 20 (detailed fetal heart included), 28, 34 and weekly of amniotic fluid levels and placental health from then til delivery. Saw diabetes consultant and obs fortnightly-ish from 12w. 

This time, I was scanned much earlier. Saw the diabetes MW the day after I  called to say I was pregnant, and was scanned at 7, 9 and 13 weeks, then 19, 28 and 34. Weekly from next week, which'll be 35. Similar pattern for seeing consultant too. Monthly hba1c. Retinal assessment in each trimester. 

I've also seen my community mw, altho being a 2nd timer, not as much as I did first time. They're still important, imo, for discussing the more general bits of pregnancy / labour / feedingn / new baby stuff.

Hope that's vaguely useful!


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## Cate (Dec 20, 2012)

My stuff is all done at the hospital, I don't see any community MWs at all (no access to them either).  I saw the GP at 6ish weeks and got referred, viability scan at 7 weeks but due to bleeding not diabetes (covered both though!).  First clinic appt at 8 weeks, fortnightly from then.  Booking at about 11 weeks, blood tests inc A1c.  Nuchal scan at 13+5 weeks.  Eye check with the other hospital.  More clinics (BP & wee check, then see DSN, MW, consultants).

From now (am 16+ weeks) there'll be the 20 week scan in mid-Jan, plus a seperate fetal echo cardiogram that they send me to the larger hospital for.  Expecting scans at 28, 32, 34, 36 weeks and delivery by ELCS sometime between 36-38 weeks (I asked the consultant this week, that's what she thinks will happen anyway!).  Eye check in each trimester, A1c done each trimester too.  Anti-D given at 28 weeks as I'm rh neg.  I presume I'll get swabbed for group b strep at some point too, as I was +ve for it when DS was delivered.

I would say:
a) take out a permit for your hospital car park 
b) get a pile of good books/mags/something to while away time in waiting rooms.


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## Akasha (Dec 21, 2012)

I'm based in the west midlands. 
NICE guidelines sounds like a good idea to look at. Thanks for that. 

I currently have a scan booked on 11th Jan. Booked by midwife at doctors. This is my standard 12 week one. 
Phoned the hospital to check what on earth was going on and was told I would find out at my apt on 15th Jan. (Which I hadn't been told of prior to the phonecall) 
Not helpful. 

I have been told that My hosp put all diabetic's onto CGM at least 3 times in pregnancy. I had the first at 6/7 weeks (When I found out) and am booked in for the second in March (Around 21 weeks I think)


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## Emzi (Dec 27, 2012)

Hi Im 6 weeks pregnant on Sunday and I saw my Pregnancy team 2 weeks ago when I was 4 weeks as I found out very early. I found out on a thursday night, phoned the diabetic nurse on the friday morning and had an appointment at the diabetic pregnancy clinic on the following wednesday so very quick turn around, I met my team of 6 - had about a 2 hour appointment. they made me my next appointment for 2 weeks and also a scan at 6 weeks which I am due to go for on the 31st - New Years Eve. So I have been really impressed with the care I have received so far. they gave me loads of leaflets and all my pregnancy notes, took blood from me and did a variety of tests etc and I have all my teams numbers so if I have any queries I can call any of them. I am waiting for a call from my midwife at the gps but part from that I only have 4 days left til my first scan, my viability scan  so all my fingers and toes are crossed that everything is fine because im nervous and not sure what to expect.


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