Pregnancy diary: week 29 – midwife appointment and glucose tolerance test

After our lovely holiday, it’s been hard to get back into the reality of everyday life this week. I felt like I had a good rest, but I guess going back to work and having to do all the usual stuff around the flat have been difficult because I had a nice week without them. I think this is probably partly due to being pregnant, and being more tired than usual anyway. Some people talk about ‘blooming’ in these weeks (about 20-30), but I can’t really say that I feel like I’m blooming. ‘Growing’, yes, but ‘blooming’ suggests something much more positive to me. Not that I want to give the impression that it’s awful being pregnant, it’s just that I don’t think I’m enjoying it as much as some mums say they do. Now that I’m generally not feeling too sick (just in the evenings before bed when I’m really tired, and when I smell food cooking), things are a lot better than before 20 weeks. But still I get tired, I think mainly due to having a toddler to run around after, because I’m sure I feel more tired this time than last!

As I said last week, I was supposed to have a 28-week appointment with the midwife and have my glucose tolerance test last week, but this was impossible as we were a few hundred miles away! So I had these appointments a week late – not that it has to be so precise anyway. You might be wondering what a glucose tolerance test (GTT) is. In our area, all pregnant mums are offered a GTT at about 28 weeks of pregnancy. As far as I can see from some googling, it’s not the same in all parts of the country – in some areas, only ‘at-risk’ mums are tested. At risk of what though? A GTT is used to diagnose gestational diabetes, by checking how your body regulates its blood sugar (glucose) level. Gestational diabetes results when a pregnant mum’s pancreas doesn’t produce enough of the hormone insulin to properly regulate her blood sugar level, when it needs to produce extra to the normal amount once the baby is growing rapidly in the second trimester. If it is left undiagnosed or untreated, both mum and baby are more at risk of complications, a major one being that baby can grow very large and this can cause problems with a natural birth. The condition is usually treated by managing the mum’s diet (including eating less sugar), or, in some cases, insulin injections.

Even if I wasn’t offered this test routinely, I’d probably be offered it anyway, as I have a family history of diabetes. My dad has had diabetes since he was 30, and my mum had gestational diabetes. Thankfully, this is the only factor of increased likelihood of gestational diabetes that I have. Others include: a BMI of over 30; previously given birth to a large baby (9.9 lbs or more); previously had gestational diabetes; family origin with a higher prevalence of diabetes, e.g. South Asian, Middle Eastern, African-Caribbean.

This test is slightly more complicated than the other routine blood tests that I had in early pregnancy. It involved drinking 273ml (precisely!) of Lucozade, and then waiting 1 hour without eating or drinking anything (except water). After this hour, the nurse took a sample of my blood in the usual way (vein in the arm) and sent it off to be analysed. I’m pretty sure this is only the second time in my life that I’ve drunk Lucozade! The first was my GTT when pregnant with Andrew. I can’t stand sweet drinks, and it wasn’t a particularly pleasant experience having to drink it all in one go. But I managed it, and hopefully I won’t have to do it again in this pregnancy.

Wearing my new, very comfy trousers that I got for my birthday. Bump looks like it's growing more week by week now.

Conveniently, I managed to get the nurse appointment for the blood test directly before my midwife appointment. According to the NHS ‘Pregnancy’ book, my midwife should do the following at this check-up: use a tape to measure the size of my uterus; measure my blood pressure and test my urine for protein; offer more blood screening tests; offer my first anti-D treatment if my blood type is rhesus negative. As my blood type is rhesus positive, the last one wasn’t applicable, and also I don’t think I or baby are particularly at risk of other conditions or complications that would be screened for, so I wasn’t offered any more screening tests. The midwife did measure my bump – 28cm, which is bang on the average size for 29 weeks, according to the graph that’s in my notes (I love a good graph, as you’ve probably seen from previous posts). Whilst I was lying on the examination table she also used a little machine to listen to baby’s heartbeat (a probe a bit like the ultrasound scans, but sound only, not pictures), which was 150 beats per minute – that might sound fast, but it’s a good healthy speed for a baby in the womb. My blood pressure and urine were also fine.

We had a chat about various general things, like how I’m feeling and what life is like at the moment being pregnant, working and looking after a toddler. I guess it’s the midwife’s job to tell me to rest whenever I can, but still be active enough. I’d like to think I’m getting a good balance where possible! The topic of where I’d like to give birth also came up, again. She seems very keen on home births. I can understand that as my first labour, which took place in a midwfie-led birth centre rather than the main maternity hospital, was pretty fast and uncomplicated, I’m a good candidate for a home birth this time. I’m still not entirely sold on this prospect, but as I said to her, my current thinking is that I’ll plan to go into the birth centre again, but if it looks like baby is coming even faster than last time, I would probably prefer to stay at home, because I’d rather have a home birth than a ‘car birth’! She gave me a leaflet on home birth, and when I get chance, I’ll sit down and read it properly – from a quick glance I can see that it tells us the kind of things we would need to prepare. Once I’ve thought more about this properly, I’ll write a post about where I’m planning to give birth.

I think that’s covered what my antenatal care was like this week. The next time I see the midwife should be at 34 weeks, so not so much of a big gap between appointments once we’re in the third trimester. Incidentally, just something else I read in the NHS ‘Pregnancy’ book for this stage in pregnancy: it says that if I have young children already, it’s good to talk to them around now about the new baby. I think Andrew is still too young to understand what is going on. I’ve tried to explain to him that there’s a baby in my tummy, even with the 3D photos that we got from the extra scan. But even if he understands the concept, which I’m not sure that he does, I don’t think there’s much I can do to prepare him for what it’s like to live with a newborn baby. There are only 18 months between me and my brother (there’ll be 21 between Andrew and baby), and my parents said that I was too young to really understand what was going on, and I just sort of accepted my brother because I wasn’t old enough to think or do anything much different. I’m hoping this smallish gap will result in the same acceptance for Andrew.

I can’t believe that next week we’ll have reached the big 3-0! That really makes it sound like we’re on the homeward straight. Also, with only 6 weeks left at work, I’m starting to realise that our time as just the three of us is coming to an end, and I’m getting more and more excited about meeting our new addition 🙂

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