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Re: [IP] Labor with Pump on

On Tue, 18 Jul 2000 16:20:58 -0700, Kristen wrote:

<<To anyone who gave birth while on pump, did you wear the pump during 
actual labor? I am 6 1\2 mos pregnant and asked my OB today if I can keep 
pump on and he basically said YES, he just wants to talk to my endo about 
the difference/conversion of humalog in pump to regular intravenously, 
since that is what he is used to dealing with. I'm not sure but he sort of 
made reference to letting me control my own numbers?? I'm not sure if he's 
willing to give up control though, since he kept saying he would have to 
speak to endo to determine conversion????? Any suggestions? >>

I was on intraveinous insulin during my first labor and on the pump during 
my second.  For me it was pretty much 6 of one, half a dozen of the 
other.  Here's the rundown of my experience.


As far as the conversion rate, I don't know if there is one.  I don't see 
why they couldn't use Humalog in the IV, but there would still be changes 
because you're going from subcutaneous to IV infusion.

Nurses are in control of both basal and bolus rate.  They operate according 
to a standard protocol.  This--for me--included not administering bolus 
until an hour or so after a meal, so sugars tend to go high for a brief 
period.  Because I was uncomfortable with this protocol I was eventually 
able to convince my OB to allow me to administer the boluses via 
injection.  This made me feel me feel much more comfortable, especially 
since I was on a clear liquid diet that included not much more than fruit 
juice and regular jello, and I have a relatively high carb/insulin ratio 
(between 6:1 and 9:1).

Until I had negotiated with my OB to obtain this control I was 
uncomfortable about my blood sugars.  I had just spent 12 months keeping my 
blood sugars as close to normal as possible and now the nurses wanted me to 
drink apple juice and eat jello without bolusing for an hour!

Because I use a very low basal rate, the standard protocol didn't work well 
for me and I was low until they worked out the kinks.  This isn't fun when 
you're on a Pitocin drip.  Can you say "Technicolor Yawn?" (Vomiting)

Nurses are comfortable with the standard protocol and are more 
accommodating for that reason.  When you're in labor an accommodating nurse 
is a wonderful thing.

You don't have to worry about the basal rate, since someone else is doing 
it for you, though it may take a while to get it right.  We all understand 
that, of course. (VBG)

I was on Pitocin anyway so adding insulin to the IV tree wasn't a big burden.

I was on the fetal monitoring device so I didn't have a lot of mobility; 
hence the IV tree wasn't an added inconvenience.


You are in control.  This made life much more comfortable for me.

I did not want to turn my pump off completely--which my OB had advised me 
to do--so I kept a 0.1 bolus rate going during labor.  Because of this (I 
suppose) I was a bit low during most of the labor, but not as low as I was 
on IV insulin. (No Technicolor Yawns, and, yes, I was once again on the Pit 

I still had the IV tree to carry around with me since I was on the Pit 
Drip.  No gain there.

Still had the fetal monitoring device so not much mobility regardless.

As I look over my post it seems I have a lot more negative things to say 
about the IV insulin, but I don't really feel that way.

Both of my experiences were positive and both of my daughters came out 
healthy and crying at the top of their lungs.

I guess it depends on whether you want to take the cruise ship or sail off 
into the sunset yourself. I enjoyed both journeys.

Happy Birthing,

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