Insulin during delivery?

I was wondering if anyone had any advice for what to do with my pump during deliver (I’m 25 weeks)? I’ve heard during delivery it is very unlikely that I will need any insulin at all, some people have even told me they did not need any for a few days after they got home from the hospital. I asked one of my nurses what they recommend and they said to remove my pump and they will monitor my insulin needs by “accu-checks”. I seriously can’t believe they still use the old school accu-checks that are the size of a book but they do! I told her I would like to keep my CGM on if at all possible and she did not see a problem with that but said they will remove my pump and give me insulin in an IV.  I asked to make sure and it will be fast acting insulin only in the IV. My doctor so far as been great accommodating my requests (as much as possible) so I think if I asked for soothing else they would try to accommodate but I’m not sure if just taking off my pump is the best thing or not?  

Thanks for any advise!

I am keeping my pump on, just suspending my insulin until I figure out how much I need (if any). And I will be checking my own blood sugars. If I am unable to check them during labor my husband will. I personally don't want the nurses to do ANYTHING with my diabetes. I was recently in the hospital for 4 days for pre-eclampsia and the nurses were trying to manage my diabetes and all they ended up doing was causing problems. They were using one of those old accu-check meters (the real big ones) and for some reason it was reading a good 30-40 points higher than my meter. I checked my blood on my meter at 1 point and I was 125 (post meal). On their meter I was 165 and they requested that I take a correction dose. I really didn't want to because I trust my meter more, but I did. Ended up violently sick about an hour later when my blood dropped too low. From that point on I told them they could test my blood if they wanted to, but I would only use the results from my meter, not theirs.

I kept my pump on during labor, but when I finally had a c-section I removed my pump and was hooked up to insulin IV.  Worked well since they knocked me out after my son was delivered.  I hooked back up to my pump about 12 hours later and used it for almost a week at super low levels.  As soon as I started breastfeeding I didn't need insulin for several weeks.  Then blood sugars started rising and I reconnected to the pump.

Definitely bring your own meter.  The hospital staff won't want to test as often as you will.

Yeah, I was tested by nursing about once an hour during labor, but tested more often on my own. I did need some insulin during my 2 days of labor, but I let them use their IV / novolog calculations because they seemed to know what they were doing and my endo recommended it. My BG's were great during labor -- it's easier to control because you aren't eating. I ran 75 - 100 for 2 days!

It's right after birth that your insulin needs really drop. I used about 20% of my pre-preg doses in the days right after and about 60% in the months after. I was nursing, and my doses didn't go completely back to pre-preg normal until he was fully weaned.

My pump nurse and I plan to talk on the phone about every hour and make adjustments by putting a decrease on my pump. I will teach my husband how to use my pump, probably write out the instructions too, so he can talk to my nurse and make adjustments as my labor progresses if I am not able to. Also, I don't know what pump you have, but my disetronic has a function so I can set multiple basal rate patterns. I plan to switch after giving birth to one with less insulin...similar to the beginning of my pregnancy...and then set a third pattern for when I'm nursing and the milk comes in with even less insulin. That way I won't have to bother with it too much after the baby is born, the settings will already be in place. If your pump doesn't allow multiple basal rate patterns I'd work with your educator and have a plan written on paper so you can make the changes pretty easily.

My doctor and pump nurse wouldn't even consider taking me off my pump for delivery. It just doesn't make sense to as far as I'm concerned. If you're comfortable and confident controlling it mostly on your own, I'm sure the hospital staff would be happy to let you take care of it. Good luck!!!

my endo was amazing and was in constant contact with my care team through the entire process. He originally told me to keep my pump on and he would help me throughout with adjusting basals etc. however eventually he had them put me on an insulin drip via IV. I used my meter and let the hospital use theres i wanted to test my blood a lot more than they seemed to think was necassary so I'm glad I had my own meter there to do that. Everything went really well for me and 3 weeks after delivery I am still using WAY less insulin than i was pre or during pregnancy.