Now finishing up my second trimester and heading into my third, I still don't have a midwife or doctor -- for reasons I'll be glad to tell you if you email me and ask -- and, ironically, I'm in much better health this time around than I was in my last pregnancy when I was under close medical supervision...

Last time, as you may recall, I found out in my seventh month that I should have been taking blood pressure medication from the first week I knew I was pregnant, and that I was a gestational diabetic in need of insulin. By the time I was pregnant again, I was much better educated about my risks as well as ways to minimize them.

Having received some great pointers from a fellow birth coach, I've been able to take steps and take supplements that have kept me from needing blood pressure meds again (so far, anyway). I knew the gestational diabetes would be another matter, though -- two out of three women who experienced it in their first pregnancy will have it again in their second one -- and decided to take action early. About a month ago I visited a local family practitioner, told him my history and asked him to please prescribe me some insulin rather than make me wait several weeks [or more] to take a glucose tolerance test and prove what I already knew. He was obviously caught off guard but was gracious enough to honor my request anyway. As a result, my blood sugar levels have been pretty stellar (mid-80s to mid-90s, for those of you who know what those numbers mean). Interestingly, the particular method of insulin management I followed last time called for much more insulin and greater dietary restrictions and only barely kept me under 120.

I don't plan to go the entire pregnancy without prenatal care if I can help it, but right now it seems the greatest danger presented by my self-medicating is... that an obstetrician somewhere is missing out on several thousand dollars she could be making by advising me on how to do what I'm already doing. Since it's several thousand dollars I don't have to give, though... praise the Lord and pass the needle!