Gestational diabetes but no induction?

[Gardengrowing]

Hi,

I was wondering if anyone has experience of having gestational diabetes but declining induction at 40 weeks?

I was diagnosed with GD at 32 weeks. I have controlled it with diet. I had a difficult first birth after induction at 42 weeks, and am very unhappy about the idea of being induced at 40 weeks (which feels early for me).

I have read all the NICE guidelines and understand the rationale for the policy. So dont need any replies focusing on that. I am just wanting to find anyone who as the experience of not being induced at 40 weeks - what happened? what led to your decision?

Not the answer you want, so please don't flame me. Had 4 GD pregnancies. One went to 41 weeks, three induced at 38 weeks. I have 3 wonderful DC's. Induction not nice, but end results were better than stillborn dc at 41 weeks. Sorry.

Hi garden

I had GD with DC4, and I was induced but just wanted to say it might not be as bad as you are expecting. I was also induced with DC1 at 38 weeks - and like your first birth, it was awful . Took about 3 days, and even after that ended up with forceps which took me ages to recover from.

Was induced again at 38 weeks with DC4 due to GD, and like you was very concerned that it would be a repeat of my first birth experience, but it couldn't have been more different. Had first pessary at 6am and that was it, didn't need any more, and certainly no need for any drips or anything like that. DC4 was born at 6pm, and can honestly say I was only having contractions for about 3 hours that time

So obviously don't have the experience you were after of waiting past 40 weeks, but if you do consider early induction it may not be as bad as it was before. My midwife did say that induction with first births were usually much worse than induction with subsequent babies! Good luck with whatever you decide

Went to 40+5 with dc2. diet controlled GD.

Had a homebirth. Not with NHS midwives though, after being told homebirth team 'wouldn't touch me with a bargepole'. [hmm😏]

I mean

Go with medical advice. It is sound and it is based on very real concern for the outcome for the baby. Sorry to focus on that but it is a really important factor.

I was induced bang on the dot of 40 weeks with DD4 after controlling GD with diet and it went slowly but smoothly. I had a pessary late in the evening of day one, then syntocinon about midday on day two, and DD4 was born in the wee small hours of day three. Altogether the experience took about 36 hours and I slept until about 2 am the morning she was born as well as sleeping the whole first night.

I had been induced previously at 40+7 with DS, 40+7 with DD3. DD1 was a week late and DD2 was ten days late. With DS, I had a pessary the night before but had made no progress so they gave me syntocinon at 7 am and predicted the whole business would take 8 hours. They were off by only 6 minutes. With DD3, a pessary was all it took, and labour lasted about 9 hours start to finish.

For a first induced birth, insist on an epidural. Contractions on syntocinon spike faster and higher than your own hormones. I recommend an epidural even if you end up going into labour on your own for a first birth. I had one for DD1 I couldn't believe the pain but not for induced DS or any of the rest of them.

Thanks for your positive stories about induction. If I am induced, I dont want to repeat the Oxytocin drip and epidural - would rather have a repeat cesarian! But would try the gel.

Shagmund freud - am interested in finding a bit more about your story. what made you decide to wait, what was the reaction of the medics?

Foad - so sorry to hear about your experience. I hope you dont mind me asking but were you taking insulin to control your GD?

"Shagmund freud - am interested in finding a bit more about your story. what made you decide to wait, what was the reaction of the medics?"

I knew I was carrying a very large baby and I believed that both induction and epidural can make shoulder dystocia even more of a problem in this situation.

I also wasn't aware of any research into higher rates of stillbirth among mothers with diet controlled gd - my understanding at the time was that evidence on stillbirth in gd pregnancies was extrapolated from research into pregnancies among women with type 1, insulin dependent and early onset GD. It may be that by now this research is there to back up the recommendation for induction at term for pregnancies like mine, but at the time my consultant wasn't able to point me in the direction of any.

I also had the support of an independent midwife and a consultant midwife from a large London teaching hospital.

As for what my consultant said - he didn't actually discuss induction with me. Perhaps that's because I didn't go back to see him after 39 weeks.

"For a first induced birth, insist on an epidural"

I personally wouldn't encourage any first time mum who might be carrying a large baby to opt for an epidural. I think it's the least helpful thing you can do if your aim is to have a straightforward delivery.

gardengrowing no, I wasn't insulin controlled, just diet. He was a big baby (10lb 8oz) and shoulder dystocia was a problem. I had epidural and ended up with large tear.
Pregnancy 2 was diet until 30 weeks, then insulin controlled, then back to diet only for pregnancies 3 and 4. DD1 and 2 weighed 8lb 2oz each and DS(2) was 8lb 13oz all at 38 weeks.

My main concern would be that there are no warning signs - my baby died of a blood clot in the placenta. His death was attributed to GD. Oh, and my diet control was bloody good, no cheating, no secret eating, no sugar, no refined carbs etc.

Happy to share this if it helps. I would hate anyone to have to go through what we went through ...and still do

Forgot to say, am not diabetic. Just GD for some reason. I wasn't even overweight, just unfortunate I guess.

Another person here who had a stillbirth at 41 weeks. I had ?GD very mildly at the very end of my third pregnancy. All my babies were induced, all the births were okay. DC3's was very okay - broke my waters and he was here 1 hr and 1 min later. Not ever been into labour naturally, so nothing to compare it to.

Please don't play fast and loose with this. I begged them to induce me with DD because I was terrified she would die. They said I had to wait till 42 weeks and she died at 41+5. I know this colours my opinion in a very non-scientific way but I did do a lot of reading before and after DD's death (I am a medical librarian so I know what is data and what is bollocks) and on current evidence, I would not decline a recommended induction for GD or most other things.

"For a first induced birth, insist on an epidural"

I personally wouldn't encourage any first time mum who might be carrying a large baby to opt for an epidural. I think it's the least helpful thing you can do if your aim is to have a straightforward delivery.'

I wanted an epidural for DS, as I was being induced and I had had one for DD1 (7 lbs 5 ozs) when I laboured under my own steam, so to speak, and found it a blessing. With DS, it turned out that the hospital was having a spectacularly busy day and the anesthetist was run off his feet, so by the time he rushed to my room they were mopping me up, and picking themselves off the floor DS turned out to weigh 9lbs 4 ozs no-one had been even close with their estimates of his size. I ended up with a ventouse delivery and very healthy DS. The anesthetist apologised profusely. I had a medio-lateral episiotomy and hardly any tearing. The only problem I had afterwards was a thrombosed haemorrhoid. An epidural isn't a guarantee of a less than straightforward delivery.

Problems with the placenta can affect all overdue babies but when the mother has GD this can be more serious. Potential placental deterioration was the main reason my midwife advised me to follow her advice and be induced at 40 weeks -- or earlier if any adverse signs were detected before then.

Very sorry for your loss, Foad.

And for yours too, Mrsgboring.

I just wanted to thank you all for responding to my post and to let you know how things went. I was induced at 40 weeks + 2 days. I had been feeling some tightenings beforehand. The induction was successful (one dose of gel and waters being broken) and the birth proceeded naturally from that point forward. I gave birth to a dd 9 hours later, 9lb 6oz. Thank you again.

Glad things went well for you Garden

I read this thread with great interest as I am booked in for an induction at 40+3 according to their dates, but spot on 40 weeks according to my (correct) dates.

My GD is diet controlled, as was my last GD pregnancy and she came out 6 days early at a whopping 7lb 5oz.

Im just hoping that this little man decides to show up a little early under his own steam too, but am not so scared of induction on baby number 3 despite a lengthy and unpleasant induction with DC1

Its scary isnt it! Childbirth is scary enough, but all the talk of stillbirths and dodgy placentas makes it worse.

Sorry for your losses to those that sufferred them :(