Planned induction at FORTY weeks with Gestational Diabetes?

[Polarbear72]

Hi I am looking for some advice please.

I have gestational diabetes and am taking insulin injections to control it. I was under the impression that I would be induced at 38 weeks but I have been now told I will be induced at 40 weeks. I was very surprised but my new midwife was quite dismissive saying it's best for the baby to be in another two weeks and I could ask the consultant to deliver early but it would depend on what kind of mood they are in.

I am feeling very unnerved by this..

I am 41, this is my one and only baby and I am concerned that no other option has been discussed with me. Wouldn't an ELCS be better? I asked why I couldn't be induced at 38 weeks and was told that the failure rate is higher which leads to CS. I am also concerned about placenta failure but have been told that there is no difference in chance.

I feel totally dismissed, like it's up to them how my baby is to be delivered and I have no say it in. I have another appointment in two weeks. I asked if I would see the consultant and was told, "Maybe", or that I might see a Dr.

I don't want an induction or a c-section - I want what's best for my baby but I don't trust their current judgement. Any advice? Many thanks.

I have no advice, but I have to say that they seem to be being rather crap at the moment.

No mum should ever feel dismissed

someone will be along in a moment with proper advice, but hang in there.

Hello Polarbear72

I am so sorry that they have been so dismissive of you. Anyone with GD will have similar concerns and issues too and am sure someone with experience will come on. I have PIH( pregnancy induced hypertention) and had to be checked for GD too. I am currently 34 weeks and am due to discuss induction etc on thursday.

I think you need to go back and ask them to explain their reasoning behind this. 2 of my cousins had GD but not daily insulin injections and 1 was induced at 38 weeks and 1 went 38 weeks and a few days.

The risk is a big baby and problems with the placenta and a whole lot of other things:

If they won't will they be monitoring you every week from 38 weeks, will you have a growth scan? Will they be monitoring you? What are the implications of them leaving it to 40 weeks.

38 weeks is still classed as full term I think they have been very dismissive and would be very angry at the way they have dismissed you. Could you ask for a second opinion?

Good Luck sorry if I have asked more questions that help x x x

Sorry are you in the UK - surely you should be under consultant led care as you are classed as high risk. can you call the midwife and ask her to refer you to see a consultant and by pass the midwife.

If not I would head up to the hospital's ante natal appointment desk and say ' I need to book to see a consultant who deals with GD as I have it and am insulin dependent ' and see what they say don't be fobbed off.

When I went for my booking in appointment for me at 12 weeks she was a bit dismissive of my previous pre-eclapsia I just smiled and said I would like to see a consultant please so rather blase about it said when you have your scan ask them to book you in at the desk to see the consultant at blah blah hospital at week 16 and I did.

From your post it seems you appear to be under the midwife led care - you need to see a consultant Good Luck and don't let them fob you off-

Please don't feel like I am patronising you this is my 4th pregnancy ( lost our 1st) 2nd -pre eclapsia ( and very dismissive midwifery team until we nearly lost him)
3nd time ( consultant led care because I insisted and told them no way was I putting my baby at risk)

4rd ( now I felt silly going uptp the Day Unit today as BP went sky high through last night) and yet consultant said I did the right thing.

You can have a very high risk pregnancy that is running along smoothly but things change drastically

Good Luck sending you a hug x x x

Thanks for the replies. I am classed as high risk and was under the consultant but was passed back to the midwives as I was doing OK but have since developed the GD. I have since I posted demanded to see a consultant. I have never heard of an induction for gestational diabetes at 40 weeks especially insulin dependant to boot.

The argument is that induction at 38 weeks has a high failure rate and that babies that come out at 40 weeks are happier. Sounds like a money saving exercise to me.

I have a growth scan in two weeks. At the moment the baby is average weight but that could change. I am very worried about still birth & forceps.

I will have to push harder for more support I guess.

off course you would be worried and I would be too. I have never heard of induction that late, strange how they passed you back to the midwives too as with anything high risk it can change suddenly.

Well done for demanding to see a consultant sorry if it came across as pushy it just riles me when the professionals play on being a 1st time mum.

Good Luck and I really hope you are treated with the due respect you deserve and you won't be the first to push for more support others have done it with less to worry about x x x

The risk with diabetes is growing a big baby which won't come out naturally, but I'd they are happy that your diabetes is very well controlled I can see why they might be keen to delay induction until 40 weeks to reduce the risks of induction for you and baby - for example it not working.

You really need to be seen in a consultant clinic to verify what the plan is (in collaboration with what YOU want). Just "turning up there" might not be the best way to go about it. Ring your hospital antenatal clinic and explain to the midwife that you want to see a consultant. I'm sure they would happily book you in to see one.

I've just been induced at 40 plus 3...although I was successfully diet controlling. She weighed in at 8lb 2 which was less than the 8 lb 8 predicted...I was worried about placenta failing but they didn't seem bothered...just told me if it was managed you weren't higher risk. Didn't make sense to me!

I have an appointment booked with a consultant - I spoke to them on the phone outlining how anxious this "Care" plan was making me & outlining the NICE guidelines. Which is 38 weeks. I just want the safest option for my baby & I. I just don't feel they are taking it seriously. I chatted to a lady in the waiting room & she was induced at 38+1 with her last pregnancy due to insulin based GD & she delivered a healthy baby girl and is having the same again & this lady was 15 years younger than me.

Just watched the midwives programme on BBC2 & the lady in her 40's was given a c-section at 38 weeks!

Thanks for the replies. Appreciate the time taken.

Thanks Pinkr - my GD is being controlled by Insulin but the units are increasing on a weekly basis as I become more intolerant.. I am also worried about placenta failure...

As was I totally...they just wouldn't listen. I also had polyhydeamnios and was huge.

Hello OP

I had also read 38 weeks induction for GD - BUT i think this tends to be when the growth scans show large size, when it is diagnosed later or when the mum is not controlling it well.

I had GD - same age as you - gave birth naturally at 41 weeks+3 - they would also have waited another 4 days before inducing.
They checked size and amniotic fluid every visit. As long as they were fine then we were iyswim - dc was just over 8lb and fine - totally in proportion, no breathing probs or jaundice, 10 on score. So i did all that worrying and googling in vain. He did have lower blood sugar first two days though but suspect that would have been the case earlier too.

This is not in UK btw and I had fortnightly visits with diabetes consultant, with gynae and every 2 days with hospital from due date - no cost cutting here as insured. Telling you that as their policy seems to be similar - i questioned the 38 weeks, placenta, size, shoulder dystocia etc
and nonetheless told to wait for nature as more risks with inducing earlier.
My numbers were fine though even though i fell off the wagon sweet-wise a couple of times and probably under the overweight to obese category as well as old

There are also plenty of women who have undiagnosed GD and larger babies - as you are being checked for growth presumably, this will lower your risks somewhat BUT you have every right to ask for a second opinion, reassurance and to ask for induction that hurts more though oe elcs.

Here there is no way you would be midwife led if you had insulin dependent GD, I doubt you would if you were diet controlling either.
Also here if you cannot diet control (so on metformin or insulin) you will be induced at 38 weeks, regardless of babies anticipated size.
I wouldn't worry when they say "doctor" or consultant because by doctor they will mean the consultant's registrar who will also be a specialist. It will still be "consultant-led".

Ps I wouldn't worry generally because my guess would be that your midwife doesn't know what she is talking about and the dr will clear it all up for you.

Thanks again for all your replies. I have spoken to a friendly midwife I have seen from time to time and she advises me to wait and see what the scan says next week and to speak to the consultant. Whilst I can appreciate an induction has a better success rate at 40 weeks compared to 38 weeks I am not sure this is best for the baby. I am very worried about induction in general as it tends to increase the need for intervention and also worried about shoulder dystosia. This is also my 1st baby so there's a good chance it may take a very long time. I am high risk because I am in my 40's and also insulin dependent GD. Apart from this I am fit and reasonably healthy.

Incidentally I was watching the Midwives program again last night and the lady that delivered an 8lb 3oz baby - I went - look at the size of that chunk! Then realised my baby is going to be about 8lb... Really shouldn't watch this kind of TV. No more!

Thanks again for all your advice, it's much appreciated