Gestational Diabetes & Induction

[TanE]

Hi all,

I've just been reading through this website and thought I'd ask for some help re the above. I have been diagnosed as being glucose intolerant (GD) and told I will need to be induced at 39wks . Not looking forward to being induced and trying to convince consultant to leave me longer (i.e induce at 40wks). Blood sugar are monitored 3 times a day and diet controlled - no problems, blood pressure and urine checks all fine. Given I've previously delivered 9lb 10 and 9lb 2 babies I don't think babies size is an issue. Any idea's why they still say automatic induction at 39wks? Has anyone taken on consultant before and won?

Tan

Firstly, they can't induce you if you don't agree to it.
Secondly, if everything else is fine what reason are they giving for induction?
I had GD in my last 2 pgs (diet controlled with DS1 - consultant happy for induction at 40 weeks / had to go onto insulin at 37 wks with DS2 - induction booked for 38 wks since risk to baby is apparently greater if you're on insulin) I had battles all the way with consultants but I was confident of my position. They can't force you to do anything you're not happy with (unless they section you of course )
Have a look at this site I found it really useful. HTH

It's worth remembering that different consultants have different protocols on this. Not all recommend induction at term or before if GD is well controlled by diet alone, and as Iris66 has pointed out, you don't have to agree to it if you don't want it. I chose NOT to be induced with either of mine and went 6 days over with second and had third at term. My personal feeling are that it's swings and roundabouts. Yes - early induction might result in a smaller baby, but on the negative side, you're probably going to have less mobility during labour as you'll be monitored. You also might end up wanting an epidural - and frankly I can't see how that'll help you push out a baby over 9lbs (all mine have been over 9lbs too btw).

Sorry - should have added that I had GD in both my last two pregnancies.

Sabire,

Did you have to be quiet forceful and demand no induction or was your consultant quite accommodating to your wishes?

No - I wasn't offered induction. I know some people are with these particular consultants (a friend of mine was offered induction at 40+4 for GD by same consultant - ended in an emergency c-section for failure to progress) With my second I think I wasn't offered because my consultant knew I was planning a homebirth with an independent midwife (which of course he tried to talk me out of - I just used the broken record technique as described above: "I appreciate your concern, I'll think about your recommendations but right now I'm intending to go ahead and have my baby at home" - repeat as many times as necessary). With my third I wasn't offered induction because I'd managed to squeeze out two 9lbs/10lbs 12oz babies at 41 weeks and I suspect they felt that size wasn't as much of an issue. Maybe it's because I'm bolshy and I made it clear I didn't want to be induced from quite early on.

Sabire,
I had GD on my last pregnancy. Initially they talked about inducing me earlier, but they agreed to keep monitoring size.

I asked consultants many times, is there any reason besides size? She said is mainly a size issue, bu there are some very rare cases of the placenta starting to degrade (or something like this). Because of the latter she wouldn't let me go past 40 weeks, but since size was under control, she agree to monitor me twice a week between 37 and 40 weeks, and wait until then.

Good luck!

check out the Homebirth Site's page on GD for info.

You give permission for them to even lay a finger on you, so if you are diet controlled and have already birthed big babies then I can see no reason why you shouldn't labour spontaneously.

You don't have to take on the cons, you simply have to tell him you've listened to his opinions, done your own research and have made your own informed decision. They can't come to your house at 39wks and drag you in!

If he still makes claims you are unhappy with you can ask him to provide evidence-based research to support these claims.

I'm sure that latest research (can't find it just now, hopefully someone else may have it) recommends that mums with GD are not induced early

Sorry to bring up this thread again but I've just got back from the hospital where I was told they want to induce me on Tuesday when I will be 39+5.

Long story, had GTT at 28 weeks and that was fine. Some glucose in urine at 37 weeks so they sent me to diabetic clinic on Christmas Eve. Was given monitor and told to check 4 x per day. With the exception of two times (Christmas lunch and one day when I slept all day), all readings have been within their limits. They said I didn't need to see a dietician and I'm not on insulin or anything. But because I am overweight and my father is diabetic, I feel like they are trying to prove that I have GD. They have written it on my notes but no one has actually said, yes you have got it.

They said that LO is measuring big but surely as I have a gargantuan tummy anyway, they can't get any sort of exact measurement? Sorry, not sure what I want anyone to say, just a bit confused about the whole thing, scared of induction (and labour!) and not sure if I should worry about being diabetic or not.

They've put a note on my file asking SCBU to be aware of birth in case she needs it. What am I supposed to make of that?? Sorry, slight panic mode here...

Hiya,
The concern about babies born to mothers whose blood glucose has been poorly controlled around the time of the birth is that they may have problems after the birth with their own blood sugars, which can be quite serious and needs prompt attention. HOWEVER - I've not heard of this happening to the babies of women who are borderline glucose intolerant or who've been diagnosed with GD but have well controlled blood sugars with diet alone. Remember that a diagnosis of glucose intolerance is VERY common in pregancy and almost invariably turns out to be of little importance clinically.

If you are unhappy to be induced then you need to see a consultant and get a clear explanation of what the issues are that are particularly relevant to YOU.

And ask for facts and figures if they raise the issue of problems with the baby - ask them to be clear as to whether these refer specifically to the babies of women who are glucose intolerant or have diet controlled GD or whether these are drawn from studies of women with pre-existing diabetes or those whose GD sets in very early in pregnancy.

Sarahjct - if I were you I would ask for a consultant appt and ask him/her to give you then name of the piece of research on which they are basing their decision.

If your GTT was fine and your self blood tests are fine then you do not have gd. There is therefore no need to be induced. I'm 99.9% positive that all the research says that women should never be induced because of a suspected "big baby" UNLESS they have GD. You do not have GD so I can't see why they want to induce you.