gestational diabetes and induction

[becksydee]

posting this partly to try and get my thoughts in order, but also to see if anyone has any advice to offer ...

so, the background:
i'm 39+4 with my first baby, and was diagnosed with GD at 32 weeks. apart from a few blips around the week i was diagnosed and started monitoring my blood sugar, i've managed to successfully control the GD through diet. my glucose control overall (hba1c??) has also been good. i've had several scans, including a growth scan at 38+2 and the baby's weight is around the 70th centile & this has been consistent throughout - so a bit on the big side, but not absolutely massive. from what i can tell, the baby hasn't so far been adversely affected by the GD at all.

at the moment, i'm booked in for induction on my due date (wednesday) & have been told that this is routine for women with GD controlling it through diet. i'm not particularly keen on the idea for various reasons - in an ideal world, i'd like the birth to be as natural and intervention-free as possible. i would have liked a home birth but it's not practical, i've just been told i can't use the midwife led birthing centre, and so starting off on the labour ward is already a long way down my list of choices.

i've done a bit of research but can't seem to find anything to sway my decision either way.

• NICE guidelines say to offer induction from 38 weeks, but that monitoring can also be offered up to 42 weeks
• obstetricians say that the main risk involved is "unexplained stillbirth" after 40 weeks (and yes, obviously, this is the bit that scares me)
• i know that induction is more likely to lead onto other interventions, which can then increase other risks i.e. shoulder dystocia etc
• research suggests that for caucasian women, 41 weeks gestation is the average rather than 40

my vague plan so far is to go in on wednesday but to ask just to be monitored, & if everything is looking ok, then i'll go home and wait it out for a bit longer. i'm doing all the usual stuff to try and get things moving a bit more naturally (baths with clary sage oil, evening primrose oil, raspberry leaf, curries, bouncing on birthing ball etc. i've also had 3 sessions of acupuncture, and have an appointment on tuesday evening for electroacupuncture with the intention of trying to induce labour that way). at my last appointment with the obstetrician at 38+5 i was given a sweep and was 2cm dilated at that point, so my body is evidently gearing itself up for the big day ...

sorry this is so long! does anyone have any pearls of wisdom to offer? or any experiences to share? thanks

well firstly good for you for takin it all so well, and managing to control it too. like you i am diagnosed, but was diagnosed at 28 weeks, and my levels seem to be up and down still despite me being very careful. I have scan at 32 weeks and that will be a deciding factor ive been told.

I cant really help i dont think to much, as i didnt have the option homebirth or midwife led as the unit closed down in july , Ive also been told so many scary things (by my midwifewho is a bit to sya the leat...)that so long as baby is big enough im ok (not happy but ok) with induction although recognise the risks of further intervention. Midwife has said that if induction is started in a case such as this i can opt for a c section rather than vetouse etc, not sure if that is a positive or negative?? Has your midwife been much help with this? i do feel you should stick to your guns as per your last paragraph as it is your birth and so long as your baby is healthy my understaanding is you should be given some choice?

I had GD with my first DC and I went in to be induced the day after I was due. They strapped me up to a monitor and I was already having very mild contractions. As the baby was fully engaged and very low they just broke my waters and my DD was born a few hours later. So it wasn't really that traumatic having intervention.

It sounds as if you are ready and honestly if they only need to break your waters it is not that bad. Even with my 2nd DC I was induced with a pessary and even though that took longer it wasn't that bad. Apparently I didn't have GD with my 2nd but was induced a week after my due date as I was measuring big

Good luck x

I also have gd, was diagnosed at 31 weeks and haven't had a single blip in my blood sugars. they are always in the 4's and 5's. btw im 37+4...i had a growth scan at 35 weeks and baby is dead on for its gestation although i have been measuring 2 weeks ahead since 28 weeks. also fluid is bang on too. I have been told im bein induced at 39+5 because 'its common practice to induce women with GD around thier due date.'

I dont underatsnd why they are inducing me because baby is measuring peefect and havent had a problem with my GD. I wanted to avoid induction this time cos my first dc was induced at 36 weeks (waters went and nothing happened) but looks like i have no choice. I was really hoping for a homebirth this time and wanted it all to start of naturally. Im trying everything atm to start things off but dont think im going to be lucky enough!

Well done for keeping it under control. Bottom line for all your efforts is to have a healthy baby, and that may mean letting go of your ideal birthing scenario. I was induced at 40 weeks on the dot after controlling gd since diagnosis at 26 weeks. I was 36. MW thought baby would be largish, and she was 9lbs in the end. The uterine environment deteriorates after 40 weeks even in the best of circumstances, and gd is not the best of circumstances, hence the induction. Even though I was induced (with gel, and then Pitocin when that had no effect) I had no other medical intervention, even painkillers, and in fact managed to rest comfortably in the early stages of labour. (This was not my first baby, so I wasn't too nervous to snooze). Delivery was in hospital, but I got to decide what position to use and things went smoothly. You haven't failed because of having gd and all the resultant things that mean divergence from the ideal birth. Try to be joyful in anticipation of the healthy little baby you will bring home; the rest is details.