induction? c-section? natural birth?

[Geminiwitch22]

Would like to say this website is awesome and answered so many questions in the past. Anyway. I'm 35 + 3 I've been consultant led due to graves and pcos, found out I had gd so transformed to a new obstetric team who specializes in this. However she is infamous for putting woman through c-sections, breaking unborn baby limbs trying to change there position (very scary woman as well). Talked to her registrar about induction in diabetes and she said this is likely, but I want a natural birth, they have scared me my babydespite all the odds has been very healthy and I have felt I have had no choice. Tomorrow is supposed to be my last obstetric appointment and I have a feeling she will tell me induction orc-section.

What can I say or even do? Tia

I'm in a similar position, pcos and gd and been advised an induction is likely. I'd say go with an open mind and listen to the options, ask lots of questions and try and understand why they are advising certain things.

I don't want an induction, but ultimately if it's the safest thing to do then I will follow their advise.

Ultimately if you don't want an induction or c section I think you can decline.

Thanks firsttimekat. This woman first time I met her (the day before told on the phone that I had gd), had a student didn't mind but she dictated to me said my diet was rubbish (oh is a chef) and that I would be diabetic in 2 years if I didn't lose weight bearing in mind I've only put on 8lbs. I don't mind inducement (means dc will be close to mommy's birthday yay) but she tends to perfer c-sections which I can't afford as I'm the only person who drives.

Hi, I have type 1 diabetes and have known from the start that diabetic mums are induced at around 38 weeks. However, induction does not immediately mean c-section. My midwife told me a c-section would only be used if the induction failed. And, remember, it is your right to turn down a c-section.

Thanks guys, just been told I have to go in on Thursday for a scan then to the day unit.... no reason given.

You should ask!

I would have but this was from the Secretary not the consultant, seeing my midwife Tuesday hopefully she'll enlighten me. Can't believe I've made it to 36 weeks

I see. Yeah, well done that's great :-) Don't forget to tell her what kind of birth you want and don't be talked into anything unless it's for a good reason!

Will do

I'm being induced too so I share similar worries.

Remember doctors are only advisors. It's your body and you are the decision maker. Don't be afraid to question why they are advising something.

I have APS syndrome and have been induced at 38 weeks for both dds and will again for number 3 (currently incubating).

The thing to do is to get as much info as possible - get an appointment with an anaestist to discuss medication options during birth. Do you have a consultant or doctor you see for graves and pcos apart from the obstetrician? If so make an extra appointment with them.

I do not view induction as anything to be scared of but I am very well informed and trust my doctors. Can you request another obstetrician if you are not happy with this one?

Pomme I also have APS. What is the reason for 38 weeks? I am expecting 40 weeks this time same as last time when I was induced on due date. Did it depend on outcome of scans?

Pomme: the problem pretty much day one is that my endocrine consultant knows nothing about obstetrics, and obstetrics knows nothing about endocrine. Because I'm now known as a diabetic I only can have one specific obstetric consultant who is known to force women into c-sections. I'm stuck having to make decisions on my own research because of this

kat - o that's interesting. Always been presented to me as a totally standard thing to offset risk of stillbirth. I think I might be treated a bit different though as I was diagnosed with APS post an extremely severe clotting incident in my twenties and the severeness always seems to be a big deal with people. Personally I think it sounds a lot easier than being diagnosed post recurrent miscarriage which is how the majority of women with APS find out I am told. I take warfarin when not pg and take 2 x fragmin when pg.

gemini - that's a real difficulty not to have interlinking info - due to the above APS and pregnancy links are quite widely studied. I think you should still look into requesting a different consultant though, especially if you do feel bullied post first appointment. I would chose induction over c section personally but I appreciate that's post some experience (and my drugs make being cut open a bit more of a worry!).

Pomme, that's the main problem, there is no other consultant if you have GD there is only one consultant. Same with any endocrinology condition one consultant. I have said I would like someone who knows both but there is not one in the area, which is one of the reasons I think im having an extra scan and then being transferred to the maternity day unit to be seen by the team or even my care transferred to a different hospital. I just have to wait and see. Baby is head down (yay for small miracles) so there is no clinical reason at this point to consider a C-section.

gemini The scan is likely to check for growth and blood flow to the placenta - to make sure baby isn't too big due to raised blood glucose levels and to make sure the placenta is working properly. I was diagnosed with GD at 28 weeks and had growth scans first every two weeks and the ever week from 36 weeks on.

Our hospital handles things a bit differently, I always had an appointment at endocrine to check my glucose numbers and then an appointment at the GD ante-natal to do scan and talk through the implications, my endocrine doctors made it very clear that it was the ante-natal consultant who I should talk to as 'I am not a baby doctor'.

Usually they like to induce before the due date, certainly if you end up on metformin and/or insulin, but there is room for negotiation based on what your results.

I've had consistently normal glucose results since the diagnosis and a baby on the 50% percentile, so I pushed for a later induction, I'm actually going in today at 40+4 - so it's definitely worth discussing it with your doctors. Just make sure you read up on it, I found that if they realised you knew what you were talking about and had a fair idea of the risks either side they were much easier to talk to.

Oh sorry gemini - that seems a bit rubbish. She might be less of an old battle ax in actual person though, I hope so.

The consultant was lovely when I had a scare (baby not moving), but other than that nothing. Well see, mw tomorrow house is pretty much spotless thanks to oh as I've been I'll with cold. Thanks for all the support, I will update as I find out more.

Quick update
Saw a midwife on Tuesday not my normal one as was snowed under (saw her in clinic last week) she doesn't normally work at my hospital but said it was normal (bs) although several friends are worried as this is not normal procedure. I'm going up today at 330pm for my scan then onward to day unit... but on the bright side birthing plan done

Update
Was sent to daycare due to clinic being cancelled and that they should have informed me of this
Did not see a consultant or doc of any kind but told by lovely mw (same one who looked after me during monitoring) that baby is fine. However is angry at mw who saw me at home did not do a proper antenatal check, that I'm not being seen more often by diabetes team, mw and consultant are not seeing me enough. So I'm going back in 2 weeks to be seen supposedly, but mw is speaking to consultant when back on Monday. So I'm more in the dark and this doc who saw the scan has ?gdm meaning am I diabetic or not

Are you on medication and/or insulin?
If not, it's strange if they are recommending intervention as early was 38w. I had GDM with dd1 and was left go to 40+6 due to good diet control. Now 38+5 and booked for induction at 39w, but due to contributing risk factors of GDM (again) and my age (42). Perhaps your other health/risk factors are having more impact.
Very weird to be pushed to have a cs in the first instance (though many people would elect to have a cs if the only other option is the induction drip as it can be very intense and the monitoring/drip means an "active birth" is not an option anyway, and can end up with an unplanned cs. Have you actually asked the consultant why she prefers cs over induction?
Good luck whatever happens!

Bumblebuzz: this is the issue because it is rare to have someone like me with so many metabolic issues which is why I think they want to induce, however they are now questioning if I have gdm, as I'm staying stable on diet alone.
This particular consultant is infamous for cs when waiting may be better, and for causing other issues. I'm hoping that I'll see the consultant either next week or at 38 weeks and get some clearer picture of a plan, my endocrinologist is amazed at how well I'm doing considering and I'm seeing him next week (never seen a registrar always the consultant), he may give me some indication.
Hope all goes well with your induction let me know how it goes please

update:
hope everyone is ok!
saw consultant yesterday after an internal they have said 2cm dilated and had on off contraction for last 2 day =) if not here by wednesday being induced