Induction and Gestational Diabetes

[sarahelizabeth99]

Currently at 35 weeks and have been diet controlled for gestational diabetes, haven’t had to take any medications for it and baby’s growth has been fine. Have a consultant appointment next week where I think they will talk to me about having an induction at 39 weeks (I’m in Scotland, not sure if the dates are different in other countries for induction).
My question is, has anyone had an early induction before due date? How did it go? And did anyone with gestational diabetes or other medical reasons where they suggest an early induction decide to wait/decline induction?
At the moment I’m swaying towards asking to wait until 40 weeks before induction since my gestational diabetes has been really mild.

They probably chose 39 weeks because that is the perfect balance between the child’s development and the still birth risk (which is increased even in well controlled gestational diabetes). After 39 weeks the stillbirth risk for healthy women does increase and for women with any kind of health issues it’s even higher. I haven’t had the conversation yet but due to my thyroid issues (I produce antibodies which also increases stillbirth risk) my mw has already warned me that I may need an induction at the 38/ 39 week mark. If I get gestational diabetes too I’ll probably be induced even earlier (I know women who have had indictions / c-sections at 34 weeks when they had 2 conditions).

I got induced at 39 weeks cause I got GD but I was on medication.

Literally last week I gave birth to my DD. It was my first pregnancy so I didn’t know what to expect.

I had the pessary and it worked 1st time for me so I had a quick labour. The ward called me in on the day and gave me about 1 and half hour notice that I had to go in for x time. I was really anxious about giving birth but it happened and I was fine in the end.

Thanks @Xyzzzzz
Did they book you in for a day for the induction in advance and you got a call about the time? Or did you not know at all when it was going to be in the week?

I have GD and my for the best part it was diet controlled but had to start medication. My midwife and obstetrician have both stated that they prefer to induce GD pregnancies before 40 weeks due to higher risk of stillbirth as the placenta starts to deteriorate quicker in GD than non GD pregnancies. We are looking at induction plan, I am currently 32 weeks and they will start putting plans in place for 38-39 weeks

I was informed at 28 weeks I would be induced and extra scans provided due to the GD. At 37 weeks they informed it would be when I was 39 weeks and I was called on the day by the midwife looking after me on the ward.

I’m in Scotland too and gave birth in January. I had GD and used medication. Everything I read talked about being induced early but when I asked about it at 35 weeks they said they weren’t planning on inducing me early. I had a whole load of other pregnancy illnesses and begged to be induced at 38 weeks. I was given an appointment to go in to get the pessary and was to return the next day to be induced. Turns out I was already 5cm gone when I went in so never ended up going home and my wee boy was born the next day. 39 weeks is considered full term so I wouldn’t worry to much about the part. Only thing I’d say is the drip gives you pretty severe contractions. The nurse told me this as she administered it so there was no turning back lol

I had gd in pregnancy and was induced at 40+6. I was diet control only and well managed.

I am in the UK so guidelines may differ. I also had baby at a teaching hospital which is regional hub for complex births which could make a difference.

Interestingly I was in very early labour a day before my induction in the end. I went ahead and induced as I was very tired from the pre labour as I couldn't sleep.

I would perhaps ask the Dr or your diabetes nurse could talk it through with you. I would get reassurance from them if you are still unsure.

Sorry in UK not in Scotland though x

Google NICE guidelines, which recommend induction by 40+6 for well controlled GD, such as yours. I'm in a similar situation and planning to put off induction as long as possible.

I had DD4 in the US in 2001. I was induced at exactly 40 weeks after GD that was diagnosed at 24 weeks but well controlled by diet, no medication. DD was born on 40+1 (almost 40+2). Pessary took a while to kick in.

DD turned out to be 9lbs 1oz even with really well controlled GD and little or no weight gain in the last 4 weeks on my part. She was a very sleepy baby for her first 2 weeks - lost over 10% of her birthweight and I had to supplement bfing with formula.

You may have some testing as 40 weeks approaches - non stress tests, maybe a scan to determine condition of the placenta and cord, status of amniotic fluid, and also to try to estimate weight of the baby. These things can't be predicted by how well you control your GD has been controlled.

I had GD controlled by diet, and all results (growth scans etc) within normal limits. Fortunately no other complications. I was told they would induce early but as above, I said that the NICE guidelines did not support this. We agreed induction at 40+4 to ensure not going over 41 weeks. I went into labour naturally and my son was born at 40+3 weighing 7lb 1oz, all his blood sugars normal thank goodness. I was able to have him in a midwife-led unit because I was lucky enough to have no complications.

I am 36+2 with GD, diet controlled the same as you. Growth scans have been fine.
I am 41 though and prior to the GD diagnosis was told that they would not want me to go over 40 wks due to stillbirth risk from age and the GD now increases the risks. At 37 weeks they will decide if induction should be at 39 or 40, but it will be induction unless I go in to labour naturally before.

I am happy with whatever they recommend, baby’s safety is paramount. There are other risks with GD babies even when growth scans are ok that mean I am opting to go with the consultant recommendations.

My consultants were awful tbh - astounded that I had any questions and answered me as though I were a troublesome little girl. Did not inspire trust. I had to do a lot of research myself to get answers and understand the NICE guidelines for someone in my situation. I know not all obstetricians are like that (my parents are doctors) but they were so dismissive and patronising

@HerSymphonyAndSong that’s how I felt! Patronising me even though I’m a 32 year old woman!

I’ve got 2 consultants, 1 obstetrician and one diabetes and I see them together- not patronising at all, listen to my views etc. I have heard loads of horror stories but my experience is brilliant. My obstetric consultant is risk adverse, he says that himself-but as this is likely our one chance to have a baby I am happy to follow his lead as I trust his judgment (and I’m risk adverse too). My objective is healthy baby delivered as safely as possible and if that requires induction or section that is fine with me.

Please, I am risk averse too! Just clearly our risks are different

I was induced for 2 of pregnancies due to GD I was induced at 38 weeks. My first GD pregnancy was my 3rd child and I honestly preferred the induction to spontaneous labour. I was diet controlled to begin with but ended up on metformin. I had scans every 3 weeks and I was told a few days before my induction that everything was fine baby would be 7lb max. Midwife examined me before giving me the pessary and said baby felt small. She was 9lb 11oz and the placenta fell apart as I delivered it. I was so grateful I had been induced as there were zero indications of any issues with her placenta or size and if I had gone any longer she could have died.

First baby, my blood sugar was well controlled and they didn’t talk about early induction. Second time around they recommended induction at 38 weeks right from the start. I did end up taking metformin for the last two weeks, but that wasn’t a factor in the recommendation for inducing early. I think my age (I was almost 40) and it being a second birth (so diabetes was likely to be harder to control) may have been behind the recommendation for 38 weeks, but could have just been different protocols in different areas or a change in policy over time.

Induction was very slow to get started; the actual labour was brutally fast. Baby was absolutely fine.

Interesting points raised about maternal age. I was early 30s when dc was born no other risk factors so perhaps why the 40+6. Baby was 6lbs 13 in the end.

Yes, age is a factor. I was 37, and DD was my fifth baby.

Wow this was so reassuring to read. Reading through this thread because I have just been encouraged to book induction due to recent diagnosis of GD (which I have been able to effectively control with diet since the original test!). My main objection to induction is because I have such a strong preference for the midwife led unit. My ideal would be what you experienced! I’m wondering if I should book induction on latest possible date for this reason, but obviously don’t want to increase any risks (still pretty unsure what they actually are!).. anyway, well done, sounds like you got things just right!