Gestational diabetes- rethinking delivery options

[Whatnow45]

I'm 35 weeks pregnant and had a second glucose test after sugar in urine. I'm just over threshold for GD and they've confirmed a diagnosis. Bmi is only 21 but strong family history so not surprised.

I was planning a natural waterbirth and wanted to avoid an induction at all costs. They think my GD should be diet controlled and natural delivery still possible but theyre not likely to let me go past due date so induction more likely.

Part of me is tempted to just go for an elective and avoid induction altogether. My mum also suffered from postpartum preeclampsia which is more serious type of preeclampsia and I'm at risk for this (been taking aspirin and calcium though) and I read diabetes increases preeclampsia risk even more so I'm more reluctant than before about natural delivery. It feels like there are more risks as much as I don't relish the idea of a c section either.

Anyone been in similar situation? Not sure what to do

Bump

I had GD with my 1st - the threshold for a positive diagnosis was 7.8 or higher and I got 7.8 🤦🏻‍♀️ I was diagnosed at 29 weeks, it was diet controlled the whole time, started collecting colostrum at 37 weeks. Induction was never even discussed, ended up going into labour at 41+2 the day after a sweep, tried for a water birth but the little sod was back to back (that hurt. A lot.) so ended up being episiotomy and ventouse at 41+3. Baby was fine, I was fine.

I had GDM diagnosed about 24weeks, readings never very high and i ŕemained diet controlled throughout.
I didn't want to go overdue so had an induction booked on my due date (obstetrician was happy to let me choose induction anywhere between 38+5 and 40+4), and I went into labour at 39+6.
Was very happy with the outcome and would make the same choice in that situation again.

Thanks for replies, I think I'm only just over threshold too so they think it can be diet controlled and that natural delivery should still be ok. I've just heard so many bad stories about induction it was the one thing I wanted to avoid. I had visions of a nice waterbirth and lots of sugary snacks to keep me going through birth! Maybe it's still possible - I have an appointment next week at hospital to discuss

Hey! This happened with my first baby. Diagnosed with GD at 28 weeks. Diet controlled till about 34/35 weeks. Then went on metformin for the last 3/4 weeks. I was having regular growth scans and they advised on inducing me at 38 weeks as they said baby was looking big at 9lb. They did recommend an induction/natural birth but said I could book csection if I wanted to. I took their advice and went for induction.
Induction was pretty quick to be fair. I had been harvesting colostrum and I think this did actually help. But baby ended up stuck and I had to go to theatre for forceps. He was 8lb 13oz. I think if I'd known he would get stuck and I would need forceps/episiotomy (which they had said could happen but told me to try natural anyway) I think I would have saved myself a lot of bother and just gone straight for a csection.
I'm now pregnant with my second and if they tell me baby is big again I'll be booking a csection right in! I think it just all depends on the circumstances and have a good chat with your consultant about it when you make a plan.

A natural birth has much better (short and long term) outcomes for you and your baby. I had GD and was able to easily control it with diet. I was also able to have a water birth (although at the time I ended up forgetting all about it!)

If you can avoid induction, avoid that too. Start looking at natural ways to bring on your labour, Raspberry Leaf Tea etc

I ended up on insulin so slightly different and baby measured big so I was induced at 37.5 weeks with the propess pessary and then had my waters broken 24hrs later.

I found the induction absolutely fine, bit boring waiting for something to happen, but once they broke my waters everything went really quick and DD was born 4 and a half hrs later with just a bit of gas n air.

Is this your first pregnancy?

I'm unsure about your comment re pre-eclampsia and mode of delivery. A vaginal birth doesn't increase the risk of pre-eclampsia. In fact, whatever way you end up going will not affect your risk of developing pre-eclampsia.

Just wanted to clarify that so you don't use this as a deciding factor.

If you want to avoid induction but they are happy to let you go up to your due date, could you not wait until then before making a decision? There’s a very good chance you’ll just go into labour naturally before then anyway.

I haven’t personally had an induction but I know several people who have and who had good experiences. I appreciate there are some horror stories out there too though!

I had diet controlled GD but was also over 40 so consultant led and couldn’t go over due date due to risk of stillbirth.

I had a failed induction at due date (long story-they had to abandon it as I had a rare reaction to the pessary) but had a spontaneous 6hr labour and natural birth later that day. If I hadn’t I’d had to have a section the next day as I wasn’t suitable for another induction attempt due to the reaction I had.

If they are happy for a natural delivery I’d go for that over a section.

Just bear in mind that you have to stay in for 24hrs minimum regardless as the baby has to have blood sugar monitored for 24hrs before discharge.

I had GD, diagnosed from the glucose drink test. My numbers were never very high so although they wanted to give me insulin I refused as other than the blood sugar readings there was nothing to show I was having any problems. They also strongly wanted to induce me early but the only reason they could offer me for that was that there was a greater risk of baby being big. But I was having 2 weekly monitoring scans and they consistently showed baby was measuring on the 50th centile. So I said unless I started to show signs of problems I was going to go into Labour naturally and they accepted that. As it happened I did go into Labour a bit early anyway at 36 weeks.

I had GD in both pregnancies. With DS1 I was diet controlled the whole time and I was told all the way through by the midwife that I would need an induction and to be attached to a drip for labour. I really didn’t want this as I was set on a water birth at the MLU, however they practically scoffed in my face when I said this. When I saw the consultant at 36 weeks for the birth appointment, she was the complete opposite and said I could have whatever I wanted as I was diet controlled and had all green readings.

With my second I had a section for unrelated reasons. Point is, it really depends on how you cope with your glucose levels over the next trimester and what the consultant says. Don’t automatically rule the water birth out if you stay diet controlled but do be prepared to discuss all options at your appointment.