Induction after C-section (Gestational Diabetes)

[TrixieTrix]

Hello All!

I am currently 24 weeks pregnant and was diagnosed with gestational diabetes around 2-3 weeks ago (it runs in my family unfortunately!)

I'm managing my blood glucose with diet during the day but my fasting BG is always high and there isn't anything I can do from what the midwife has said. So I'm now on Metformin and Insulin and the likelihood is that this will increase.

Originally I wanted a VBAC (by my due date my EMCS will be just under 5 years ago) but I know with GD the likelihood of me being able to go to term is pretty slim!

I thought that's fine, I can have an induction and still (hopefully) get my VBAC but the diabetes midwife seemed concerned about me being induced because of the risk of uterine scar rupture which in turn has massively freaked my partner out which I get, but with any medical intervention/surgery etc there is risk, its unavoidable!

I was just wondering if anyone was in/ has been in a similar situation?

<3 thanks in advance xx

Someone I was discussing this with the other day who I know very well and who has taught antenatal classes for years told me that most inductions end up as a c section anyway.

I had an induction 2 weeks ago after having a c-section 3 years ago and went on to have a successful VBAC although I did need the help of forceps. They used the dilapan rods first which were successful. They could also use the balloon. I was told they don't like to use any hormonal methods of induction following a c-section but the mechanical methods are fine.
I didn't have gestational diabetes though so not sure if that will make a difference.

That is really helpful! I'll have a look into non-hormonal inductions.

I think with the GD its the fact it may be a big baby (and I already make big babies unfortunately! My first was (9Ib1oz)

Thank you <3

My consultant has advised me not to have induction due to previous EMCS due to risk of scar rupture, I'm a long way off that stage yet but they'd prefer CS if I haven't laboured naturally. Do you have consultant you can speak to see their opinion?

What's the first signs of it?

I had a c section in May 2023 and baby 2 is due in February. Had a consultant appt last week and the consultant said they’d book me in for induction at 40 weeks, saying the risk of uterine rupture (which means of ALL sorts, not just catastrophic ones) was 1-2 in 100 for natural labour and 3-4 in 100 for induced labour. I declined anyway but she wasn’t particularly concerned about it, so if it’s what you want, it’s definitely an option.

I have an induction 2 years after a C-section - I didn't have gestational diabetes but I did have a very big baby, just under 10lbs. I had a really positive experience and was told the risk of rupture was very small. I had had a previous successful vaginal birth though.

Slightly different situation, I didn't actually have GD second time around, but I would have had to have been induced at term due to age rather than waiting any longer for spontaneous labour.

As pp has said, you need to carefully understand what induction routes are open to you having had a previous CS. I was also told the threshold for deciding the induction wasn't progressing, or was progressing too extremely was lower than a non-VBAC hence the increased likelihood of EMCS.

It was a few years ago now, so I can't remember the details. But having had such a smooth ELCS the first time, I opted for a second.