Inducing Due to Gestational Diabetes?

Cynthia Flynn's picture
Experts: 

QUESTION

Dear Midwife,
I am 41 and 36 weeks pregnant.I am so worried and burst in to tears at the hospital today.

At 30 weeks I was diagnosed with gestation diabetes. I was border line and adjusted my diet. For the past two weeks I was put on insulin injections just to help me control my sugar levels and since then my sugar levels have been perfect.

My baby's growth is perfectly following my growth chart and today was estimated to weigh 2642g, so he isn't a huge baby. But today I was told that I will be induced on the 12-6-09 which is twelve days earlier than my due date. I have been given a leaflet and it is still sinking in.

It's not what I wanted. I wanted to go into natural labor and spend my early labor at home. But what worries me the most is that when they break my waters and if I don't start labor, there is a chance that a C-Section will be performed.

This really is so upsetting me. Do I have a say in this? Can they force me to be induced? What if I need a section? If they just leave mother nature to do her best am sure everything will be fine. I had 2 children in my mid 20's with no problem at all.

I am just so confused and upset about it all.

ANSWER

Of course you have a say! It is your body, your birth and your baby, and YOU are the one who will need to live with the consequences of any decision that is made. The risks and benefits of each possible alternative (including your favorite, do nothing) should be explained to you. You might also consider getting a second opinion.

All that said, this stopped being a normal pregnancy a while ago, certainly when you were not able to control your sugars with diet or oral medications. As will be explained to you, this does put you at a somewhat higher risk for a late fetal demise. I'm assuming that you are getting non-stress tests twice a week, and these can help (but not guarantee) that the baby is still ok.

I'd really suggest that you do what research you can on the internet, and then have a good discussion of the options with your provider. If s/he does not or cannot give you good answers to your questions, I'd suggest considering another care provider--late as it is. You need to be on the same page with the person who will attend your delivery. Hopefully, you will be able to work it out with your current provider.

For what it's worth, I tell my own clients that I am very clear about my personal priorities, which are: 1) Safe mother and baby; 2) a vaginal birth; and 3) whatever (I mean whatever) the mother wants---in that order. Because if you get what you want, but you or the baby are not ok, I don't think you will be happy. And I do what I can (within the limits of safety) to keep moms out of the operating room for the same reason. But you don't have to agree with me, you can have your own priorities; it's your right. But it does work two ways: if you were my client and insisted on doing something I knew to be unsafe, I would not want to put my license (and you and your baby) at risk, and I could ask you to find another provider.

Hope all this helps!

-- Cynthia, CNM. PhD.