I read the other post about BP below, and maybe I can get some more opinions about my situation and whether you think it would compel you to agree with induction.
The doctors got worried I had pre-e at 25 weeks because I had elevated protein. That went down and the doctor said it was probably just a bladder infection. I've had marginally high bp the whole pregnancy (although it was never high before that), which is usually about 130/84 in the office but more like 117/75 at home.
They next said I had g.d., although the results were marginal and I probably wouldn't have been diagnosed in some practices. Since then, I monitor my blood sugar at home and it is never even slightly elevated beyond what is average for a non g.d patient and I can't get it to elevate even if I drink soda and orange juice and eat white rice. They say fine, but you're probably still just controlling it with diet and better to say you have g.d. than that you don't. The baby measures in the 74th percentile, my weight gain is slightly below average, and there is no other reason to suspect g.d.
The high risk OB wants to induce at 39 weeks, and says better that than to risk having a stillborn. I certainly don't want to put my baby at risk, but I'm not convinced my blood pressure is high enough or my g.d. real enough to merit induction. It seems they're over-careful, and although that's great when it means extra watchful monitoring, when those results aren't compelling, why not assume induction is not necessary? On the flip side, is induction so bad? It's my first pregnancy, so I don't know if it's worth a battle.
Re: Induce or not?
I went to the high risk person when they diagnosed pre-e. She said, no, you absolutely do not have pre-e, but we'll induce anyway at 39 weeks b/c of your marginally high bp. After that, I didn't see her, but now I will because they think I have g.d.
I am 34 and had pretty terrible morning sickness for the first 2 trimesters, but overall they always have said things were fine and it was a completely uncomplicated pregnancy until the scary 25 week appt where they found the elevated protein.
It's more like they're just like, "if you fail the 3 hr g.d. test based on our criteria, you have g.d. and we induce g.d. patients" and "if you have marginally high bp, it's always safer to induce." I guess it makes sense to have rules, but it just seems like it would be better to try to consider more data and make a case by case judgement, and it seems like they don't really do that. Unfortunately, they are widely regarded as the best OB office in town, so I'm not sure if there is a place to get another opinion.
Is your BP always that elevated when you see your OB? Have you ever had readings where the top number was 140+ and/or the bottom number is 90+? You don't have to have pre-e for BP to be a concern during pregnancy. PIH(pregnancy induced hypertension) can be bad enough on its own. I think you need more information before making a decision regarding this.
With regards to the GD, you kind of have to go with what your office categorizes as GD. I know some offices say under 140 is good, while others say under 130. You can't really make one doctor's office use the standards of another.
My bp at the OB office is always around 130/80, and it has never been over 140 or over 90, except at the first appt where it was 159/80, but I was nervous, and when she took it again, it was back to the 130/80 range. What information about this should I look for?
I know they have their rules about diagnosing g.d., but when results are borderline I think they should look at your blood sugars, baby's growth, and perhaps a few more office measures before deciding if you have g.d. that merits changing the way they treat your labor.
I was induced with my first baby right at 40 weeks and ended up having to have a c-section after 14 hours due to failure to progress. As it turns out the baby was turned and would not drop or engage, my OB said that I probably wouldn't have been able to deliver him. That said I wonder if I had not been induced if I would have been able to have a vaginally delivery. That said it it came down to a question of the baby's health, I would say to err on the side of caution. I had a good c-section experience, but then I have nothing to compare it to.
Well ACOG doesn't recommend induction for GD at all. And my BPs are exactly like yours. In the office I'm high b/c I'm stressed but at home I'm perfectly ok. Hypertension can also be completely separate from pre-e. I've had this discussion with my high risk OB. She monitors my BP and checks it again at the end of the appointment and it's always on its way back down. As long as it doesn't get ridiculously high and/or I don't have protein she knows she's gonna have to present some cold hard facts and evidence based research to convince me to induce. Especially since I'm now doing weekly NST so unless those become "bad"...
ETA: ACOG doesn't recommend if their reasoning is for big baby. Haven't done the research on GD alone. But I don't see why they'd just indue for GD especially if you and baby are fine.
From my understanding, inducing for GD is not really about having a big baby, but more about GD causing the placenta to break down faster than normal.
Sit down with your medical team and ask them to explain your case to you.
It sounds like you now have two doctors, discussing two diagnosis and recommending possible induction. You can come online and ask opinions, but the truth is that we don't have the whole picture that your physicians do...and every patient is different (so even if someone's BP is "just like yours" it doesn't mean anything).
Doctors don't know that you don't understand what is happening unless you say so. It sounds like you have many questions outside of induction (you are still questioning your GD diagnosis) that need to be explained first. Your health care provider's job is to explain to you things in a way that you understand and can follow. Just saying something is "their protocol" means nothing....why and what evidence prompted this protocol to be enacted?
It can be hard during an appointment for patients to sort through their thoughts (I know that sometimes I forget to ask things once the doctor is actually in the room), so I recommend that you bring a notebook to your appointment with your questions and concerns written on them. Also bring your DH or someone else with you who can help ask for further clarification as well.
I hope that you are able to sit down with your OB and get a better understanding of what is going on.
I was a scheduled CS at 39 weeks, since my brother was big, and my mom's OB said the only reason babies get big is because of GD. My mom NEVER had a high blood sugar reading, but her OB still diagnosed her as GD. (Wouldn't you know it, my due date was right around Thanksgiving.)
I'd say no, unless they can give you a more compelling reason.
Have you heard of the term white coat hypertension? Many people have an elevated BP reading while at a doctor's office because of stress or anxiety around the appointment.
From your lower readings at home you might have it. Talk to your doc about it.
I have it and always take some time to relax before getting my BP checked. Easy to do with the longer midwife appts. Maybe not as easy to do at shorter and more stressful OB appts.