GD-frustrated with delivery options
gen2009
member
I'm due January 2nd. I got put on insulin a couple weeks ago. My OB stated that since I am on insulin, it changes things. I have to have a bpp/nst every Wednesday and the first bpp results were great, except baby is measuring large.
They said baby is 5-12. Greater than 90th percentile? Dr. said she knows these can be way off, but if baby continues to measure large, she would advise a scheduled c-section if measurements say she's over 9 pounds because of risk of shoulder dystocia. She also said that I can't go over 39 weeks. So, I guess I'd be induced? I'm so upset about this. I don't want a traumatic birth experience, but I didn't want there to be this much medical intervention.
My whole family has over-9-pounders. There is no history of gestational diabetes with any of the women I'm speaking of. My mother, my husband's mother, my sister-in-law, my cousins...
Does anyone have GD delivery experiences to share? Is there no way I can wait 'til after 39 weeks to deliver? I've heard induction before baby is ready to come out usually fails and ends with surgery. And I just plain old don't want a c-section.
P.S. Should I bother bringing up the fact that I ovulated late? She didn't seem to care when I first saw her, but now it's a matter of days. I was keeping track of my cycles and I got a positive reading for an LH surge 22 days into my cycle.
Re: GD-frustrated with delivery options
Honestly...you need to tell the doctor what you want and they need to give you a little more wiggle room.
A) if your family has a history of big babies then I wouldn't get too shook up about your baby measuring larger. Ultrasounds in late pregnancy aren't accurate and can be off up to 2lbs.
C) Being diabetic sucks because you have more requirements and restrictions but it is possible to have the birth you want. You can do natural induction and wait out being medically induced.
D) Pregnancy is not an exact science, even if you know when you ovulated. I say that because even if you're told you're over due, your baby could have needed more time to bake.
E) Tell the doctor straight up, a c-section is the last resort and there will be more than just your blood and tears shed over it. I told my OBGYN's that (I have 2) and they agreed it's not in my best interest to have a c-section. However you need to be realistic about it, so have a plan, but have a back up if it has to come down to that. Also do your homework, because alot of doctors will use scare tactics aka fetal distress to get you to just have a c-section...there's enough info online where you won't need to buy a book, but know what you can before anything happens because you're the number one boss of what happens to your body regardless if you're diabetic or not!
I was in your boat when I delivered my son. I'd had this whole vision of how his birth would be, what music we'd play. None of that happened. I had a scheduled c-section.
My whole family has a history of huge babies (my brother was 10.5 pounds, I had a cousin who was 13 lbs. at birth). I mentioned that to my doctor who said there is probably gestational diabetes in the family. My mom and grandmother were never tested for it. When they had huge babies, they were tested for diabetes after the birth.
If you had an early ultrasound, it would date the pregnancy. If the baby were measuring behind at that date, they would have moved your due date.
I had a scheduled c-section with my son. They were concerned he was measuring way ahead but his head wasn't and my placenta was aging. Aging placenta is common with GD babies and can lead to stillbirth. IF the shoulder is wider then the head(my son's was) the baby can come out with a broken arm (like my nephew) or worse.
Bring your fears and concerns up to your doctor.
I agree with pps, talk to your doctor about your concerns. My doctor let me go to 40 weeks before scheduling an induction. My growth ultrasounds were off. They were estimating that DS would be about 8.5 lbs. He was 7lbs 5oz.
I am hoping for the same this time around.
I am in a similar situation. Baby is estimated to be around 9-10 lbs at birth, and my Dr. is hinting at a c section. I am very aware the size u/s can be off, and I have reminded my dr. of that at every appt.
I politely informed my Dr. that I wanted to try vaginal first, and if she doesn't come down then I'll go to c section. She's not the most comfortable with it (but she pointed out that it is my birth and she can only advise), however I have to go to a perinatologist Friday for insulin, and they're doing a level 2 scan as well. I'm guessing they'll give me another guesstimate on size.
It's a hard situation to be in... my husband and I have been discussing it a lot. Because it's all about weighing unknown risks, it makes it a difficult decision.
Scenario A I have a c-section to avoid the risk of birth injury. If she comes out 8 lbs or less and healthy shape, then we did unnecesary surgery. If she comes out large with broad shoulders, we did the "right" thing.
Scenario B I try vaginally and there is some birth injury to baby and I due to size.
Scenario C I try vaginally and am not successful and then go to C section.
It's a hard decision. We are not going to decide our plan of action until a couple days prior. I am scheduled to be in duced at 39 weeks (2 weeks!).
Best of luck. I have found that as long as we voice our opinion and state what we want, it makes it a lot easier. Then the decision is ultimately up to you (still sucks), and you get to decide which path you take. All we all want is healthy babies.
I had well controlled GD with DS (on insulin the last 3 weeks for borderline high fasting numbers). I was scheduled to be induced 2 days after my due date. A routine NST the day before my due date showed an slightly elevated heart rate and contractions every 3 minutes, so they induced that day and DS was born on his due date.
I had a (in my opinion) very easy induction and DS was born vaginally at 8.5 pounds, perfectly healthy. My doctor NEVER talked to me about C-Section or inducing early.
I don't know what you should do about your doctor, but I wanted to share my experience to let you know it is possible!
I had two 39 week inductions due to GD. Both were long (56 hours with 38 in labor and 23 hours with 22 in labor) but were successful vaginal deliveries. I had patient doctors who were willing to wait things out and not rush to c-section unless there was distress to me or the baby. I had small babies (6lbs 11 oz and 6 lbs even) but before my growth u/s showed that, my doctor promised to induce unless the baby was measuring 9-10 pounds. At that point he felt the risks of birth injury were greater than the risks of a c-section and was not comfortable inducing. He probably still would have if I had pushed for it, but with very very close monitoring and a c-section at the first hint of trouble.
As for the going early part - for my doctors, it was a matter of being pro-active to go at 39 weeks. I was on insulin, with well controlled sugars and small babies. My NSTs/BPPs looked great, and my placenta did not appear to be aging prematurely. They still recommended inducing at 39 weeks, because they wanted the girls out while they and I were healthy, rather than risk problems cropping up if we waited. They also felt the inductions would be more successful and less stressful if done before complications arose. I did plenty of research on my own before agreeing to it, and based on that research felt confident 39 weeks was a safe time to deliver. I would have refused anything before that point, however.
DD1 Feb 2010
DD2 Sept 2011
Thank you so much for your stories so far. I went for an NST BPP today and they called my doctor overhead. Guess WHERE she was?!?
The O.R.!!
I appreciate all of your stories and advice. Someone asked what position baby is in: head down. Cervix is still long: 4 cm. NST and BPP looked great. Chubby cheeks on this one.
The automatic c-section with big babies is for actual good reason, because if the baby's shoulders get stuck aka dystocia, they can die during birth. I'm a nursing student and one of my teachers is an OBGYN nurse at one of the local hospitals (the one I'm delivering at). She had a mother, 2nd pregnancy, she's 10 cm dilated, she's pushing and she couldn't push her baby out anymore..the shoulders were stuck so badly her baby died...My teacher said it shouldn't have happened at all, but it does and that's why they would rather do c-sections. (this lady was having a 11lb baby though)
I was in the same boat. I wanted to have a vaginal birth too. I was worried about my recovery from a c-section. I felt that they call it an emergency c-section for a reason. But hearing my doc tell me that with such a big baby (97th %) they have had cases of having to break the babies shoulder I was all for having a c-section.
You have to decide what is best for you. I told my doctor that the baby and his health was priority number one, and that we would do whatever he recommended. After all, this was my first baby and he had delivered thousands!
Best of luck to you