GD and Induction

ac5008 · July 2013

I am just curious how many of you are or have faced early induction due to GD (early being before 42 weeks). Since my diagnosis I have transferred to the "high risk" team at the military hospital, and have so far received two different answers on this (one that will not let me go past 39 weeks no matter what, one that will not induce unless sugar readings go out of control). I am diet controlled but do take Glyburide at night.

Although I know it will vary based on provider, I am curious how many were induced and how many were able to go into labor on their own with GD.

cinderin · July 2013

when I was first diagnosed with GD, I was told I would be induced at 39 weeks (I was about 24 weeks when diagnosed).

after my OB saw that I was good at controlling my BS and that I followed all of their direction and after a couple measuring u/s estimated baby at around the 40th percentile (estimated 7.5 lbs at birth) OB said she would let me go to 40 weeks, which I was excited about.

at my 34 week u/s baby was breech. baby is still breech, so I have a scheduled c/s at about 40 weeks. so, i guess she kept her word about letting me go to 40 weeks. :-)

not what I wanted, not quite what I had imagined (kind of like most of this PG :-))

I think the important thing is to ask questions and listen to your doctor.

ask specifically why they want to induce at 39 weeks.

is it your placenta? my OB was most concerned about the placenta because GD can be hard on it. she said that often if the placenta is beginning to deteriorate, when you go into labor/get induced, the placenta won't be able to make it through the labor and you might end up with an emergency c/s. so she wanted me to have the best chance at a vaginal birth.

so much for that :-)

SeaConquest · July 2013

I've had GD twice and was not induced with my first. I was diet controlled, except for Metformin which I always take for PCOS. My son was born spontaneously at 41w1d, the average for a first gestation, and was 7 lbs. 11 oz. Baby and I were fine after delivery. I was in a free standing birth center with midwives and received extra monitoring with a perinatologist.

I am AMA with this baby and have GD again. I still take Metformin, but have had to add Glyburide at night to control fasting numbers. I was seeing midwives again until we moved internationally, and now see a natural birth friendly OB and peri. We have agreed that, as long as my BPPs/NSTs/growth scans/sugar control are fine, then we would not discuss induction until 41w.

I see fear re placental issues discussed quite a bit here, but the reality is that, if you are getting regular BPPs, which is pretty standard with GD, they are checking your placenta. I am a few days away from my EDD and my placenta is still grade II. If it started to deteriorate, we would know. I wouldn't be scared into a birth plan because of what could go wrong with a hypothetical pregnancy because the list of possible complications is long, even though the actual risks on a percentage basis are generally low. These issues really aren't one size fits all; they are specific to each woman and each pregnancy. And, with extra monitoring, you and your doctor should have a good idea of how you and baby are doing. Having said all that, my advice for any woman is to specifically discuss birth options with her care provider, do independent research on evidenced-based care, and decide for herself where her comfort lies with various interventions/birth options, including induction.

One of my favorite sites for research on evidenced-based care is this one: https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

memali26 · July 2013

I was on insulin in both of my previous GD pregnancies and had two 39w inductions. My BPPs and NSTs all looked good, my babies were small, but with #1 my blood sugar was not as well controlled as it should have been, even on insulin (due to poor care from my diabetic team, no fault of my OB) and with #2 I had high fluid levels.

Every OB will have their own standard of care for GD - my first induced all GD patients at 39 weeks, period. My second took a wait and see approach for diet controlled, but preferred induction at 39 weeks for insulin controlled. In both cases, DH and I weighed the risks of induction vs the risks of our particular situations and chose to agree to early induction. It was the right decision for us and I don't regret it for a second. If we hadn't felt comfortable with it, we would have pushed to wait longer, even a few days, with heavy monitoring.

24karat · July 2013

I've had two diet controlled GD pregnancies. The first I was induced at 40wks. My midwives usually induce at 39 for GD, but let me go to 40 because my numbers were low and well controlled. The second time I had a c/s at 37wks but that had more to do with having complications and a twin pregnancy than GD.

PennyLane26 · July 2013

I had diet controlled GD and induction was not even a discussion. OB said there was no need.

I ended up being induced anyways at 37w5d for pre-e.

Starofd00m · July 2013

I'm not the OP, but just wanted to say thanks to you ladies for replying! I've been wondering the same thing - my OB says she'll let me go as long as my #'s are still good as I progress through the end of the pregnancy (I'm not on meds or anything now, just diet controlled), but my high risk doc told me "I don't let ANY of my GD ladies go past 39 weeks." I really don't want to be induced unless it's necessary for my health or babys health...I say if the numbers are good and baby's ok let it keep cookin!

Juliebird8307 · July 2013

My OB just told me today that they won't let me go past 39 weeks. I'm a diet controlled GD.

ac5008 · August 2013

Thank you for all the replies! I met with my new OB yesterday and after I discussed my concerns with her, she said she was "open" to the idea of not inducing at 39, given that I do 2x weekly NST's and one more growth scan. At 35.5, baby girl was measuring just over 5lbs, so she doesnt look like shell get very big as long as I keep up what Im doing (hopefully). This is #3 and I hope shes more eager to join the world than her big brothers!

BlessUrHeart29 · August 2013

I asked my OB about this at my last appt. He said he typically delivers his GD patients at 39 weeks, and would very rarely let them go past 40, but it really just all depends on the situation that is going on at the time. There are so many factors involved in the whole picture that he couldn't really give me any definitive answers when we've still got at least 2 months to go.

bnikiz · August 2013

I was told they would not let me go past 39 except that im attempting vbac so in that case i can go till 41 if nothing comes up. Military hospital also

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