Anxious about delivery! Need helpful advice!!

Jebjeb2013 · June 2014

I'm 36 weeks 4 days and have gestational diabetes. The ultrasound at the begining of the week estimated baby boy's weight at 7lbs 3 oz. I'm currently 75% effaced, 1 1/2 - 2 cm dilated and at -2 station. We haven't scheduled a csection or induction yet but doctor said she doesn't want me to go past 38 weeks. She anticipates a vaginal delivery but is concerned about there being a problem with his shoulders fitting. She said there are maneuvers she can try but we may have to end up delivering csection. I've scared myself by reading on the internet about complications. Has anyone had a smooth vaginal delivery with gestational diabetes? Anyone y'all know?? I'm so anxious.

RJHarmon · June 2014

I've had 2 easy/successful inductions at 39 weeks. Both babies were just shy of 8lbs at delivery.

This time, my most recent growth scan (Monday) said that my lo is estimated at 6.5 lbs at 34.5 weeks. Around the 96th percentile. I'm a bit more concerned this time...

whimsy515 · June 2014

I had GD and gave birth vaginally on the 17th. We scheduled an induction on the 20th, but DS decided to show up on his own. I had already made progress like you have, and things went smoothly. DS was 6lbs 14oz, and his blood sugar was great. Try to think positive thoughts. Easier said than done, but thanks to this board, I've seen lots of GD mommas have successful/smooth deliveries!

Jebjeb2013 · June 2014

Thank y'all so much! I'm a FTM and don't have any family/friends that have experienced GD. I can't tell you how comforting it is to hear that y'all didn't have major problems!

GPeterson24 · June 2014

Late-term ultrasounds are notariously inaccurate so I wouldn't put too much stock into it.

Moving around and switching positions frequently during labour will help your baby descend and move however they need to in order to make their grand entry. Look into the Gaskin manouevre that can remedy shoulder dystocia should it occur while pushing on your back, some OBs have heard of it but some haven't. It could make the difference for you if you encounter shoulder problems.

Sounds like your body is getting ready and will do what it's designed to do. I know many people that have had successful births with GD. Good luck!

JSS1002 · June 2014

Idiot question - what does GD have to do with delivery complications? Is it just that they estimate a larger baby due to the GD?

RJHarmon · June 2014

JSS1002 said:

Idiot question - what does GD have to do with delivery complications? Is it just that they estimate a larger baby due to the GD?

Yes, GD can cause larger babies. However, the bigger concern is the breakdown of the placenta. It occurs much faster in moms with GD and especially if the mom is controlling the GD with Insulin or meds. Most OBs want the babies delivered before this occurs in order to limit the risk of stillbirth. This is also why GD moms have BPP's and NST's frequently. (I'm on meds and I have them 2x/week)

missmiss307 · June 2014

I didn't have GD last time (I do this time), but DS1 was 9lbs5oz at 41 weeks, and I had him vaginally. I only pushed for about 30 minutes.

JSS1002 · June 2014

Good to know, I had no idea!

*LrCg* · June 2014

Google the Gaskin maneuver. It's generally done for shoulder dystocia or even large babies. Just wanted to point that out so you're not worried about the baby not fitting. I also agree with pp about inaccurate weight estimates in ultrasounds.

argonne · June 2014

I had GD with DS. I delivered him at 41w3d with no complications. He was 8lbs8oz. I had NSTs twice per week from 38 weeks on. It seems weird that your OB is so eager to induce you at 38 weeks if there are no issues (like a poor NST).

Cat&S · June 2014

Size alone is not a reason to induce, especially before 39 weeks. As everyone has said, u/s are not very accurate later in pregnancy for estimating weight and can be off by +/- 1 lb, and plenty of ladies have delivered 9+ lb babies just fine. I would also wait until at least 39 weeks to induce, if not longer.

foreverapartofme · June 2014

One of my friends gave birth to a 10 pound baby! I think it all depends... I wouldn't worry about the estimated size because it can be a pound off either way. Just breathe and know that you and your baby will be fine. Good luck!

Jebjeb2013 · June 2014

I think its more than the size she's worried about. I've done the non-stress tests since about 32-33 weeks. He did poorly once and we were rushed into ultrasound to ensure he was okay. I've been on oral meds for sugar since 26 weeks then was switched to insulin at 34 weeks for better control.

argonne · June 2014

Jebjeb2013 said:

I think its more than the size she's worried about. I've done the non-stress tests since about 32-33 weeks. He did poorly once and we were rushed into ultrasound to ensure he was okay. I've been on oral meds for sugar since 26 weeks then was switched to insulin at 34 weeks for better control.

How are the NSTs now? It sounds like your GD is fairly severe, and I know that if you have to take insulin, there is definitely a push to have baby sooner than later. I believe that if if you have to take insulin, the placenta can deteriorate sooner.

Jebjeb2013 · June 2014

I had NST yesterday and the nurse said he responding to practice contractions positively. I still can't feel the contractions but they were 3 minutes apart. Should I take steps to try to induce naturally because of the placenta risk?

RJHarmon · June 2014

Jebjeb2013 said:
I had NST yesterday and the nurse said he responding to practice contractions positively. I still can't feel the contractions but they were 3 minutes apart. Should I take steps to try to induce naturally because of the placenta risk?

I'm not sure what they told you, but although they monitor you for contractions, they are seeing if baby has the appropriate heart accelerations when movement occurs. During the bpp they look for practice breathing as one of the criteria.

No, you should not try and naturally induce. If your doctor wants to induce, that's one thing, but taking measures to delivery before it's medically necessary is not a good idea.

argonne · June 2014

Jebjeb2013 said:

I had NST yesterday and the nurse said he responding to practice contractions positively. I still can't feel the contractions but they were 3 minutes apart. Should I take steps to try to induce naturally because of the placenta risk?

I don't know what they mean by responding to contractions. During a NST, they monitor movement and baby's heart rate. They want to see the heart rate increase with movement and then come back down once the movement stops. The big thing is the heart rate recovering quickly after an increase as this implies that the placenta is still doing a good job at providing oxygen to the baby.

JSS1002 · June 2014

argonne said:

Jebjeb2013 said:

I had NST yesterday and the nurse said he responding to practice contractions positively. I still can't feel the contractions but they were 3 minutes apart. Should I take steps to try to induce naturally because of the placenta risk?

I don't know what they mean by responding to contractions. During a NST, they monitor movement and baby's heart rate. They want to see the heart rate increase with movement and then come back down once the movement stops. The big thing is the heart rate recovering quickly after an increase as this implies that the placenta is still doing a good job at providing oxygen to the baby.

I thought that they were also checking to see how the baby's heart rate responded to contractions.

No advice on what to do regarding the induction (that's between you and your doc!), but I also was told my entire pregnancy that I was measuring "way ahead," and to expect a 9-10 lb baby, and at 39 weeks (induced due to preeclampsia), had a very normal-sized 8 lb 4 oz baby. That's after weekly monitoring from 32 wks onward. Everybody told me that the size estimates were always notoriously wrong and I didn't believe them, but that was definitely true in my case!

argonne · June 2014

JSS1002 said:

argonne said:

Jebjeb2013 said:

I had NST yesterday and the nurse said he responding to practice contractions positively. I still can't feel the contractions but they were 3 minutes apart. Should I take steps to try to induce naturally because of the placenta risk?

I don't know what they mean by responding to contractions. During a NST, they monitor movement and baby's heart rate. They want to see the heart rate increase with movement and then come back down once the movement stops. The big thing is the heart rate recovering quickly after an increase as this implies that the placenta is still doing a good job at providing oxygen to the baby.
I thought that they were also checking to see how the baby's heart rate responded to contractions.

No advice on what to do regarding the induction (that's between you and your doc!), but I also was told my entire pregnancy that I was measuring "way ahead," and to expect a 9-10 lb baby, and at 39 weeks (induced due to preeclampsia), had a very normal-sized 8 lb 4 oz baby. That's after weekly monitoring from 32 wks onward. Everybody told me that the size estimates were always notoriously wrong and I didn't believe them, but that was definitely true in my case!

I guess if you're having contractions (I never had a contraction during any of my NSTs), they can monitor the baby's response, but the main goal of NST is to make sure the heart rate rises and falls with movement.

I agree that U/S size estimates later in pregnancy are notoriously wrong and I hate it when doctors use them to push for early inductions.

Jebjeb2013 · June 2014

Thank yall so much! I've always been a planner and this last few weeks of waiting and uncertainty is driving me nuts!

RachelCA29 · June 2014

I did not have GD but I did have shoulder dystocia during my very fast labour (he was out with 10 minutes of pushing). There was fetal distress and then his shoulder got caught in my pelvis. To get him out safely and quickly (for breathing purposes, etc.) the delivering OB had to break my son's humerus bone. He was in a body wrap/sling for 3 weeks post birth, but he is healing remarkably well/fast.

My baby was not that large at birth (7 pounds 13 ounces), but I guess I have a narrow/weird shaped pelvis. My OB said if I have another baby it's likely to happen again - based on my body.

Nothing to do with GD or size, but it is something to consider if your doctor is worried about your LO's size/shoulders during delivery.

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