If you had GD...

BPer · June 2014

One of my closest friends is now 40w4d with her first, and has GD which I believe she has been able to keep in check throughout her pregnancy.

At her u/s 2.5 weeks ago, baby was estimated to be 8.5lbs (which I know, is just an estimate, but holy shit). She hasn't done much in the way of progressing on her own, and hasn't had any periods of consistent contractions.

Her OB has not even talked induction, let alone scheduled one, which I thought was odd considering the GD diagnosis. I seem to remember a lot of GD mamas being induced 39w or after due to the risk of large babies, in addition to any health risks.

Am I making this up, or is induction the norm? She's miserable and I feel like this is setting her up to end up an emergency c-section...but I'm not a doctor, so what do I know.

Eastie156 · June 2014

Honestly, at about 37 weeks, my OB estimated Ethan was between 8-10 lbs and I started losing it. We weren't big babies (my side) but H's side was. Now, granted, I didn't have GD. But still, E was born at 40 weeks exactly and was 6 lbs 12 oz.... It's seriously just an estimate and they can be off by up to 2 lbs. I'd assume if her OB/MW doesn't see an issue with the babies weight and birthing, then it's not an issue, IMO.

@Bper, if her GD is controlled, why would they induce? (I don't know much about it, TBH)

willy_gert · June 2014

My doctor told me he wouldn't let me go past 39w because of my BP. He never said anything about inducing me because of GD though. I think they just watch you and baby closely. I had a BPP the day before Luci was born and they measured her close to 8 pounds, she came out 6 lbs 8 oz....

So those can definitely be off! If she isn't progressing on her own, she may have a c-section anyway. I would just try to encourage her to advocate for herself if she is worried and to be open with her doctor.

When I was starting to lose it at the end because I was so tired, and hurting and I couldn't keep control of everything like my BP, my GD, my anxiety, etc. I was really honest with my doctor about it. He was very comforting and I think it helped him make some decisions along the way, because he already knew how I was feeling/ thinking.

BeebopandBuddy · June 2014

I had GD with Ethan and I was told that I would not be able to go past 40 weeks under any circumstances. Ethan was breech so I was scheduled for a C-section on my due date.

I had high fluid and was getting an NST twice a week. I ended up getting induced one day before I was 40 weeks because Ethan turned so I could deliver him vaginally. My understanding though, is that with GD, docs don't want to go past the due date due to breaking down of the placenta and the possibility of a large baby.

It sounds like your friend should call the doctor and insist on a plan.

BPer · June 2014

BeebopandBuddy said:

I had GD with Ethan and I was told that I would not be able to go past 40 weeks under any circumstances. Ethan was breech so I was scheduled for a C-section on my due date.

I had high fluid and was getting an NST twice a week. I ended up getting induced one day before I was 40 weeks because Ethan turned so I could deliver him vaginally. My understanding though, is that with GD, docs don't want to go past the due date due to breaking down of the placenta and the possibility of a large baby.

It sounds like your friend should call the doctor and insist on a plan.

This is what I was thinking too. I know every doctor is different, but mine won't let women go more than a couple of days beyond their due date, even if they're healthy. She had said that she's seen a lot more issues with women going beyond their due date, than those that were induced while mom & baby were both healthy at 40w.

I thought maybe her doctor was just crunchier than mine, but it seems odd to not even have a plan. Especially because it took 6 days for me to get in for an induction from the day my doctor scheduled it.

Eastie156 · June 2014

BPer said:

BeebopandBuddy said:

I had GD with Ethan and I was told that I would not be able to go past 40 weeks under any circumstances. Ethan was breech so I was scheduled for a C-section on my due date.

I had high fluid and was getting an NST twice a week. I ended up getting induced one day before I was 40 weeks because Ethan turned so I could deliver him vaginally. My understanding though, is that with GD, docs don't want to go past the due date due to breaking down of the placenta and the possibility of a large baby.

It sounds like your friend should call the doctor and insist on a plan.

This is what I was thinking too. I know every doctor is different, but mine won't let women go more than a couple of days beyond their due date, even if they're healthy. She had said that she's seen a lot more issues with women going beyond their due date, than those that were induced while mom & baby were both healthy at 40w.

I thought maybe her doctor was just crunchier than mine, but it seems odd to not even have a plan. Especially because it took 6 days for me to get in for an induction from the day my doctor scheduled it.

@Bper, this is suprising to me. If the mother is healthy, why induce? isn't there a window of time between 7-14 days that some babies need to grow more? I totally get wanting to be done with pregnancy at 40 weeks, but unless an induction is needed, I don't understand why a Dr. would do one.

MrsKipper · June 2014

I just went through this with GD. I had a growth scan at 38w4d and he was measuring 8lbs7oz. He was born at 39w5d weighing 8lbs0oz. I kept my GD very controlled with diet and his size showed that, even though my fundal height was measuring ahead.

I was scheduled for an induction but went into labor on my own the day I was supposed to go in. They absolutely were not going to let me go past my due date. I was told that the recommendation is to go straight to c-section if a GD baby is measuring around 8lbs13oz.

I don't know, it's a catch-22 to me since those scans can be off and can lead to unnecessary intervention, but then again if the baby really is too big and there is no intervention it could lead to a complicated labor and delivery.

If I were her I would definitely be discussing a plan and risks of going over with GD to get a feel for how necessary intervention is, but if she's not on insulin then (I believe) the risks aren't as high as being diet controlled. Don't quote me on that, though, I'm no expert!

BPer · June 2014

@eastie156 From what I gathered from her, she's seen far more complications with mother's going 1w or more past their due date.

She'll usually schedule an induction once they hit 40w if nothing is happening, and the absolute latest she will allow is 41w exactly, so typically an induction scheduled for 40w5d if there's nothing else going on that requires earlier induction.

In my case, I was induced on my due date because my placenta was showing signs of calcification around 39w.

Eastie156 · June 2014

BPer said:

@eastie156 From what I gathered from her, she's seen far more complications with mother's going 1w or more past their due date.

She'll usually schedule an induction once they hit 40w if nothing is happening, and the absolute latest she will allow is 41w exactly, so typically an induction scheduled for 40w5d if there's nothing else going on that requires earlier induction.

In my case, I was induced on my due date because my placenta was showing signs of calcification around 39w.

@Bper, don't get me wrong, I was induced too, for lack of fetal movement as well as a baby with a dropping heart rate. But if that hadn't happened, my OB would've let me go 10 days. She said if I was younger, she would've let me go up to 14 days!

Hyaline · June 2014

The whether-to-induce question seems to vary a lot between docs. Some push for induction, some push against, and IMO it varies based on what they're trying to avoid. @BPer, you talk about wanting to avoid an emergency c-section...but induction can increase the chance of "emergency" (ie unplanned) c-sections. So it's kind of a complicated question that I think depends quite a bit on the woman, her individual health, and how the baby is doing.

Personally, I'm with Eastie--if mom and baby are doing fine per regular check-ins (as most docs and MWs will insist on when you go post due date), I don't think a GD diagnoses makes a huge difference in the ultimate "do we induce" question.

This article talks more about the issue and I think makes really good points (the blog is written by a PhD nurse): https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

Eastie156 · June 2014

Hyaline said:...but induction can increase the chance of "emergency" (ie unplanned) c-sections. So it's kind of a complicated question that I think depends quite a bit on the woman, her individual health, and how the baby is doing.

Stuck in a quote- This why I believe I almost had a C-section. Like narrowly avoided it. After 3 hours of pushing, I was given the "final push" and that was going to be it-they were ready and waiting for us to be brought for a C-section. Scary shit. Ethan was not ready at 40 weeks to come out, but circumstances decided that for him/us with an induction.

BPer · June 2014

@hyaline I definitely understand the variance between doctors. I think I'm just feeling badly for her because I know my OB would at least be giving me a light at the end of the tunnel.

Personally, I prefer my OB's approach (though I know there are many who wouldn't)

lbrown9807 · June 2014

I didnt read other replies, but I had GD both times around and was scheduled for an induction at 39-39.5 weeks both times. My OB said it is standard for GD. The info you gave with her gest date and approx weight of the baby (which I know is just a guess) would worry me too.

Hyaline · June 2014

BPer said:

@hyaline I definitely understand the variance between doctors. I think I'm just feeling badly for her because I know my OB would at least be giving me a light at the end of the tunnel.

Personally, I prefer my OB's approach (though I know there are many who wouldn't)

Definitely--I'm a "least intervention possible" outlook, so I'd be happy as a clam with her OB. I feel like, if I could give one piece of advice for first-time pregnancies, it would be "really think about your priorities and outlooks when picking an OB and/or MW."

MississippiCatfish · June 2014

Every doc is going to be different, like so many already said. But if you think about it, having kept a record of your blood sugar readings really proves whether there should be concern about a big baby related to the GD. If your readings have been consistently normal throughout your pregnancy, that's proof that baby has not been getting more than the average baby and really shouldn't be bigger related to the GD.

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