AW: Which would you choose?

mrsdanielleM2010 · September 2014

After my appointment today, I'm facing a choice regarding how to get my boy out safely. Info: I'm just over a fingertip dilated, 60% effaced, and soft & spongy. Baby has measured consistently in the high 90's for percentile all along. Current estimate is between 8.5-9 lbs now, and he's gained about a half pound a week. I have gestational diabetes, and for the first time today we discussed insulin for my fasting numbers, which have been slightly high. The potential that baby would need nicu to monitor his blood sugar if I take insulin is higher than if I don't. My doctor presented me with three choices, and I'm curious which one other people would go for. I think my mind is made up, based on which option the doctor most encouraged, but I'm curious what other people would do.

ETA for mobile users - I'm due 9/13, so the induction or cesarean would be during the 40th week of pregnancy.

mcstrepp · September 2014

I personally would want to avoid the baby in the NICU but everyone's birth plan is different. Good luck! Thoughts and prayers for a safe delivery and healthy baby in whatever you decide.

kaleb87 · September 2014

I'm mobile and can't see, how far along are you? That will help me to decide, but this is a tough question.

mrsdanielleM2010 · September 2014

kaleb87 said:
I'm mobile and can't see, how far along are you? That will help me to decide, but this is a tough question.

Added in OP. I'm 38 weeks, 6 days today. Induction or cesarean would be early next week.

mrsH1112 · September 2014

Im in a sort of similar position though my GD is already glyburide controled. I have my growth scan scheduled this weekend. At my appointment yesterday my dr told me that as long as our NST's go ok in the next week and a half that she wants to schedule induction 2 weeks from now.

She said for her patients that have GD she never really likes to go to 40 weeks as the chances of the placenta breaking down and having to increase meds is higher, the chances of the baby being pretty large is higher, chances of a short NICU stay are higher as well She said ideally shed like me to be a few centimeters dialated by then (im not dilated at all right now at 37 weeks) as it will make for a shorter labor and less of a chance for emergency C.

I say you are so close to your due date now, if it were me Id go for the induction and not mess with the insulin at this point in the game.

kaleb87 · September 2014

mrsdanielleM2010 said:

kaleb87 said:
I'm mobile and can't see, how far along are you? That will help me to decide, but this is a tough question.
Added in OP. I'm 38 weeks, 6 days today. Induction or cesarean would be early next week.

Thank you!

peanutbuttervibes · September 2014

I think this is a choice only you and your doctor can make. I'm sure you will make the best decision for you and your LO! Good luck with whatever you choose

mrsdanielleM2010 · September 2014

braybee said:
I think this is a choice only you and your doctor can make. I'm sure you will make the best decision for you and your LO! Good luck with whatever you choose

Thanks for the well wishes! Like I said, my mind is pretty well made - I'm just curious. Based on the poll results, our choice is the one most other people would make too.

amom2four · September 2014

I had gd with my last pregnancy as well as this one. I was induced at 39w4d last time and dd was estimated at 8 1/2 lbs. by both us and feeling by my doctor. You could have higher fluid levels making it seem like baby is bigger. I always measured normal fluid wise.

The nutritionist is talking about meds for me this time because my fasting levels are borderline. I have also talked about what to do should I make it to 39w. At 39, I am personally ok with induction just to make sure that baby is still healthy and placenta doesn't start acting wacky or shutting down.

It's really a decision on what you are most comfortable with. Also, I had a wonderful nurse that was with me at the end of delivery and she really emphasized the importance of breastfeeding instantly and basically continuously or as often as possible for the first several hours, if you are planning to bf. It helps to keep baby's blood sugar levels up for the checks they do. I did and it worked.

Fingers crossed you go into labor on your own before insulin is needed and baby maintains levels!!

Bonnesetter27 · September 2014

Just because you have the baby via induction a week early does not suggest your lo won't go to the nicu. It all depends on how he/she deals with delivery and their sugar levels. Also GD babies tend to have a higher risk of undeveloped lungs, so going early may mean a nicu stay for that.

I have GD too. I take insulin at night for fasting numbers. My dr. told me that there is no research that proves inducing early leads to better outcomes for mom or baby. She is allowing me to go to 41 weeks. My induction is scheduled for tuesday. However, lo is measuring on track in the 50%ile. I am already 2.5 cm and a soft 30% effaced. Baby is still very high though. Check out your bishops score (you can google it). I am a 7 right now so induction is still risky for me. Also your numbers should get easier to manage in these waning weeks as your placenta does less. If you don't already you might ask for NST's to keep an eye on LO and your placenta.

brittneyandadam · September 2014

I'm sorry you have to make this tough decision. I think you could make a good argument for any of the choices...but I would personally schedule the induction. That way, you have a day scheduled, but if baby comes beforehand then you don't have to worry about it. GL hun

ashaw512 · September 2014

I would schedule the induction. I don't know much about GD but I would want baby to stay out of NICU. From my personal CS experience it's not something I would just choose.
It would give you a chance to have a labor and birth rather than jumping into surgery.

mrsdanielleM2010 · September 2014

Bonnesetter27 said:
Just because you have the baby via induction a week early does not suggest your lo won't go to the nicu. It all depends on how he/she deals with delivery and their sugar levels. Also GD babies tend to have a higher risk of undeveloped lungs, so going early may mean a nicu stay for that.

I have GD too. I take insulin at night for fasting numbers. My dr. told me that there is no research that proves inducing early leads to better outcomes for mom or baby. She is allowing me to go to 41 weeks. My induction is scheduled for tuesday. However, lo is measuring on track in the 50%ile. I am already 2.5 cm and a soft 30% effaced. Baby is still very high though. Check out your bishops score (you can google it). I am a 7 right now so induction is still risky for me. Also your numbers should get easier to manage in these waning weeks as your placenta does less. If you don't already you might ask for NST's to keep an eye on LO and your placenta.

Thanks for the perspective! I know there are no guarantees with any birth plan, so it's about each person weighing their own risks.

Good luck for a safe delivery and healthy LO to you

Jayhawkali · September 2014

I was always measured large and had a 9lb baby. I would be induced if I could have to avoid a csection with my first

teenybean · September 2014

tough decision, but you know your family best and will come to the right choice for you with your doctors help. Best of luck and prayers for good fasting number in the meantime.

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