If You Have Gestational Diabetes, This Is What Your Doctor Will Do
Gestational diabetes (GD) can have a big impact on mothers’ and babies’ health, but it doesn’t always have to be a big deal that requires all the tools in the medical toolbox—or a major diversion from the patient’s hoped-for birth plan.
GD babies are at somewhat higher risk to come earlier than their due date. If mom’s blood sugars aren’t well controlled, babies can get too much glucose through the placenta and grow too big. That can trigger premature labor, damage the placenta and bump up risks for delivering a baby whose lungs aren’t fully developed. Premature and super-sized babies tend to have more respiratory problems and a tough time stabilizing their own blood sugars too.
That doesn’t mean these problems are guaranteed to happen to you and your baby. It means there’s a greater risk. Many GD babies are born healthy with normal weights and perfect birthdays and never have any problems at all.
Doctors tend to practice risk-based OB care. They prevent bad outcomes (sometimes big, scary ones) by preventing as many risk factors as they can anticipate—such as intervening to deliver a baby earlier if they're worried about gestational diabetes. That can work out great, but most interventions have risks of their own. And, just because there’s a greater risk for something to go wrong doesn’t mean it’s guaranteed to happen. It’s a risk. There are risks involved in every, single delivery. Every one.
While a 39-week induction is likely to turn out just fine, there are risks involved in jumpstarting labor. A lot happens in the last weeks and days leading up to spontaneous labor. All kinds of changes happen to moms’ and babies’ bodies that put the finishing touches on pregnancy and set the stage for labor.
If you don’t go into labor on your own, or your baby shows signs he/she’s getting too big or isn’t thriving in the uterus, then you can do an induction. Your doctor can keep careful tabs on how baby’s doing with non-stress tests, kick counts and ultrasound.
And you don't have to have a "just-in-case" epidural. If trouble erupts during labor, the anesthetist can slide in a spinal or epidural pretty darn quickly and get you to the operating room on time. If it’s a major no-time-to-wait crisis (some c-sections are, but most aren’t), they’ll use general anesthesia. C-sections have their own set of risk factors.
The bigger question is: What should you do if you feel you’re being railroaded into interventions you don’t think you need?
The answer: Communicate.
Schedule an appointment with your doctor to talk about your concerns.
Take your partner with you for support and backup.
Tell your doctor what your hopes and goals are for labor.
Be specific about your induction and epidural worries.
Give your doctor a chance to explain his line of thinking.
Listen carefully and ask all your questions.
Then, once you have more information, make a choice:
A) Negotiate with your doctor for the labor you want,
B) Go with your doctor’s plans or
C) Find a new provider.
There are risks associated with each option, but that’s how it is with every labor and birth. There are always risks.
