Gestational Diabetes Induction - Do I Have to Be Induced?
What's the average week of delivery with gestational diabetes and should I need to be induced?
No.
Not at 38 weeks, 39 weeks or 41 weeks. It is always your decision. Depending on where you live the average week of delivery with gestational diabetes can change significantly. Does it make sense that your zipcode should influence your access to best practices?
Your local hospital might routinely induce everyone with a Gestational Diabetes Diagnosis but doesn’t mean it is the healthiest decision for you and your baby. Induction is not risk free and needs more discussion so parents can weigh up the pros and cons of each decision.
If your Gestational Diabetes is well managed with diet (you can check this Eating Dates During Pregnancy blog post), exercise and stress reduction then you have even more wiggle room if you and baby are well. The placenta does not simply shut off at 40 weeks, it’s very likely that your provider is checking not only baby’s size but blood flow through the placenta to your baby during your pregnancy. Have you been told you can’t eat dates due to their high sugar content? They’re not off the table for some women. there are so many benefits and may encourage your body to go into spontaneous labor.
Why Are Some Babies Bigger with Gestational Diabetes?
Uncontrolled high blood sugars does damage blood vessels. If your GD hasn’t been well managed then induction may make sense to reduce the risk of stillbirth. ‘Well managed’ Gestational Diabetes also means your baby is growing at a normal rate so the ‘big baby’ scare stories and pressure to induce is misguided.
Induction can change your experience of labor significantly and your baby’s. Induction has a place in maternity services and when it’s necessary it’s a welcome intervention to keep moms and babies safe. The GentleBirth App includes hypnobirthing resources and meditations for a positive induction.
Gestational Diabetes Inducing Labor
However too many parents are not getting all of the information to make an informed decision about Gestational Diabetes Inducing Labor and there’s a lot to consider. If your provider is suggesting a cesarean for GD and you have no other complications I have no hesitation in encouraging you to quickly get a second opinion before you commit your health and your baby’s heath to undergoing major surgery.
If you’re confused about your options and whether Gestational Diabetes Induction is necessary for be sure to read the following articles from ACOG and Dr Rachel Reed and talk to your careprovider about your individual circumstances rather than the hospital's blanket policy.
World Health Association - Gestational Diabetes Induction
Recommend that induction of labor should not be offered for Gestational Diabetes unless there is evidence of other abnormalities occurring, such as abnormal blood glucose levels.
ACOG - Practice Bulletin No. 180: Gestational Diabetes
For women who have well controlled Gestational Diabetes with exercise and diet careproviders can take the reasonable approach of expectant management approach and NOT offer induction until 40 +6 days.
For women using medication to manage Gestational Diabetes ACOG recommends induction between 39 and 39+6 (those 6 extra days can mean a very different birth experience for you and your baby).
Queensland Health (Australia) about Gestational Diabetes Induction
Australian experts recommend that if blood glucose is well managed, there is no indication for induction for gestational diabetes.
Be sure to check out Lily Nichols - Pilates Nutritionist brilliant books for meal plans and common sense dietary advice that won’t leave you starving.
Stress raises your blood glucose levels as well as sleep deprivation too so be sure you're practicing with the GentleBirth App daily and definitely the day of testing (if you decide to have it). Here’s how you can help lower your blood glucose numbers throughout your pregnancy - not just on the day you go for your test.
In recent original research article, "Sleep Duration and Blood Glucose Control in Women With Gestational Diabetes Mellitus," Dr. Twedt and colleagues found that "short sleep durations are associated with worsened glucose control in women with gestational diabetes.
Note - Feb 2022:
Since the original article in 2020. There are growing concerns among providers that GDM(Gestational Diabetes Mellitus) is being overdiagnosed and some women are excessively restricting their diet in pregnancy and that healthy normally growing babies are being growth restricted and born smaller due to the overuse of medication that may not be necessary. Talk to your provider about your concerns.