I really, really don't want to be induced, but my midwife wants me to at 38 or 39 weeks- doesn't even want to consider letting me go to 40. If the baby's fine and not too big, I don't see why not.
I'd love to hear your birth story, especially about whether or not you were induced, how many weeks, circumstances that called for induction (or was it just because you're diabetic?), methods you used to induce, the health of the baby, and if you think the best decision was made and why.
T1 since February 2011, due January 31st (27 weeks pregnant)
I was induced at 37+4 weeks and it didn't progress so elected for a c-section (and have not once regretted my decision). I think something important to be aware of is the risks of attempting to deliver a large baby - shoulder dystocia and other complications can be VERY dangerous and it is not worth it to risk it. Second baby was delivered by c-section at 37+5 weeks. Both very healthy, both more than ready.
Full term is defined as 37 weeks gestation.
Ultrasound cannot accurately predict the size of your baby at term.
The other basis for early induction/delivery is that the placenta of diabetic mothers is thought to age faster. This is similar to the complications such as eye, kidney, etc disease but the placenta is much more sensitive. What happens then, is small areas of the placenta then start to die and detach. This increases your risk for placental abruption (placenta detaches from uterus) and other poor outcomes at 40 weeks. Think of the placenta like a funnel, capturing the nutrients and oxygen and delivering them to your baby. If there are holes in the funnel, fewer nutrients/oxygen go to the baby and if there is a large deprivation, this can lead to harm to the fetus.
Hayley- I was just told on Monday (at 28 weeks) my placenta is dying early so they gave me steroids to help with baby lungs because I most likely will not be able to carry to full term. You seem to know something about this, we are a little freaked out right now so anything more you can share I would greatly appreciate. Thanks!
Tara- How did they find out that your placenta was dying early??? what test did they do?
Tara, I'm so sorry to hear that. I pray everything goes well with the baby. I am only a week behind you, so I can imagine how frightening this must be. Please let us know what happens. (Not to be a bother, but for my education, how well controlled were your blood sugars? I'm so afraid that I'm not doing a good enough job, even though I have heard of moms having perfectly healthy babies even if BG aren't always great.)
Absolutely if the baby is getting too big or is in distress due to the placenta breaking down (detected by stress tests) that it would be dangerous vaginally, a c-section is better. The thing is, like you said, ultrasound can't predict size very well and sometimes babies are much smaller than they say- I can't tell you how many stories I've heard of moms giving in to a c-section only because a doctor said their baby was over 1.5 lbs. bigger than they actually turned out to be. I just want a medical reason for an induction or a c-section- just being considered "high risk" when my blood sugars are well-controlled isn't good enough for me! I know full-term is technically 37 weeks, but I'd like my baby to come when she's ready, not when the doctors are tired of seeing me lol
Nicole- they did not do any specific test but they have eliminated every other possibility (rupture or tear, uncontrolled blood sugars, high blood pressure, birth defects, kidney problems for baby) so are they are saying the low fluid levels could be due to the placenta dying early. I have had three non-stress tests done daily on baby since Monday and all have come back looking great.
Katherine- my A1C before getting pregnant was 6.5 it is currently 5.6.
Thank you for everyone’s thoughts and prayers, we are a little freaked out right now but have another ultrasound tomorrow to check fluid levels again, hoping for some good news!
Katherine - is it worth risking even the chance that they're wrong? IMHO, it is too dangerous to risk going to full term or when the baby is ready. Many first-time moms go beyond their due date the first time naturally. Beyond 42 weeks, it is too risky for non-diabetic women to wait as the placenta is so aged that the infant starts to become nutrient (including oxygen) deprived. Even with the best blood glucose control, the fluctuations in glycemia lead to stress on the microvasculature. The placenta is quite sensitive to this. It is unfortunately the nature of type 1 diabetes.
Tara I'm so sorry to hear about what's going on. I believe that diabetes is also associated with low amniotic fluid but cannot remember off the top of my head. There are some things that can be done and sometimes they'll put people on bedrest, sometimes as an inpatient. Hopefully you'll be able to wait another 4 weeks before it is time for delivery. Do you see a perinatologist? Doing NST is good. Are they doing biophysical profiles too? Hang in there and follow their instructions to a T.
We got some good news yesterday and I was able to go home after 4 days in the hospital! The fluid levels came up just slightly (but at least they did not go down again). Because I don’t have any tears or ruptures in the placenta I don’t have to be on bed rest, just taking it easy, drinking lots of water and resting. At this point they are hopeful I will be able to carry the baby for another 4-6 weeks, possibly even to full term if we are lucky. I see a high risk OB. They are planning on doing doppler ultrasounds (?) on the baby to measure the blood flow from the placenta to that baby. Thanks for everyone helps input, it really made the last few days easier on me to be able to talk to other diabetics!
Tara!!!! that is great news! what a relief. Take care of yourself and get lots of rest and drink lots of water.
That's great, Tara! Thank God. I pray you can go to term. I have a friend (non-diabetic) who went into labor way early and they were able to stop the labor and put her on bedrest and she was able to carry to term. I'm glad you don't have to be on total bedrest though. Take care!