Your doctor is actually being cool to give you a realistic expectation of what will happen. It doesn't matter how well controlled your diabetes is or how healthy you and your baby are... a type 1 pregnancy is high risk and your doctor will want to induce early. Cesareans are so common now for all pregnancies (over 30% in the US) because it protects OBGYNs from malpractice lawsuits.
This French study is has a small survey group, but the info is interesting. It says 71% of type 1 moms have cesareans and that being overweight before or during pregnancy can contribute to the likelihood.
A few things to think about:
- At week 39 ask your doctor for an honest assessment of an induction being successful. If your cervix isn't dialating and you don't have other symptoms that you're ready, considering skipping induction and just scheduling the cesarean.
- If you decide induction is right for you, ask to use your pump through labor. Because you can't eat it's pretty easy to have perfect blood sugars with a pump. If you have a cesarean you'll have to go on the insulin/glucose drip because you'll be put unconscious after your baby is born, while they finish removing the after birth and stitching you.
- Ask your doctor to write on your chart that you will resume the pump as soon as you are conscious and able to monitor your blood sugar. You should be ready about a day after delivery. (Note: After pregnancy and especially after you start breastfeeding, your insulin needs will be extremely low. I'd had type 1 for 28 years when I became a mom and took NO INSULIN for a couple weeks after my son was born.)
- Induction and cesarean can delay your breast milk coming in. Make sure your child is given formula until your milk is ready. You'll know it's there because when the breast is squeezed droplets of milk will appear on the nipple. Some people are afraid bottle feeding will inhibit breast feeding. My son had no problem switching between, but if you're really worried you can give the baby formula from a cup.
I had your same frustrations when I was pregnant. I worked so hard to be healthy and had a non-diabetic A1c with no lows. Felt great and my baby was completely healthy. But it didn't matter when it came to deliverying my son. My body was no where near ready to give birth at 39 weeks. I went in on a Monday night at 6pm to begin the induction, they started pitocin the next morning at 6am, and I labored until my son was born by cesarean at 3am on Wednesday. Worst part about it was that I couldn't get out of bed or eat from 6pm Monday on! I felt so weak and my recovery from the long labor (pitocin makes contractions more painful) and surgery took longer than it should have.
Trust your instincts, but know that your doctors will want to be more cautious than you would have chosen. At the end of the day it won't really matter how you baby is born. You'll deal with whatever happens. If your baby is due a week earlier than you think best, it isn't a big deal in the grand scheme of things.