Trying to decide-Gest Diabetes & getting close...

[ellairiesmom]

Is anyone else in this situation or does anyone have some knowledge that can help me toward my decision???

I have GD that is nicely controlled BUT with Metformin...not diet alone. I have been on Metformin for 9 years for Insulin Resist./PCOS & stayed on it this pregnancy to avoid actual insulin. It worked, but it still counts as "medication controlled GD".

I am also going for a VBAC & had come to a decision that I would like to have until 41 w 3 d before we evaluate our options. OB is somewhat willing to let me go to 41 weeks but has expressed anxiety over it. If my cervix looks good, she is also willing to try a little pit as opposed to just scheduling a section.

She had an infant death last year at 39 weeks with a GD mom. She also happens to be a friend of the family so she is even more personally involved...it isn't about control issues, being an evil medical OB etc. She genuinely wants me to get a chance to do things the way I want to try, but she also knows of the small risk with GD & going past 40 weeks & it's hard for her to just ignore it.

I of course want my baby to be healthy-that matters more to me than how she comes into the world. I had a very positive c section experience with DD1. But we did Bradley this time, hired a doula & I want to be able to know I did everything within my control to try for my VBAC.

Baby is only in 42% for size...so not big at all. Vitals for both baby & I are great. I started EPO orally & vaginally. Nipple stim, DTD, walking, spicy food...all on the list.

I am trying to come to terms with the safest decision for my baby-all things considered. I can't seem to find stats on controlled metformin GD & fetal death or complications & I also don't know how much to let stats help me decide.

I have checked with several midwives & across the board-none would allow a GD mama on meds to go past 40 weeks. So I feel like if my OB lets me, it is because of the personal relationship & really against her better judgement.

I just don't know how long to fight the fight to go to 41 weeks or so-if anything happened to my baby because of GD, I would never forgive myself.

Any thoughts, info, experience??? TIA!!!!

[kltroy]

Honestly, I'm very pro-VBAC, but one of my good friends had GD and lost her baby at 38 weeks around Thanksgiving this year. If you'd asked me before this happened, I would have said wait it out. I know that statistics can never predict what will happen to you individually, but like your OB, it is a little too close to home for me now. I would ask your OB lots of questions about risks - what are the risks of having problems if you wait versus not? Ultimately we all play the odds. Pregnancy is a hope and not a guarantee. Things go wrong with c-sections and inductions too, and there are some obvious drawbacks to each of those. I hope you can find enough information to make a good informed choice and feel at peace with your decision.

FWIW, I think a crappy induction that works is still better than a c-section, so if you're uncomfortable with the risks of waiting it out past 40 weeks then you might consider that - they can always do a crash c/s if needed, since you will be closely monitored during the induction. Best of luck.

[ellairiesmom]

Wow...I am so sorry for her loss. That is just awful. If you don't mind me asking (if so-I totally understand) was she on medication & if so, what? Were they able to provide her any explanations as to what happened? Normally, they let GD mamas go to 39 weeks so to see something go wrong at 38 weeks is just horrible. And it scares me.

I so appreciate your response & your candid post. I am definitely going to pose more questions this week to my OB about the risks & more specifics.

[Thenu]

I am exactly facing the same situation as you. I am 36 weeks right now and having GD from day one of pregnancy. Had GD starting from 3 months of pregnancy with my DS and was insulin dependent. I was induced at 38 weeks with cervadil and pitocin , took epidural when I was 3 cm and dilated to 10 cm within an hr. I couldnt push because of the epidural and DS's heart rate was dropping so had emergency c-section. DS was in NICU for breathing problems. I had severe postpartem depression and till now doubt whether that induction at 38 weeks was necessary, if I had avoided epidural i would have given birth naturally etc.

For this pregnancy I am scheduled for a repeat c-section at 38 weeks 2 days on Feb 5th. My doc won't do VBAC but I have talked her into trying one for me if I go into labour on my own before the scheduled date. My diabetes control is not that good this time and my a1c was 6.7 when they tested me 2 weeks back. I take 3 shots of insulin everyday despite that I am having a hard time controlling my diabetes. After reading kltroy's post I am getting really worried. We were originally thinking about postponing the c-section date to 39 weeks for lung maturity. Now I am thinking we took the right decision to go for the c-section at 38 weeks esp with my uncontrolled GD. I really really want to have a VBAC but my baby's safety and health comes first and carries more importance than what I want at this situation.