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I need opinions on induction/GD

post #1 of 7
Thread Starter 

Hi everyone,

 

I'm 29, pregnant with my first, and during this pregnancy it was discovered I have gestational diabetes. It was also discovered that I have PCOS and insulin resistance so the GD really wasn't a big surprise one we put all the pieces together. I had classic symptoms of PCOS (inability to shed my last 20lb even as a runner, dark spots in my armpits). Infertility, obviously, was not a symptom I experienced.

 

My sugars were very hard to get under control. They are now, for the most part. I'm on insulin and I've gained about 35lb. 

 

Let me say first that I have AWESOME care providers - I'm in CA and I'm seeing practitioners at Sutter Davis. They offer midwife care, water birth, etc. They have the 3rd lowest C section rate in the state (17%). They are ok with me going to 40 weeks. As I understand it, the practice around here is to induce GD moms at 38 weeks or so. They don't want me to go much past 40. I had a long conversation with the OB yesterday. I am currently doing NSTs and amniotic fluid checks twice a week and so far the baby looks great. She said that the tests do tell us that the baby is doing fine AT THIS MOMENT but the first indication of the placenta "wearing out" (which is a concern with GD) is low fluid. She said that most women come to their facility wanting no interventions, so if they are GD and get to 40 weeks, they want a few more days to see if labor starts. She said that it's better to induce at 40 weeks because the placenta has a higher probability of deterioration faster at 40, and there's a chance that if you induce after 40 weeks, the placenta won't be able to sustain the baby through labor and he could be in distress and we could end up with a C section anyway.

 

She also was very open that induction doubles the risk of C section. So basically, it's a gamble either way.

 

My due date is June 15th. I have my last appointment on that day and probably they will want to start induction on the 16th if nothing's happening.

 

I had tons of irregular contractions at 36 and 37 weeks. My body has been "quiet" for a week. When I was examined at 37 weeks, my cervix was softening and I was dialated to 1 cm. I'm at 38 weeks and 5 days now.

 

Does anyone have any thoughts on this? I want to trust my providers since they have been nothing but respectful, fantastic, and I don't think they are being alarmist, necessarily. However I want to spare my body and baby the stress of induction. I realize this is one of those situations where I may need to just pick the best option and hope for the best.

 

Of course, best case scenario would be that I go into labor on my own. I had thought this would happen at 36 or 37 weeks when I was having contractions, but that seems to have stopped for now.

post #2 of 7
Im in a similar situation with being induced. I haven't been officially diagnosed with GD but I was boarder line and needed to home monitor. My sugars have been totally manageable but I'm 41 weeks now and my first baby was pretty darn good size. I trust my doctor and midwife and am going in tonight for an induction.

I've even doing everything I can to ripen my cervix. A ripe cervix gives you such a better chance with the induction. You can google something called the Bishop Score...it is a score that is assigned based on readiness for a smooth induction. Though I'm sure there are tons of moms who went in for an induction with an unripe cervix and have had a favorable outcomes... It's just the odds of a section go up if the cervix isn't ready.

Things that may help are taking the supplement Evening Primrose Oil, sex, orgasm, using techniques from spinningbabies.com to get baby into a good position.

Since the forum leans towards doing things naturally you will probably get a lot of feedback about standing up for yourself if you don't want to be induced. Which of course is your right if you feel that is the best decision for you. smile.gif I tend to lean towards the middle ground and trust my providers so that is where I am coming from.
post #3 of 7

There is also a chance that the placenta could fail before 40 weeks, making it unable to sustain the baby through labor and delivery. If your blood sugar is well-controlled (regularly hitting 140 at 1 hour PP is NOT well-controlled!!!) then your risk of complications is going to be lower. Personally, I'd base your decision on what you know about your own body. Are you checking your sugar a LOT? If not, then you don't really know what it's doing. Four times a day is nice, but it doesn't tell you what your blood sugar does after that morning/afternoon/or evening snack, you know? Your meal time sugars might be great, but you could be hitting big spikes after your snacks. If you've been checking 7 or 8 times a day, then you have a better idea of what your body is really doing. If you haven't been, then you don't really know. Also, if you search my posts, I've linked to an article about normal blood sugars in pregnancy. The numbers your doctor has given you for targets may or may not be anything close to what is actually normal.

 

So basically, if you've been checking obsessively and your numbers are staying close to normal, then maybe you'd feel more comfortable going a little past your due date. Maybe not though. I mean, that's such a personal decision.

post #4 of 7
Thread Starter 

Well, I ended up going into labor at 39 weeks and 1 day. 39 hours of labor, and my son was born on Sunday June 10th weighing 6lb 12oz. His sugars were tested after delivery and were absolutely fine. He was sunnyside up, however and ended up with a huge bruise on his head from ramming against my bone (I pushed for 3 hours). He developed a little jaundice and we spent a total of 6 days in the hospital. But I had him vaginally (barely, I think) which makes me very happy. Thanks for the replies!

post #5 of 7

Yay, Katherine! Good news!

post #6 of 7

Congratulations!
 

post #7 of 7

Yay!  Congratulations!

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