[limboland la la]

Hello-- I'm in Thailand and planning as natural a birth possible but my doctor (like most Thai doctors) doesn't share my views. Anyways, I'm at 39 1/2 weeks and the past two checkups they've found sugar in my urine. The doctor wants to perform a gestational diabetes test tomorrow. The 8 hour fasting, drinking a sugary drink and blood drawn over 3 hours.

To tell you the truth,I'm not looking forward to the test as I'm not sure the benefits of performing it at this late in the game. I'm not quite sure how the results of the test would change my pregnancy or my baby's birth.

When I asked the doctor about this she told me that my baby's lungs might not be fully developed and she have more fat accumulation round her chest. When I asked her to explain because I thought that most baby's lungs were fully developed around 37 weeks she said that my baby might die and would need to be born before 40 weeks. That gives me 4 days. If I chose not to be induced or "cut", I would need continual stress test monitoring.

I had never heard of higher stillbirths with GD, so I asked her what caused the greater stillbirth rate with gestational diabetes and she said that wasn't known. And at the time, I didn't think to ask her about the actual statistics of still births.

The statement "stillbirth" sent me for a kicker, as I don't want to be hurting my baby.

So, I've been searching the internet and mothering.com about gestational diabetes for if had it. My main concern is how it would effect my baby, and if the doctors statement that my baby has a greater chance of being a stillbirth is true.

To me, it seems like unnecessary worry to have a gestational diabetes test performed now. I would rather just try to control my diet a bit this last week or two, and get a little more exercise. It doesn't seem like I can do much of anything else.

So here's what I'm asking the professional community here:

* First, what I'm looking for is numbers, and statistics about how gestational diabetes effects a newborn baby. (Particularly, stillborn statistics....as that scared me).

* Secondly, in your professional opinion, do you believe a woman should be induced at 40 weeks were she to be experiencing gestational diabetes?

* Would you recommend a client take this test at 39 1/2 weeks?

* And finally, if I were diagnosed with gestational diabetes at 39 1/2 weeks, what actions would I need to take, or could I take to help the situation?

Thanks for ahead for your input.

 

[MsBlack]

Can't answer all of your questions exactly, but--it is common for there to be sugar in urine during pregnancy, if you ate something sweet (even fruit/juice) in the hour or so prior to testing. And I would not agree to the test, or to an induction/csec based on what you have told us....does not sound at all evidence-based to me. I would want some evidence that the baby was in true need of being 'rescued' from my womb--not just a fear of GD. While it is true that women who have a blood-glucose control problem during pregnancy tend to grow larger babies with wide chest diameter, this is not necessarily a problem. And stillbirth or other issues with baby are only more of a risk for women with more severe Gest. Diabetes (requiring meds to aid blood glucose control--and if you did need meds, you would be symptomatic and in no doubt that you had a problem).

Plus, as I understand it, Thailand has a very high rate of csec and very little knowledge of, or tolerance of, natural birth. It also seems true there that docs are generally more accustomed to obedience from patients--and might not willingly give up authority over your care. You may need to take a strong stand for yourself if you really want a normal birth. If you feel ok, and baby is still vigorous within, then I might watch my diet more carefully and get more exercise as you have mentioned--but mostly, I would plan for how to deal with the docs!

 

[BirthLovinMomma]

I can't seem to find the link to the article that I read recently but it talked about how blood sugar levels naturally go up slightly in the 3rd trimester of pregnancy. So if they do a GTT on you at 39 1/2 weeks but weigh it against the levels considered normal for earlier in the pregnancy, it is likely that they will diagnose you with gestational diabetes. Whether or not you actually have it is another concern. Hope that little bit of info was remotely helpful.

 

[MamaRabbit]

Wow. Hmm. I think MsBlack pretty much summed up the OB issue. I have plenty of pee sticks if you want to come over and retest your urine

(

Thailand C/S rates)

FWIW, I spoke with a GD mother today (36wk diagnosed a while ago), and her actually quite laid back OB at Bumrum(expensive)grad Hosp. has said nothing like what you've been told. And that hospital has 90% C/S rate.

 

[majikfaerie]

yeah to what ms.black said.
at 39.5 weeks, i'd be just letting labour happen.
if you're accessible to BKK, definitely give mamarabbit a call. she's gold

 

[limboland la la]

Thanks everybody! And hi mamarabbit!

I've just decided to sit it out-- been trying to move around a bit more and avoid the sugary foods. I'm a little upset at the doctor, saying my baby might die seemed overly dramatic to me.

Thanks again for the input!