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I'm doing a bit of research here for a friend-- any help appriciated. Friend is pg w/ 2nd dc...had 1st dc one month before due date by failed induction/c-section due to GD diagnosis. Baby was average size for gestational age-- friend was told baby would be too big due to GD but that was not the case. Now prego w/ #2, been diagnosed w/ GD but is managing it through diet and exercise-- most of the time her blood sugar levels are borderline diabetic or below...<br><br>
She is hoping and planning to have a VBAC but has been told that once she gets to 38 weeks she will be induced as the Dr's are not happy to allow her to carry on past 38 weeks. To my friend this seems unreasonable considering her GD is being managed well (without insulin) and the likelihood of her birthing naturally at 38 weeks is slim. She is tempted to ignore medical advice and carry on until she delivers naturally so long as her measurements (belly) are normal and her blood sugar levels are good. Obviously she doesn't want to put her baby or self in danger but feels like she was robbed of the chance to deliver vaginally with her 1st pregnancy and has had to fight through out this pregnancy already to avoid being "overmanaged" by the medical establishment.<br><br>
Anyone have any experience of this /thoughts/ suggestions/ resources?<br><br>
thanks<br><br>
Zoe mama to Thomas 01-06
 

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<a href="http://www.plus-size-pregnancy.org/gd/gd_index.html" target="_blank">http://www.plus-size-pregnancy.org/gd/gd_index.html</a>
 

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I've gone through two GD pregnancies - both requiring insulin so farther along the spectrum of insulin resistance than your friend. My second birth by the way was a HBAC. I used a CPM for maternity care and an endocronologist for sugar management.<br><br>
Have your friend contact the Amer. Diabetes Assoc. as well as the Amer. College of OB/GYN to find out the current recommendations for induction for GD. Back in '99 when I had my first, the recommendation was 38 weeks but then a study came out showing no improved outcomes and it moved to 40 weeks. If ACOG has a practice bulletin on the topic they will mail her a copy for free.<br><br>
Aside from that, it is a good idea for your friend to have a back up plan on where else and with whom else she can birth in case this is an issue. Many many many of the GD women I'm in touch with have normal, healthy babies and IMO sectioning a GD woman (who is at risk for reverting to permanent diabetes later on) due to the failed induction is a terrible choice because of the impact it has on your health and fitness. It was 6 months after my cesarean before I could take even a gentle 5 minute walk without activating my ab pain. It was a long long time before I regained any fitness. Very unhealthy.<br><br>
-Barbara
 

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I agree with your friend. GD is not an excuse for c-sections nor is it an excuse to take a baby early, "just because"<br><br>
She needs to find a new care provider IMMEDIATELY!!!
 

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That's frustrating! My cousin had a baby 2 wks after Ilana was born and was on insulin for her diabetes, I think she was induced at 38 wks as well. Her baby wasn't even 7#, smaller than my non-GD baby (39 wks). I was induced however w/ Ilana at 39 wks and things went well. I was 3cm at 38 wks and 4cm and contracting at 39 when I went in. It's not best to be induced, we all know that, but if she's doing well, there's no reason to believe she's going to have a 12# baby!
 

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and even if she did have a 12# baby, she could birth naturally!
 

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I'm planning a VBAC and my OB said that she would never induce someone who is attempting a VBAC because it increases the risks of uterine rupture. She's seen 3 uterine ruptures while she was an intern and all three times, the woman had been induced. For that reason alone, I would refuse to get induced.
 

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I had GD that was difficult to control: even with insulin, diet and exercise, I had trouble keeping my numbers below 130. My daughter was delivered by c-section the day before her due date (and I had to fight to go that late, because she was breech and the ob overseeing my midwife refused to let me go into labor), and she was only 6 lbs, 12 oz, and had no health issues whatsoever. Personally, I think the link between GD and big babies is a load of hooey.
 

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There are studies that show controlled GD yields better outcomes (vaginal, live births of healthy weight babies). My advice is to keep the diabetes under control so there is no ammunition for an OB to use to induce/c-section her.
 

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Twelve-pounders can birth at home safely! Most GD can be diet/exercise controlled, and where insulin might be necessary, ITA with the PP about seeing an endocrinologist. I would do everything possible to birth at home= if you are in a hospital, they are going to try to induce, it avoids lawsuits for them. See if you can find a CPM, I bet your friend could birth at home a whole lot easier without an induction hanging over her head....
 

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I don't have much time but I would not induce at all for a VBAC, at least not artificially.<br><br>
GD is not a reason to induce either! Its being managed, she's fine, baby's fine. Leave it alone!<br><br>
The more a normal pregnancy messed with the worse the result is going to be. At this point its still a normal pregnancy!
 

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Pshaw! My mom had gd, and she vaginally gave birth to my brother who was over 9 pounds. A friend of mine, who did not have gd and who is 5'2", gave birth to a 10 and a half pound baby.<br><br>
BTW, here's an article about "supplementing" babies born to gd moms: <a href="http://www.thebirthden.com/Articles.htm" target="_blank">http://www.thebirthden.com/Articles.htm</a> It's in the middle of the page.
 

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What? I think she should find another doctor. I was on insulin for 4 mo. of my pregnancy and my OB would have let me go until 40 weeks as long as the ultrasounds came back within range and the NSTs were fine.
 
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