July 10, 2003
permalink Delivering diabetic babies early

Another massive issue for me for months has been the fact that my regular endo had told me "I won't let you go a day over 38 weeks". It wasn't that I was hell-bent on a 'natural' 'vaginal' birth, but I kept feeling that if the baby was induced early it would be much more likely to result in medical interventions like episiotomies, forcep deliveries, potential caesar, and to my mind worse... chronic problems with my pelvic floor eg inconinence.

Yep, I'm paranoid.

But I guess I felt with my small size (5"2'), narrow hips, long-standing diabetes with some changes to my connective tissue, and the risk of a bigger baby due to diabetes than I would have otherwise had, I would want either to go into spontaneous labour (which I'd heard had the most positive outcomes) and try a vaginal birth or go straight for a caesar.

Anyhow, the fact that he was adamant that 38 weeks was it made me upset because to me it pushed me right towards an unpleasant birth experience. My endocrinologist said there was a small increase in the risk of unexplained intrauterine death in diabetics. Mainly linked with higher blood sugars. So they liked to get them out early. "Even if one baby is to die after all you'd been through that would be too many."

hmmmm....

But what were the risks to mum and bub of forcing a birth at 38 weeks I wondered? How did the two risks compare?

So I fired the question at the endo I saw today. The one from the specialist Diabetes and Pregnancy clinic. "Is it routine practice to deliver diabetic women early at 38 or 39 weeks?" He said no, we try to let them go as close as possible to term but not beyond it. To 40 weeks. Delivering early when the baby and cervix etc aren't ready is more likely to result in caesars. Huh!! Good.

Good to have this information. Good perhaps to have a choice.

He did say though that it all depended on what else was happening. Eg blood pressure rises usually meant early delivery etc. And it would depend on how my obstetrician chose to manage it. Hmmmm.

It's an interesting area.

I was glad my two questions were answered informatively. My regular endo, whose views I also valued exceptionally highly, was to be away on holidays for week 37, 38 and 39 of my pregnancy, so it was likely this one would be "managing me" around the time of my baby's birth. It will be interesting to see what happens....

Posted by M.A. at July 10, 2003 10:28 PM


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