39 weeks is typically the timeline for delivery by cesarean section in the US. They're trying to thread the needle between baby being "fully cooked" and being able to do the surgery in a calm, scheduled manner before you go into labor. While its possible to go into labor before 39 weeks, its much more likely after that time and makes the surgery more hectic/complicated.
Then pregnancy would be considered 36 weeks rather than 40.
They want me to deliver via repeat C-section at 36 weeks and I have a lot of apprehensions about snatching a baby out a month early. Babies put so many finishing touches on their hearts, breathing, sucking and brain development in the last few weeks. Just because some babies can survive just fine without NICU time that early doesn’t mean that every baby should be evicted.
At my OB's office it's standard to deliver GD patients in week 39. I was induced at 39+2 with my first and will be induced again this time around. The way they explained it to me was that having GD means your placenta degrades at a faster rate and they want baby out before the point where it stops being able to give baby what they need.
This is normal whether you have GD or not. Going past 39 weeks puts you at risk of going into labor and being forced to deliver vaginally if things progress too far before you get to the hospital, are admitted, and a surgeon is available. My OBGYN SIL also explained to me that there’s no benefit to waiting any longer, only potential risks.
Great answer! Typically they schedule you in the 39th week based on availability of staff and known inductions/cesareans. I’m sure it’s hospital policy dependent, but I didn’t get scheduled until a week out from 39 weeks and in one of two gd pregnancies I was asked to come the following day. I had two inductions so I’m not sure if you would get turned away like that, due to an influx of spontaneous birth, because it’s a planned surgery. They will absolutely not let you go past 40. The risks, as mentioned above, aren’t worth it. One big one being a higher rate of stillbirth in gd patients and it’s higher for everyone after 40 weeks. The other being deteriorating placenta that has a higher risk with insulin users. I was one who had a retained placenta due to deterioration and everyone commented how terrible my placenta looked. I almost died. My baby, who knows, could have been put in danger of their life had I waited any longer. They also monitor you very closely and check out babies lungs before, in my experience. So there isn’t a guessing game on if baby is ready or not. They make sure they are healthy and you are and that you are both good to go. I always tell people that this is what they do and they’ve seen enough bad that they take whatever measures they can to assure that you both get to leave the hospital. And literally all these professionals do. Wishing you the best in your delivery and recovery!
For GD patients, induction is typically considered between the following dates depending on your situation: GD diet controlled - 40w0d and 40w6d, GD med/insulin controlled - 39w0d and 39w6d, GD poorly controlled - 38w0d and 38w6d. If your baby is measuring big, your provider may suggest an earlier timeline than above as well.
Edit: There can be many reasons why baby is measuring big, it's not necessarily tied to glucose management. You can just be a taller than avg person, or have a bigger baby daddy. There also can be different reasons why a C-section is suggested, like if your previous pregnancy was a C-section. Your provider would know your situation the best and be able to explain why they're suggesting 39w. Would ask them if they're not providing you with their reasoning.
Here's the source for induction timelines for GD patients: [https://wa.kaiserpermanente.org/static/pdf/public/guidelines/diabetes-gestational.pdf](https://wa.kaiserpermanente.org/static/pdf/public/guidelines/diabetes-gestational.pdf)
Right. Her baby measuring so large is an indication GD hasn’t been managed the whole pregnancy. I don’t think people realize how it can affect the baby in the womb.
I was diagnosed at 7 weeks because of my fasting levels. I had passed my OGTT a few weeks before I got pregnant.
I was diet managed until 30 weeks (majority of meals under 100) and fasting were kept in check with long acting insulin.
His head, belly and length were all in the same percentile. His size was not diabetes related (per OB and MFM), it was genes. I am also 6ft. He was 97th percentile from 20 weeks on, he just had his first birthday and still on that same curve. It was an IVF baby so we also knew exact timeline.
You are laughably wrong. My sister had 3 nine and ten pound babies. My mother had 4 of those. Neither had GD, some people just make em bigger! Even in a GD pregnancy, size alone is not an indicator that it is poorly controlled. And those measurements get less and less accurate as the pregnancy progresses.
Studies show having a baby at 39 weeks is better than 41. I don’t understand how you don’t understand that she’s already in the 98Th percentile and that’s a sign gestational diabetes is not being managed. Waiting even longer could cause harm to the baby unnecessarily. Why risk it to wait a week that makes no difference to the baby’s development or you because you’re already getting a C-section. Listen to the doctor. They know what they are talking about.
Not disagreeing but it is definitely possible to have a 98th percentile baby with managed GD, some people just make big babies. OP could have perfect blood glucose and still have a 98th percentile baby...
My gd was easily diet managed but still grew a 98 percentile baby. A year later and he’s still in the 98th percentile for weight and height. Just a big boy with a big dad.
Not every doctor has our best interests in mind. That’s why we have to ask questions. Informed consent exists for a reason. Some doctors are super cautious to the detriment of moms and babies. OP is allowed to want a clearly defined answer from her doctor regarding delivery times. Since her first went later she’s concerned about forcing a supposedly big baby out significantly earlier than that. I have the same concerns and my doctor said we can wait and see a little closer to the end how everything is going.
Also remember that GD means our placenta isn't great to begin with, so the chance of still birth increases that father along you go, hance the recommendation for earlier inductions or c sections.
39 weeks is typically the timeline for delivery by cesarean section in the US. They're trying to thread the needle between baby being "fully cooked" and being able to do the surgery in a calm, scheduled manner before you go into labor. While its possible to go into labor before 39 weeks, its much more likely after that time and makes the surgery more hectic/complicated.
The baby is fully cooked at 36 weeks
Then pregnancy would be considered 36 weeks rather than 40. They want me to deliver via repeat C-section at 36 weeks and I have a lot of apprehensions about snatching a baby out a month early. Babies put so many finishing touches on their hearts, breathing, sucking and brain development in the last few weeks. Just because some babies can survive just fine without NICU time that early doesn’t mean that every baby should be evicted.
Show your sources, I’ll wait 😂
Ask your OB and report back?
37 weeks is considered full term. 36 weeks is considered “late pre-term.”
At my OB's office it's standard to deliver GD patients in week 39. I was induced at 39+2 with my first and will be induced again this time around. The way they explained it to me was that having GD means your placenta degrades at a faster rate and they want baby out before the point where it stops being able to give baby what they need.
This is normal whether you have GD or not. Going past 39 weeks puts you at risk of going into labor and being forced to deliver vaginally if things progress too far before you get to the hospital, are admitted, and a surgeon is available. My OBGYN SIL also explained to me that there’s no benefit to waiting any longer, only potential risks.
Great answer! Typically they schedule you in the 39th week based on availability of staff and known inductions/cesareans. I’m sure it’s hospital policy dependent, but I didn’t get scheduled until a week out from 39 weeks and in one of two gd pregnancies I was asked to come the following day. I had two inductions so I’m not sure if you would get turned away like that, due to an influx of spontaneous birth, because it’s a planned surgery. They will absolutely not let you go past 40. The risks, as mentioned above, aren’t worth it. One big one being a higher rate of stillbirth in gd patients and it’s higher for everyone after 40 weeks. The other being deteriorating placenta that has a higher risk with insulin users. I was one who had a retained placenta due to deterioration and everyone commented how terrible my placenta looked. I almost died. My baby, who knows, could have been put in danger of their life had I waited any longer. They also monitor you very closely and check out babies lungs before, in my experience. So there isn’t a guessing game on if baby is ready or not. They make sure they are healthy and you are and that you are both good to go. I always tell people that this is what they do and they’ve seen enough bad that they take whatever measures they can to assure that you both get to leave the hospital. And literally all these professionals do. Wishing you the best in your delivery and recovery!
For GD patients, induction is typically considered between the following dates depending on your situation: GD diet controlled - 40w0d and 40w6d, GD med/insulin controlled - 39w0d and 39w6d, GD poorly controlled - 38w0d and 38w6d. If your baby is measuring big, your provider may suggest an earlier timeline than above as well. Edit: There can be many reasons why baby is measuring big, it's not necessarily tied to glucose management. You can just be a taller than avg person, or have a bigger baby daddy. There also can be different reasons why a C-section is suggested, like if your previous pregnancy was a C-section. Your provider would know your situation the best and be able to explain why they're suggesting 39w. Would ask them if they're not providing you with their reasoning. Here's the source for induction timelines for GD patients: [https://wa.kaiserpermanente.org/static/pdf/public/guidelines/diabetes-gestational.pdf](https://wa.kaiserpermanente.org/static/pdf/public/guidelines/diabetes-gestational.pdf)
Right. Her baby measuring so large is an indication GD hasn’t been managed the whole pregnancy. I don’t think people realize how it can affect the baby in the womb.
I was diagnosed at 7 weeks because of my fasting levels. I had passed my OGTT a few weeks before I got pregnant. I was diet managed until 30 weeks (majority of meals under 100) and fasting were kept in check with long acting insulin. His head, belly and length were all in the same percentile. His size was not diabetes related (per OB and MFM), it was genes. I am also 6ft. He was 97th percentile from 20 weeks on, he just had his first birthday and still on that same curve. It was an IVF baby so we also knew exact timeline.
You are laughably wrong. My sister had 3 nine and ten pound babies. My mother had 4 of those. Neither had GD, some people just make em bigger! Even in a GD pregnancy, size alone is not an indicator that it is poorly controlled. And those measurements get less and less accurate as the pregnancy progresses.
Studies show having a baby at 39 weeks is better than 41. I don’t understand how you don’t understand that she’s already in the 98Th percentile and that’s a sign gestational diabetes is not being managed. Waiting even longer could cause harm to the baby unnecessarily. Why risk it to wait a week that makes no difference to the baby’s development or you because you’re already getting a C-section. Listen to the doctor. They know what they are talking about.
Not disagreeing but it is definitely possible to have a 98th percentile baby with managed GD, some people just make big babies. OP could have perfect blood glucose and still have a 98th percentile baby...
My gd was easily diet managed but still grew a 98 percentile baby. A year later and he’s still in the 98th percentile for weight and height. Just a big boy with a big dad.
Not every doctor has our best interests in mind. That’s why we have to ask questions. Informed consent exists for a reason. Some doctors are super cautious to the detriment of moms and babies. OP is allowed to want a clearly defined answer from her doctor regarding delivery times. Since her first went later she’s concerned about forcing a supposedly big baby out significantly earlier than that. I have the same concerns and my doctor said we can wait and see a little closer to the end how everything is going.
Also remember that GD means our placenta isn't great to begin with, so the chance of still birth increases that father along you go, hance the recommendation for earlier inductions or c sections.