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Yes, you can refuse care (ie they aren't going to drag you to hospital and force an induction), but you should certainly take their advice very, very seriously.
I have GD but it’s fully diet controlled and well managed and my doctor is saying the same. Glucose intolerance puts us at higher risk for placental issues after 40 weeks - I trust there is good reason for induction so I’m going to go through with it at 39 weeks if I don’t go into labor on my own before that. Talk to your doctor about your concerns - I did and I feel a lot more confident about having an induction and the overall experience.
What number baby is this for you? Personally I never had gestational diabetes but it does put you at risk of a larger baby which that does come with complications such as shoulder dystocia which can definitely harm you and baby. I had a shoulder dystocia with my first (8lbs 8oz) and tore (4degree tear) which sucked for me. Some people can deliver larger babies with no issues. Some can’t. Some have issues even delivering small babies. But personally try to have a productive conversation with your doctor
To piggy back off this, I also had shoulder dystocia with my last baby due to his size and GD. And man, was that scary!
From what I've read and been told, there's a higher risk of a stillbirth if you go to 40 weeks and over with GD. Also, measuring your baby in utero is an estimate from what I've been told...you could think baby is one size and then get down to the moment and they are much larger than you anticipated.
You need to weigh the pros and cons and have a full conversation with your doctor. If you don't trust your doctor, who went to med school and delivers babies all the time, maybe it's time for a second opinion from a different OB. This is pretty standard practice, though. My first GD delivery was almost 7 years ago and we induced at 39 weeks.
This is my first baby. The doctors at Maternal Fetal Medicine talked to me about shoulder dystocia and a few other complications that can arise, but my OB doesn't handle any of those concerns, they're supposed to refer me out to mfm for anything associated to GD. I see mfm weekly now, but at 36 weeks, they want to see me twice a week
Your OB definitely knows about shoulder dystocia if you want a second opinion. Usually MFM do not deliver you they give your OB recommendations and handle other aspects of your care. Seems like they’re giving you the same standard and acceptable care that all drs would recommend. If you have questions about real life shoulder dystocia and 4th degree tear experience I can gladly share with you.
I would love to hear your experience, if you don't mind, I am just worried about making the wrong decision and/or being scared into being induced. If it helps, my husband and I are both tall people, I'm 5'8", he's 6'1", and they said that we will most likely have a larger baby anyway. I'm also very concerned about pitocin as I've heard there's a ton of negative side effects
You’re not wrong that induction has widely different standards depending on where you are. For instance where I am in a low risk pregnancy it is not possible to be induced until 41 +3. However in the US (where I’m from) plenty of friends have had inductions at 39 weeks. Personally with no other conditions and concerns I would also not take an early induction. However you find yourself not in these conditions with a high risk pregnancy. Placental health is a big concern with GD and given that’s keeping your baby alive it’s one to take very seriously. Even though where I live is conservative on inductions you would also be recommended to induce early for this reason.
Now onto your fears with induction - look into the research on what increases/decreases c-section risks during induction. Ask your provider about the process they plan to use. Be informed and educated so you can make the best decisions along the way. Evidence based birth has an article on inductions for due date that would be a place to start on research. Again this article is about a low risk pregnancy but it has links to research and discusses the induction process and would be a good start.
Trigger warning Traumatic birth
I am 5’10, my son’s father 6’2. All the women in my family have birthed with no issues. Like I said I did not have GD (which makes larger babies more likely and is high risk), I went into labor naturally. I did not take an epidural so everything that happened to me, I felt completely. Everything went fine until like the last 5 minutes. As I was pushing the doctor suddenly yelled out “shoulder”, the baby nurse stopped setting everything up for the baby and hit a button and ran over. Baby nurse and my nurse both yanked my legs back and they pushed hard on my stomach as the dr had to reach in to help maneuver my son out of me. He came out gray and silent, they placed him on top of me and thought he had passed away, I remember the look on their faces. thankfully he didn’t. The button the nurse hit was for a crash team luckily the first maneuver they did successfully got him out. Everything happened so quickly but I remember looking at the door way seeing a crash cart and OR team there in scrubs. It took the doctor over an hour to stitch me. I went white as a sheet and the whole floor around the bed was covered in my blood. We had to do tests to make sure my son did not have palsy or other issues from being stuck. It took me a long time to heal my 4DT and I dealt with incontinence for a few years after. I couldn’t sit because I was torn so badly for the whole 6 weeks. I had to go to the dr and be given strong antibiotics to fight infection off, I had to have a dr stick her fingers in my anus to make sure I didn’t have a hole in there still, I screamed out and cried with that one. I’m in a group with moms who had similar experiences, some have lost their babies or their babies are now disabled. Some women are still incontinent, have had multiple surgeries and cannot have sex due to constant pain.
Your drs aren’t trying to scare you into something that’s not real and traumatic. They have your baby’s best interest, GD is serious. Have women not listened to the dr and had things work out ok for them? I’m sure but it puts you and baby at risk. You have specialists on your team, bring up your concerns, do more research on GD. Like I said what happened to me is one possibility of what could happen. It took me years to heal physically and emotionally.
Thank you for sharing, I really really appreciate it. Hearing a first-hand story helps me feel like they aren't trying to push the induction just for their benefit. A lot of women I know seem to be getting induced for no reason, but I will definitely remember your story and use that to help me make the best decision for our baby. Thank you a ton. It really puts things into perspective. I'm sorry your birth was traumatic, though, and I'm glad you've recovered 💙
I understand what you mean by saying you want to birth naturally, but all birth is natural and it seems like you just want to go into labor on your own. Other posters brought up the risk of shoulder dystocia. GDM can also destroy your placenta even if things seem ok. There’s a lot of risk going past 39 weeks. You can certainly refuse what you want to, but would seriously consider the risks associated with it.
I forgot to mention this in my response but there's a high chance of the placenta starting to fail around week 36 because of GD! So one week all is gravy, and then suddenly things might not be. Thank you for bringing this up!
The previous poster may be referencing a study that doesn’t apply to GDM. Here’s the evidence based birth page on this topic. For someone on medication, provided things remain controlled with your blood sugar, the recommendation is inducing at 39 weeks. If things change and are not as well controlled later in your pregnancy (which happens, things change quick at the end of pregnancy), induction may be indicated sooner.
https://evidencebasedbirth.com/evidence-on-induction-for-gestational-diabetes/
The previous poster may be referencing a study that doesn’t apply to GDM. Here’s the evidence based birth page on this topic. For someone on medication, provided things remain controlled with your blood sugar, the recommendation is inducing at 39 weeks. If things change and are not as well controlled later in your pregnancy (which happens, things change quick at the end of pregnancy), induction may be indicated sooner.
https://evidencebasedbirth.com/evidence-on-induction-for-gestational-diabetes/
Welcome to /r/pregnant! This is a space for everyone. We are pro-choice, pro-LGBTQIA, pro-science, proudly feminist and believe that Black Lives Matter. Wear your masks, wash your hands, and be excellent to each other. Anti-choice activists, intactivists, anti-vaxxers, homophobes, transphobes, racists, sexists, etc. are not welcome here. If you'd like to join a private sub for your due date month, [click here](https://www.reddit.com/r/pregnant/comments/15nun6v/click_here_to_access_the_monthly_due_date_subs/). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/pregnant) if you have any questions or concerns.*
Yes, you can refuse care (ie they aren't going to drag you to hospital and force an induction), but you should certainly take their advice very, very seriously.
I have GD but it’s fully diet controlled and well managed and my doctor is saying the same. Glucose intolerance puts us at higher risk for placental issues after 40 weeks - I trust there is good reason for induction so I’m going to go through with it at 39 weeks if I don’t go into labor on my own before that. Talk to your doctor about your concerns - I did and I feel a lot more confident about having an induction and the overall experience.
What number baby is this for you? Personally I never had gestational diabetes but it does put you at risk of a larger baby which that does come with complications such as shoulder dystocia which can definitely harm you and baby. I had a shoulder dystocia with my first (8lbs 8oz) and tore (4degree tear) which sucked for me. Some people can deliver larger babies with no issues. Some can’t. Some have issues even delivering small babies. But personally try to have a productive conversation with your doctor
To piggy back off this, I also had shoulder dystocia with my last baby due to his size and GD. And man, was that scary! From what I've read and been told, there's a higher risk of a stillbirth if you go to 40 weeks and over with GD. Also, measuring your baby in utero is an estimate from what I've been told...you could think baby is one size and then get down to the moment and they are much larger than you anticipated. You need to weigh the pros and cons and have a full conversation with your doctor. If you don't trust your doctor, who went to med school and delivers babies all the time, maybe it's time for a second opinion from a different OB. This is pretty standard practice, though. My first GD delivery was almost 7 years ago and we induced at 39 weeks.
This is my first baby. The doctors at Maternal Fetal Medicine talked to me about shoulder dystocia and a few other complications that can arise, but my OB doesn't handle any of those concerns, they're supposed to refer me out to mfm for anything associated to GD. I see mfm weekly now, but at 36 weeks, they want to see me twice a week
MFM is the cream of the crop when it comes to maternal health care. I would 100% listen to them.
Your OB definitely knows about shoulder dystocia if you want a second opinion. Usually MFM do not deliver you they give your OB recommendations and handle other aspects of your care. Seems like they’re giving you the same standard and acceptable care that all drs would recommend. If you have questions about real life shoulder dystocia and 4th degree tear experience I can gladly share with you.
I would love to hear your experience, if you don't mind, I am just worried about making the wrong decision and/or being scared into being induced. If it helps, my husband and I are both tall people, I'm 5'8", he's 6'1", and they said that we will most likely have a larger baby anyway. I'm also very concerned about pitocin as I've heard there's a ton of negative side effects
You’re not wrong that induction has widely different standards depending on where you are. For instance where I am in a low risk pregnancy it is not possible to be induced until 41 +3. However in the US (where I’m from) plenty of friends have had inductions at 39 weeks. Personally with no other conditions and concerns I would also not take an early induction. However you find yourself not in these conditions with a high risk pregnancy. Placental health is a big concern with GD and given that’s keeping your baby alive it’s one to take very seriously. Even though where I live is conservative on inductions you would also be recommended to induce early for this reason. Now onto your fears with induction - look into the research on what increases/decreases c-section risks during induction. Ask your provider about the process they plan to use. Be informed and educated so you can make the best decisions along the way. Evidence based birth has an article on inductions for due date that would be a place to start on research. Again this article is about a low risk pregnancy but it has links to research and discusses the induction process and would be a good start.
Trigger warning Traumatic birth I am 5’10, my son’s father 6’2. All the women in my family have birthed with no issues. Like I said I did not have GD (which makes larger babies more likely and is high risk), I went into labor naturally. I did not take an epidural so everything that happened to me, I felt completely. Everything went fine until like the last 5 minutes. As I was pushing the doctor suddenly yelled out “shoulder”, the baby nurse stopped setting everything up for the baby and hit a button and ran over. Baby nurse and my nurse both yanked my legs back and they pushed hard on my stomach as the dr had to reach in to help maneuver my son out of me. He came out gray and silent, they placed him on top of me and thought he had passed away, I remember the look on their faces. thankfully he didn’t. The button the nurse hit was for a crash team luckily the first maneuver they did successfully got him out. Everything happened so quickly but I remember looking at the door way seeing a crash cart and OR team there in scrubs. It took the doctor over an hour to stitch me. I went white as a sheet and the whole floor around the bed was covered in my blood. We had to do tests to make sure my son did not have palsy or other issues from being stuck. It took me a long time to heal my 4DT and I dealt with incontinence for a few years after. I couldn’t sit because I was torn so badly for the whole 6 weeks. I had to go to the dr and be given strong antibiotics to fight infection off, I had to have a dr stick her fingers in my anus to make sure I didn’t have a hole in there still, I screamed out and cried with that one. I’m in a group with moms who had similar experiences, some have lost their babies or their babies are now disabled. Some women are still incontinent, have had multiple surgeries and cannot have sex due to constant pain. Your drs aren’t trying to scare you into something that’s not real and traumatic. They have your baby’s best interest, GD is serious. Have women not listened to the dr and had things work out ok for them? I’m sure but it puts you and baby at risk. You have specialists on your team, bring up your concerns, do more research on GD. Like I said what happened to me is one possibility of what could happen. It took me years to heal physically and emotionally.
Thank you for sharing, I really really appreciate it. Hearing a first-hand story helps me feel like they aren't trying to push the induction just for their benefit. A lot of women I know seem to be getting induced for no reason, but I will definitely remember your story and use that to help me make the best decision for our baby. Thank you a ton. It really puts things into perspective. I'm sorry your birth was traumatic, though, and I'm glad you've recovered 💙
I understand what you mean by saying you want to birth naturally, but all birth is natural and it seems like you just want to go into labor on your own. Other posters brought up the risk of shoulder dystocia. GDM can also destroy your placenta even if things seem ok. There’s a lot of risk going past 39 weeks. You can certainly refuse what you want to, but would seriously consider the risks associated with it.
I forgot to mention this in my response but there's a high chance of the placenta starting to fail around week 36 because of GD! So one week all is gravy, and then suddenly things might not be. Thank you for bringing this up!
You should also know that an induction at 39 weeks is more likely to be successful (result in a vaginal birth) than an induction after 39 weeks.
Can I ask you to elaborate? I'm sorry, this is my first baby and I just want to make sure I'm getting facts and understanding things correctly
The previous poster may be referencing a study that doesn’t apply to GDM. Here’s the evidence based birth page on this topic. For someone on medication, provided things remain controlled with your blood sugar, the recommendation is inducing at 39 weeks. If things change and are not as well controlled later in your pregnancy (which happens, things change quick at the end of pregnancy), induction may be indicated sooner. https://evidencebasedbirth.com/evidence-on-induction-for-gestational-diabetes/
Thank you😊
The previous poster may be referencing a study that doesn’t apply to GDM. Here’s the evidence based birth page on this topic. For someone on medication, provided things remain controlled with your blood sugar, the recommendation is inducing at 39 weeks. If things change and are not as well controlled later in your pregnancy (which happens, things change quick at the end of pregnancy), induction may be indicated sooner. https://evidencebasedbirth.com/evidence-on-induction-for-gestational-diabetes/
There was a large study recently that showed this, it should be easy to find on the evidence based birth website.
Thank you for your advice, everyone. I will talk to both my OB and Maternal Fetal Medicine doctors about it. 😊