Jump to content
Diabetes forums
  • Welcome To Diabetes Forums!

    Registration is fast, simple and absolutely free so please, join our community today to contribute and support the site.

Archived

This topic is now archived and is closed to further replies.

Pumped

Being induced at 38 weeks standard practice?

Recommended Posts

Pumped

I’m almost 36 weeks pregnant and the little on is getting along nicely. His measurements in the Ultrasound are fine and weight is close to the 70th percentile – I think macrosomia is identified when the baby is 90th percentile or more. My ob/gyn wants to induce me at 38 weeks. She (and my endo) say it’s standard practice because the placenta can start degrading after that time. There aren't any complications whatsoever with the pregnancy, this is just what's done with diabetics, apparently.

Just wanted to ask the other mommies/mommies-to-be if being induced early has been their experience too. Can you also tell me why it’s done? Any horror stories/lessons learned you can share?

Share this post


Link to post
Share on other sites
plattb1

My daughter had gestational diabetes so her experience may not be fully relevant to yours. She was induced at 38 weeks despite very good BG control & clear indications that her baby was NOT above average in size. She has a medium to large frame & did not have any issues with her pelvis being too narrow for a vaginal delivery. The primary area of concern for her was that her blood pressure was higher than normal.

 

We were very lucky in that a wonderful nurse midwife worked with her labor & delivery and, even though labor was started artificially, the nurse midwife took her cues from my daughter's progress and from a fetal heartrate monitor.

 

When it came time to deliver, she was able to do so with four (yes, count them, 4!) pushes. I attribute that to two things: Leah took very good care of herself nutritionally & with regular exercise; and the nurse midwife was truly "in tune" with how her labor was progressing.

 

Final outcome: a healthy, beautiful, 7 lb 12 oz baby girl and normal BG for both baby & mom.

 

I wish you the best of luck in your labor & delivery. As with many things, I think it is important for your healthcare team to fully understand your wishes and for you to have good rapport with & trust in them. Let us know how things go for you & your little one - it's an exciting time! :star:

Share this post


Link to post
Share on other sites
plattb1
Hi Barrie - thanks very much for sharing that. It makes me optimistic! Here's hoping for the best :)

 

I have my fingers crossed for you & the little one. Please let us know when the time comes. There's nothing more precious in the world than a new baby!

Share this post


Link to post
Share on other sites
toosweet

I am GD at 36 weeks now. From the research that I have done about GD it is because the risk of stillbirth rises with diabetes due to the fast aging of the placenta. My MD said that we will take weekly NST and ultrasounds every 2 weeks ( began 35weeks) and induce at 39 if no problems. This is my fourth child but first with GD. I have been induced with my 3 previous babies for various reasons. I am fortunate to respond well to the pitocin and have had quick labors. One word of caution. My first I was told that contractions hurt horribly and with pitocin they are worse. I ended up being overstimulated by too much medicine and it drove my babies heart rate low as he was being crushed by the contractions. Be honest about the pain and let it guide your care. It turns out that external monitors do not pick up my contractions well and the scalp monitor is better for me. Hope things go well for you.

Share this post


Link to post
Share on other sites
Keezheekoni

I've had 6 kids with T1 diabetes. With three of my kids I wasn't induced early. My OB and perinatologist never had a problem with following my wishes to not be induced early. I want my babies to have the best chance to get their suck reflexes intact, since I breastfeed my kids for more than a year. Inducing early can cause them to not have a suck reflex, which happened with two of my kids who were induced.

 

If you do the twice weekly NSTs, usually they'll let you go naturally, as long as you're in total control and show no signs of macrosomia.

 

For those that weren't induced early, they were the best L&Ds that anyone could have! Natural, no drugs, and fast...but I have really fast labors so YMMV!

 

Good luck and congrats!

Share this post


Link to post
Share on other sites
Brookie

Hello,

 

I am a Type 1 and almost 33 weeks and my doctors said that they will induce me at 37 weeks. They prefer not to take chances with Type 1's for the reasons that you mentioned (the placenta not working as well...and higher chance of still birth). I will go in and they will do an Amnio first to see that the baby's lungs are developed enough for delivery. If NOT...they can do one of two things....give me a shot of sterioids to make the lungs develop quickly and be where they need to be within 24 hrs(but that will make my sugars crazy too because of insulin resistance!!) or if I'm in good enough control and they think my placenta is working fine, they will have me wait a week. The hospital I go to works with a lot of high risk pregnancies and I trust them, so I am not worried about delivering early. I know I'm in good hands. That's the story that I've been told! :)

Good luck and congrats!

Share this post


Link to post
Share on other sites
rak1978

My doctor would not induce me earlier than 39 weeks BECAUSE I have diabetes. They said that due to my high sugars, the baby's heart and lungs develop at a slower rate. If I made it to 39 weeks, they were going to do a quick check (I think amnio) to make sure the lungs were ready to go. Lucky me, my water broke at 37 weeks. Baby was a little over 10 lbs and born via c-section (yay).

With my other son the doctor (different one) wouldn't induce me unless he saw a great need..which he didn't. I had an ultrasound 1 1/2 weeks before my due date and the technician said he was about 7 1/2 lbs, so no need to induce. Well, I went into labor the day after and he turned out to be 9 lbs 11 oz. (not a c-section...wish it was). They were only off by a little over 2 lbs ;).

What an exciting time for you! Let us know how it goes...I'm sure it will be wonderful! :)

Share this post


Link to post
Share on other sites
Pumped

Thank you all for sharing all that great information.

 

I hope I respond well to Pitocin too - that's a good tip about letting pain guide me.. I've been reading some of the Sears parenting books and they advocate the same approach.

 

My twice-a-week NSTs and now weekly Ultrasounds will hopefully show if anything was to go wrong before hand. My doc is going to do the amnio the day before induction too - I hope I don't have to take that steroid shot - it's hard enough to control my BG as it is with all the crazy preggo hormones!!

Share this post


Link to post
Share on other sites
csad
I’m almost 36 weeks pregnant and the little on is getting along nicely. His measurements in the Ultrasound are fine and weight is close to the 70th percentile – I think macrosomia is identified when the baby is 90th percentile or more. My ob/gyn wants to induce me at 38 weeks. She (and my endo) say it’s standard practice because the placenta can start degrading after that time. There aren't any complications whatsoever with the pregnancy, this is just what's done with diabetics, apparently.

Just wanted to ask the other mommies/mommies-to-be if being induced early has been their experience too. Can you also tell me why it’s done? Any horror stories/lessons learned you can share?

 

 

Every hospital has its own standards, and every patient is different. At the Joslin in Boston (where I gave birth about two years ago), their standard was (prob. still is) 40 weeks, and no further, because of the issue with the placenta breaking down. That said, my OB kept telling me that 38 weeks would be fine, the baby would be fully developed by then if we had to induce. I was induced at 39 weeks because of preeclampsia. I ended up with a C-section after stalled labor, my developing a fever, and the baby going into distress (we're fine now!). I don't know if the induction just didn't work, or if labor stalled because my baby's head was so big (it runs in my husband's family!). I'd talk with your doctor about your options - if you want to, ask if you can go beyond 38 weeks, and see what he/she says. It might be partly because of hospital-specific issues. Just be sure you understand the plan and the reasons for it as much as you can beforehand. Congrats on making it this far, and best wishes!

 

-Christine

type 1 diabetes, 24 years

Minimed Paradigm 722 pump

Share this post


Link to post
Share on other sites
sugarsmacks

First off, let me say "congratulations" to you and your family for the precious bundle you are carrying and will deliver to the world.

 

I had a perinatalist that was very aggressive about pushing for an amnio and inducement due to my diabetes. I was very hard to control, she said I was her worst case because I had to use U-500 AND Novolog at the same time towards the end of the pregnancy (and I had a very STRONG case of Dawn's Phenomenon). Yet every time there was an ultrasound done, the fetus looked fantastic, the fetal echocardiogram was done and things looked stellar. In short, I was getting my *** handed to me because of the out of control blood sugars (I would soar up high and then crash an hour later) but the baby was STERLING and doing just fine, thank you very much.

 

I said "no" to the amnio and believe me, they really pushed it on me by telling me the worst case scenarios (placenta degradation, fetal problems, all the horrible stuff I'd read on the internet). My argument was "if all is doing great from what you can tell from the twice weekly NSTs, the ultrasounds that I have once a week and that he's at the 50th percentile from the ultrasound I had in my 8th month, I don't believe I need to do an amnio." Because I said no, the perinatalist talked to my OB and he agreed that I was to be induced at 38 weeks "to prevent fetal death due to poor diabetic control".

 

I don't want anyone to feel like they're a bad mother if they decide against an amnio. Why they want to do one on you BEFORE they induce you is, in my opinion, medically unnecessary and just an excuse to get more $$$ out of you. Now, if there are medical issues that were caught in your ultrasounds beforehand or there is something shady with your NSTS then I say go for an amnio....but if all is well and you are in good control, why go for an amnio if you're going to be induced?

 

In my case, they estimated him to be nearly 9lbs..so I was induced (had to have a cesarean because he turned breech during labor) and he was 7lbs 7 ounces. I gained the weight (and still look pregnant), not him.

 

I don't agree with perinatology automatically doing amnios on pregnant, diabetic mothers, in short. With good prenatal care and diabetic control, they should let the mothers either go on their own or, if there is a huge risk, induce.

 

Again, good luck to you.

Share this post


Link to post
Share on other sites
aiah23

I talked to my perinatologist yesterday about the same thing. She said different hospitals do things differently based on how comfortable they are treating high risk patients in general. If they don't have a lot of experience with high risk patients, you're going to find they're more prone to induce regardless of your control, etc. I'd been told that for the last 10 yrs I should plan on having a casesarian and found out yesterday that there was no reason why I shouldn't be able to do a vaginal delivery, when ready (they said 38-39 weeks delivery for a diabetic is what they commonly aim for unless there are problems warranting the need for earlier induction). Yes, our placentas do age faster as diabetics and that is always a concern. But with weekly checkups, you should be able to make an informed decision from those with your medical team. Best of luck to you! Excited for everyone pregnant on this site! Fawn

Share this post


Link to post
Share on other sites
Jenifer anderso
I talked to my perinatologist yesterday about the same thing. She said different hospitals do things differently based on how comfortable they are treating high risk patients in general. If they don't have a lot of experience with high risk patients, you're going to find they're more prone to induce regardless of your control, etc. I'd been told that for the last 10 yrs I should plan on having a casesarian and found out yesterday that there was no reason why I shouldn't be able to do a vaginal delivery, when ready (they said 38-39 weeks delivery for a diabetic is what they commonly aim for unless there are problems warranting the need for earlier induction). Yes, our placentas do age faster as diabetics and that is always a concern. But with weekly checkups, you should be able to make an informed decision from those with your medical team. Best of luck to you! Excited for everyone pregnant on this site! Fawn

 

I have heard that Raspberry Leaf Tea can help induce labour, though how much and how often I am not too sure of.

 

take care my dear

Share this post


Link to post
Share on other sites

×

Important Information

By using this site, you agree to our Terms of Use.