July 25th, 2008
I was at the OB doctor yesterday, and I asked about induction, and she told me that basically, they induce all Diabetic patients at 38 or 39 weeks. I'm pretty mad about this, because my baby weighed in at 4.9 lbs. at 33 weeks.. and is in the 50% for his weight and height. I don't understand why I've been working so hard at keeping my blood sugar under control, if I'm just going to be induced early anyway.
Were any of you induced? What was the reason for it?
I'm almost to the point of finding another doctor, because I'm so mad about it.
There's no reason why they should induce you if you don't have any complications (pre-eclampsia, breech, etc.)
Tell your doc NO FRIGGIN WAY. They can't MAKE you.
I was told that it was because there is an increased incidence of still birth after 40 weeks. I did research that at the time and found supporting stuff but who knows where. by the time I was at 38 weeks, I was ready for her to be OUT! (I'm a sissy!)
I know. there's somedays that I'm like I'M DONE! but as long as I stay in the air conditioning I'm okay.
I was induced at 37w4d for my son and was going to have a repeat c/s at 38w with my daughter but went into labor on my own at 36w4d.
Part of the reason doctors induce diabetic women early is not because of size, but because of other risks. Type 1 and 2 diabetic mothers have an increased risk of stillbirth after 38w as well as higher risks for deterioration of the placenta, etc.
I think its pretty standard to induce/c-section at 38 or 39w and it might be hard to find a doctor who won't do that.
I wonder why the placenta starts deteriorating?
I'm not sure. I was in pretty good control with my son and his started doing at 37w so I was induced right then (he also had macrosomia but that wasn't the primary reason for the induction). It never happen with my daughter, but then again I didn't make it as far into the pregnancy with her.
It's pretty standard practice. I managed to put off induction with my first until 40 weeks (and was in early labor when it started). With my second I had an agreement I could go to 41 weeks, but again went into labor around 39+3. It is possible to find someone that won't induce early, but it's difficult. But if it is important to you, I'd look into it.
Well I just figure, that letting him cook until he's ready would be the best thing for him.. instead of taking him out early.. although a couple weeks is not "premature" it's still scary
Thank you for the info!
That's why I'm mad about the situation- I feel like they're grouping me in with every other Diabetic patient, I've been working really hard on my diet and fine tuning my insulin pump as the weeks progress.. I'm going to talk to the doctor and see if we can work on things.. I have a non stress test 2 times a week until I deliver..
|Date:||July 25th, 2008 06:47 pm (UTC)|| |
I was set to be induced at 39 weeks, but Alexander came on his own at 37 weeks, 2 day.
My ob said they induce because of the potential for placental deterioration.
That weight is great! My son was 6lbs 3oz at 32 weeks and my a1c was in the 5's. I went into pre-term labor at 32 weeks and was on bedrest and had my son (without an induction) at 36 weeks. My doctor who I really trust in regards to pregnancy was going to induce at 38 weeks - or if the baby was really large (which he was consistantly) she would of done a c-section, but didn't want to. My perinatologist wanted a c-section at 36 weeks because they guessed him at 9 lbs, my OB said I didn't need one and it turned out when I have birth to him at 36 weeks he was 8 lbs 7oz. So um yea. I think it is standard practice to induce at 38 weeks.
For my previous two pregnancies (I was not diabetic with both of them) I was induced for PROM for #1 at 36 weeks and Pre-eclampsia with #2 at 38 weeks. The only one I wasn't induced for was the one where I had GD.
Whoa I have been long winded - at any rate I wish you and your baby the best :-D
Did you have GD?
I'm trying to avoid a c-section as much as possible- because I know Diabetics have a slower healing time, and I don't want to have surgery and try to take care of a new baby at the same time.. buttt he has to get out somehow!
I'm t2 and the OB is handling the pregnancy and the endo is in charge of the diabetes, just like last pregnancy. My A1c stayed in the 5.1 to 5.4 range during the pregnancy and we added insulin at around 26 weeks instead of the more common 16 weeks.
Just got a due date today (Mar 15), so I'm not sure how this pregnancy will play out.
One thing that might make a difference, or it would to me, is how exact is your due date? If it's based on LMP, then IFRC that date can be off by up to 2 weeks, depending on your cycle length.
In my case, my cycle when off of BC is so wonky that I was really surprised to be pregnant.
I guess where I'm heading with this is: 38 weeks when you know the baby has really "cooked" for 38 weeks is a lot different than saying 38 when it might be 36. With my daughter (GD Pregnancy), I was induced almost a week after my revised due date (based on US) and a few days before my original due date. After delivery, she was equal to a baby born 2 weeks early. If that makes any sense.
Insulin can start to have an effect on the placenta, so that's a concern.
My ob/gyn and endo team both indicated that induction at 38 weeks is standard practice when dealing with diabetic pregnancies, especially type 1, for the reasons other posters have outlined above. I was told, and accepted, that this was safest for baby, again, for the reasons outlined above. I had an a1c of 5.4 through most of my pregnancy (highest a1c was during the first trimester, at 5.8). However, the baby might well come on his or her own time, as mine did: 37 weeks exactly.
Having said that, I read a lot of material which suggested that this approach is overly cautious, and there's no reason to induce unless the pregnancy goes longer than 40 weeks.
It's also my understanding that despite the rising numbers of c-sections, doctors will try to avoid performing if at all possible, especially, as you point out, in diabetic women who take longer to heal.
Good luck to you. I hope that your experience in labour and delivery is exactly what you want.