My GD now requires insulin and have been told I will be induced at 38wks !!

[joel's girl]

My OB informed me today that she intends on inducing me at 38wks as I have been placed on insulin. My GD is not so bad, my fasting levels are borderline or slightly above 5.5 but the rest of the day is fine. I was only put of 12 units of insulin before bed and it has reduced my fasting levels to about 5 - 5.2 so when my OB told me that I would be induced I was surprised.

I told her that I wasn't too keen on the idea and asked a few questions about how she usually induces women and TBH I didn't like what I heard. ie: if a start induction with an unfavourable cervix then I have a 25% chance of ahving a c/section and when I asked about the timeframe she allows for progress she stated if I'm not progressing at least 1 - 2cm per hour then she'll pull the pin and intervene further. I truly do not like where this is heading and truly hope that bub can do his thing before 38wks so we both do not have to go thru this unnatural procedure. My OB is lovely and I really do trust her BUT I don't feel like I have much say in what happens if i don't go into labour prior to 38wks. Worst of all DH agrees with the doctor (only because she IS a doctor) and wants me to take her advice.

On a positive note, bubs is fully engaged and I have been having lots of prelabour signs so I'm hoping that I'm worrying over nothing. I plan to start rasberry leaf tea and Evening Primerose Oil tomorrow and wil make some enquiries about acupuncture too................will do anything to encourage labour to start naturally.

Any advice is welcome but I suspose this is a bit of the vent type post too...........Arrrrgh feels better already !!

[paradise lost]

Induction is a medical procedure and requires your consent. You do NOT have to give it. You might tell her you are not willing to be induced at 38 weeks unless there is substantial medical evidence it is necessary. It's something they do to limit bubs size at birth (to avoid dystocia) but she has no way of knowing how big your bubs will be, even AT 38 weeks their methods of measuring are approximate at best.

Shoulder dystocia is slightly more common in bigger babies, but not by any means a foregone conclusion (less than 5% of babies over 4.5kg get stuck - there is sadly no information on the position the mothers of these babies were in when the dystocia occurred, or whether or not they'd had epidural anaesthesia) and your position during labour and pushing play a huge part. Staying active and upright and pushing in a squat or on hands and knees make dystocia extremely unlikely.

You might want to let DH do a bit of reading on here to see the reality of the situation. He might still agree with the doctor after doing so but it will be an informed agreement, kwim?

Best of luck.

Bx

[joel's girl]

Thanks ladies.....

Im certainly not going to be railroaded into induction and expect some answers from the OB before I'll consider it at all.

I will have DH read some info. I read the couple of article on here about GD & inductions as well as being induction (what it really means) and I think he should be informed of the risks too - perhaps he will think differently. His support would make a world of difference.

I already have four pages of points / questions for my OB appointment next week and I'll keep researching til then.

P.S I plan on calling some acupuncturist today - will they help at 36 wks or want to wait til I'm overdue. If so, do they want proof of your EDD or could I tell them I'm closer to EDD ???

[aussienic]

I too am on insulin.. This is my 3rd pregnancy which has required it.. I am very surprised by the amount you are on.. I am on 6 units at night and my fasting levels are always over 7 and my rest of day ones are between 5.5 and 10..

I to would be questioning being induced. I (imo) would ask for an US at 36-37 weeks to estimate baby's size. I had a c/s with my 2nd baby not neccesarily due to GD but my waters broke at 37 weeks and we knew baby was going to be over 9lb and he was 9lb 14oz.. We chose a c.s for our 3rd bub and he was only 8lb 9oz and my Gd was worse with him

Good Luck..

[joel's girl]

Aussienic - Geez there certainly doesn't seem to be any consistency with the BSL's. From the get go my fasting levels needed to be under 5.5 and then 2hrs after each meal under 7.5. It was only due to my fasting levels being 5.5 - 5.6 for two days out of ten that I was put onto insulin anyway. I begged for them to let me try a few things to get it lower but was told it was best for my baby - who can argue that hey !!!!!! I was also told that 12 units was the smallest dose possible and wouldn't affect anything.

If I HAD known that my OB was going to view things differently JUST because I was on insulin then i would have fought harder to not have the insulin - but I doubt it would have mattered much.

I had a scan at 32 weeks as my fundal height was 6 wks in advance and bubs was measured in the 95th percentile at 2400grams back then. I asked my OB about size and she said if I go at 38wks as planned then she would expect a 3800 gram bub so not too big really..........I can't see why I can't wait another week or so. Bubs is fully engaged and my body is displaying good pre-labour signs so I don't think my body is too far off being ready..............I just want to give it the time it needs. Inducement is planned for say 9 - 11 days and perhaps my body only needs 11 - 15 days more.........what's the harm in waiting. It's not like I'm overdue and he's already 4500grams or anything !!!

[aussienic]

The only thing I would be concerned about with inducing early is that die to baby growning bigger due to the GD thier body grows bigger but sometimes their organs are a little slower to grow..

Isaac was born at 37 weeks and was fine diabetes wise but was sick due to completely different things. Jacob was also fine but had really low blood sugars for a few hours and he developed Jaundice

Are you seeing a Diabetes Educator as well? Thats who I see and who decides what insulin I need and what dosage.

[Trillian]

Cindy, hun, from what she is saying about inducing you, she is expecting you to give birth in a minimum of 5hrs (at a rate of 2cm an hour) and that to me is a very stupid, if not risky, thing to suggest. I know what your thoughts are on this and I think she is being unfair by putting this extra pressure on you. And she has basically told you she will intervene further if you aren't progressing to her liking and it's pretty obvious as to what that means.

All you can do is get cracking on the natural induction methods and do everything you can to get him to come on his own and not when your OB says so.

[Rach75]

um I was on 4 units each night from 29 weeks to 37 weeks when I was induced but ended in c-sect which was expected

my OB reason behind induction is babies get to big very quickly with GD and the level of amniotic fluid can make the baby quite sick

I expect to have GD again next time round but will opt for a elective c-sect

best of luck and ask for a scan prior to induction Jack was estimated to be 9lbs 90z at 36 weeks he was 8lbs 12 1.2oz at 37weeks 3 days

[nicjay]

Hi Joel"s Girl,

I'm a diabetic on insulin (have been for 20+ years) so a bit different to you, but I thought my experiences with my DD might be able to help??

Anyway, my ob would have induced me at 39 weeks, not at 38. Fortunately (for me) it didn't get to that - I went into natural labour at 37.5 weeks.

But unfortuantely my DD had all the diabetic complications - low blood sugars, jaundice and respiratory difficulty - so I really do believe that those last few weeks make a difference to your chances of the bub having problems like this.

I had a scan at either 34 or 36 weeks (I can't remember which, sorry!) and she was measuring average, so he was happy to let me keep going.

Surely if your sugars are well controlled and the baby looks like it is not getting overly large, there is no reason to induce you at 38 weeks? Maybe you could ask for another scan to check size? But also don't forget (and my ob told me this!!) that scans late in pregnancy are less accurate at measuring bubs size

Good luck!

ETA: I just remembered that deterioration in placental function can also be a problem late in your pregnancy too. If you notice that your insulin requirements are dropping, that may be why and make sure you tell your ob.

[Trish]

Joels girl just though that I would throw in for you that most accupuncturists won't induce you at 36 weeks. However they also won't ask for proof of when you are due. Just your DD.

Goodluck hun, be informed and decide what yyou feel is best for both you and your baby.

I do agree with Sherie though, what your OB is suggesting for your first labour is pretty much setting you up for failure.

[joel's girl]

Thanks ladies...............I really appreciate the support and advice.

I've been busy today reading and researching all I can. I went out and bought some EPO and RTL tablets and will start them tonight. I also found a acupuncturist who specialises in women's health and is accredited with the AACMA. I have my first appointment with her tomorrow at 12noon. She was very understanding of my situation and stated that the treatment will not put me into labour if my body is not ready but at a minimum it will assist in preparing my body for labour so in the event that I do get to the 'induction date' that a minimal amount of intervention may be all that's needed. ie: stretch and sweep or ARM, I may be able to then continue with a natural labour - as avoiding any drug intervention is my main concern.

I'll keep you guys posted...........if there is anything else that you think might assist feel free to tell me as I'm prepared to try anything to avoid this induction - IF YOU HADN"T ALREADY GUESSED THAT

[joel's girl]

update - had the acupuncture today at 12noon and by 2pm I was having mild period type pain. Made myself have a light meal then a sleep........just in case I'm in for a long night.

I've now just got out of a long hot bath and feel all refreshed.

Please send me some strong labour vibes ladies............I really want this to be it. The therapist said it should start in 48hrs and if not I could ahve a 2nd session on Monday. The back to dual with the OB on Tuesday !!!! Let's hope it's all said and done by Tuesday and that can be avoided.......

[MamaPan]

oooh good news cindy! so ironic you have spent so long avoiding labour and now you are trying to bring it on!!!

[joel's girl]

oooh good news cindy! so ironic you have spent so long avoiding labour and now you are trying to bring it on!!!

I know !!

[AnyDream]

Sounds like it's pretty exciting, hope you get some good sleep this evening then All Systems GO!!