I am currently 33 weeks pregnant, trying for a VBAC after an unnecessary first c-sec (“failure to wait”) and currently I have gestational diabetes.
Up until this week, my blood sugars have been controlled through diet alone, but now it looks as though my fasting numbers are too high (above 100) and my OB wants to put me on insulin. I would be fine with this except that she claims that once I am on insulin, the baby must be delivered by 39 weeks. I can’t understand why it would be necessary for an induction or RCS at 39 weeks if my blood glucose is controlled. I am having trouble finding evidence-based guidelines that are a high level of evidence and specific to woman with gestational diabetes that is well-controlled.
Can you give me any insight or point me to some literature? As long as I have no other risk factors and my blood glucose is controlled, would I be irresponsible to refuse an induction at 39 weeks or even 40 or 41 (assuming NSTs shows everything is fine with the baby)? I'm wondering if maybe insulin increases the rate at which the placenta degrades?
would be greatly appreciated.