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    Questions? Ask Henci!


    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Archived User

    Hi Henci,

    I am 39 weeks and 2 days pregnant today with gestational diabetes. I got GD in my 3rd trimester and I am on Glyburide. At the begining I was only on diet but the doctor then recommend glyburide am only, then both am and pm. Now only am. My sugar level is well under control.

    My question is, I would really like to deliver vaginally but this is my 2nd child. The 1st child, I was past my due date and they induced me. Induction failed because they said baby was too big 8lbs, 10 oz. I was given a c-section.

    For this pregnancy, the doctor wanted to give me a c-section if baby does'nt come by 38 weeks but I asked to wait atleast until my due date 3/23/11.

    As of 3/14/11, sonogram indicated that the baby is 7lbs, 6 oz. NST 2 times per week indicated good movement and heart rate. As of 3/17/11, I dilated 1 cm but the doctor is not sure if 1 cm just happen or it was like that a while ago.

    Is it possible to have a VBAC (no meds) with GD. Can I go over my due date even with GD? If yes approximately how long?

    I have been having very little pain and in early March I think I lost my mucous plug over a few days (saw pinkish discharge).

    The doctor recommended a c-section if nothing happens by 3/23/11 (due date). They also said if I do go into labor and experience any signs of danger, they will still give me a c-section.

    Please help. Thanks for your advise.

    Guest

    Archived User

    Hi Henci

    It s possible to do a VBAC with GD  and with no meds. At this point, the biggest thing is making sure you and the little is safe.  It’s hard to say how long you can go as each person and her situation differs.

    As far as the 1cm you can be that way for weeks, are you now seeing your provider 1x week if so he or she should be keeping a close eye on that. 

    Question did the baby show distress last time during induction or did they just decide that he or she was to big to fit in the canal? Just asking out of curiosity.

    When on losses the mucus plug she would be looking for a yellowish discharge with a mixture of pink I have always described it as slimy sticky texture.

    Good luck  and congrats, I hope they give your body time  to do what it needs to do

     

    Henci Goer
    Posted By on 20 Mar 2011 12:37 PM

    Hi Henci,

    I am 39 weeks and 2 days pregnant today with gestational diabetes. I got GD in my 3rd trimester and I am on Glyburide. At the begining I was only on diet but the doctor then recommend glyburide am only, then both am and pm. Now only am. My sugar level is well under control.

    My question is, I would really like to deliver vaginally but this is my 2nd child. The 1st child, I was past my due date and they induced me. Induction failed because they said baby was too big 8lbs, 10 oz. I was given a c-section.

    For this pregnancy, the doctor wanted to give me a c-section if baby does'nt come by 38 weeks but I asked to wait atleast until my due date 3/23/11.

    As of 3/14/11, sonogram indicated that the baby is 7lbs, 6 oz. NST 2 times per week indicated good movement and heart rate. As of 3/17/11, I dilated 1 cm but the doctor is not sure if 1 cm just happen or it was like that a while ago.

    Is it possible to have a VBAC (no meds) with GD. Can I go over my due date even with GD? If yes approximately how long?

    I have been having very little pain and in early March I think I lost my mucous plug over a few days (saw pinkish discharge).

    The doctor recommended a c-section if nothing happens by 3/23/11 (due date). They also said if I do go into labor and experience any signs of danger, they will still give me a c-section.

    Please help. Thanks for your advise.

    Guest

     

    The excess risks of diabetes for the fetus come from diabetes of long standing, which can damage maternal blood vessels and kidneys, wild excursions of blood sugar, and the fact that gestational diabetes is associated with other health problems such as high blood pressure. (See this article and this one.) If your sugar levels are under control and you have no other health problems, your baby is at greater risk of the consequences of delivery before your baby is ready, which are respiratory problems and difficulty breastfeeding, and both of you and any future children are at risk of the consequences of cesarean surgery, which are not trivial, as this fact sheet from the Coalition for Improving Maternity Services makes clear.  Unfortunately, given your doctor's attitude you are at high risk of a preventable repeat cesarean. The best that I think can be done here, short of finding another provider, which is likely to be difficult, if not impossible at this late date, is to:
    • Hire a doula so that you have someone in your corner. (You will still have to advocate for yourself, though.)
    • Barring an emergency, get the following information--which is your legal right--before deciding whether to agree to or refuse any intervention:
      • its benefits
      • its potential harms
      • what other interventions might or would become necessary as a result of its use
      • alternatives, including doing nothing
      • same info on alternatives
    • So that you are not railroaded, barring an emergency, insist on time alone with your labor companions to consider before making your decision.
    • Don't fall prey to scare tactics.

    Your best bet for a safe, healthy VBAC is a labor that begins and continues on its own. 

    -- Henci 

     


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