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    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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    Mar 08
    2012

    Have gdm doctor advising for c-section in 38 weeks

    Archived User

    Hi, I had Csection with my first baby in 2010, moreover i had GDM. I have lost my kid after 4 months due to aspiration. Again i am pregnant now, same GDM this time too, i am 36 weeks now.

    1. My care provider informed me tat if i have normal pains we can go for VBAC tat too before 38th week, if i am not getting natural labour she said no other go i need to go for c-section due to GDM.
    2. I am really worried, please advice me wt to do to get labour pain before 38th week, i.e.. 2 weeks more. i am worried a lot, coz this baby going to be my life. I want to deliver naturally.
    3. Is my doc telling truth tat i need to deliver before 38th week as i have gdm with prior c-section.

    Please give me a sort of advice. I will follow tat for safe delivery.

    Henci Goer

    The best advice I can give you is to get complete, objective information on all your options so that you can make an informed decision. I'll put some links to other resources at the bottom, but this acronym can help you do that:

    Benefits
    Risks
    Alternatives
    Intuition/instinct
    No or not now

    "Benefits" will be the reasons why your dr is recommending this course of action. It should be specific to your case, so, for example, is there a reason why your dr is recommending early delivery? Are your sugar levels not under control? Do you have other health issues such as high blood pressure? Why is your dr recommending against VBAC? With one prior cesarean and (presumably) the standard low transverse uterine incision, you would seem to be a good candidate, that is, with appropriate care, a risk of 5 per 1000 or less of the scar giving way and a 75% chance or better of vaginal birth.

    "Risks" should be factual, no "waving the shroud," as the Australians call it. If you are getting feelings instead of information, that's an indicator that you are being manipulated into a decision.

    Next, you want the benefits and risks of your "alternatives," including doing nothing and letting nature take its course.  

    Then you want to take some time to digest all of this, and once you have done that, you want to pay attention to what your "intuition" or "instinct" is telling you. Meditation, prayer, or just finding a quiet time to consider what you have learned and see what floats up can help you figure out what is best for you and your family.

    Finally, know that it is your right to say "no" or "not now" if that is what you decide, and while it is unfortunately all too common, it is a serious breach of medical ethics for your care providers to try to pressure you into agreeing with their game plan once you have done so. Saying "no" is not unequivocal. It should include a discussion of the circumstances under which your answer might change.

    Here is a page on making informed decisions about care from the Childbirth Connection website. Here on the same website is info on planned VBAC vs. elective repeat cesarean surgery. Here is a page on the Lamaze website that is also on planning VBAC.

    I hope this helps.

    ~ Henci 


    All Times America/New_York

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