Giving birth – The ideal time to give birth if you have gestational diabetes is usually around weeks 38 to 40. If your blood sugar is within normal levels and there are no concerns about your or your baby’s health, you may be able to wait for labour to start naturally.
- However, you’ll usually be offered induction of labour or a caesarean section if you have not given birth by 40 weeks and 6 days.
- Earlier delivery may be recommended if there are concerns about your or your baby’s health, or if your blood sugar levels have not been well controlled.
- You should give birth at a hospital where specially trained health care professionals are available to provide appropriate care for your baby.
When you go into hospital to give birth, take your blood sugar testing kit with you, plus any medicines you’re taking. Usually you should keep testing your blood sugar and taking your medicines until you’re in established labour or you’re told to stop eating before a caesarean section.
Can you be induced at 37 weeks with gestational diabetes?
Recently updated practice guidelines on labor induction with gestational diabetes – The American College of Obstetricians and Gynecologists (ACOG) advises against inducing labor before 39 weeks in people with GDM who have well-controlled blood sugar levels with diet and exercise alone.
- For these women, they recommend that expectant management is appropriate up to 40 weeks, 6 days.
- For people with GDM who have well-controlled blood sugar levels with medication, ACOG recommends birth between 39 weeks, 0 days to 39 weeks, 6 days.
- ACOG guidance suggests even earlier inductions for people with poorly controlled blood sugar levels, but it’s important to consider the tradeoffs, since prematurity also carries risks (ACOG, 2018).
In the United Kingdom, guidelines also advise people with GDM to give birth no later than 40 weeks, 6 days (NICE, 2015). The Polish Gynecological Society recommends that people with GDM consider induction after 39 weeks (Bomba-Opoń et al.2017). In Canada, the current recommendation is that pregnant people with GDM should be offered an induction between 38 to 40 weeks, depending on their blood sugar control and other risk factors (Berger et al.2016).
, Immediate delivery or expectant management in gestational diabetes at term: the ginexmal randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology ; 124 (4):669–77. , Fetal macrosomia. Practice Bulletin No.173. Obstet Gynecol ;128:e195–209.). “ACOG Practice Bulletin No.190: Gestational Diabetes Mellitus.” Obstetrics and Gynecology 131(2): e49-e64.,2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes; Diabetes Care; 41(Suppl.1): S13–S27. , Effects of insulin on placental, fetal and maternal outcomes in gestational diabetes mellitus. Pak J Med Sci;30(2):240-244., Elective induction of labor in women with gestational diabetes mellitus: an intervention that modifies the risk of cesarean section. Arch Gynecol Obstet;290(5):905-12., Diabetes in Pregnancy. JOGC; 38(7):667-679.e1., Planned birth at or near term for improving health outcomes for pregnant women with gestational diabetes and their infants. Cochrane Database of Systematic Reviews 2018, Issue 1. Art. No.: CD012910. , Polish Gynecological Society Recommendations for Labor Induction. Ginekol Pol; 88(4):224-234., Lifestyle interventions for the treatment of women with gestational diabetes. Cochrane Database of Systematic Reviews, Issue 5. Art. No.: CD011970., Insulin for the treatment of women with gestational diabetes. Cochrane Database of Systematic Reviews, Issue 11. Caughey (2018). UpToDate: GDM Obstetrical Issues and Management. Subscription required., Overweight and the metabolic syndrome in adult offspring of women with diet-treated gestational diabetes mellitus or type 1 diabetes. J Clin Endocrinol Metab;94:2464–70., Listening to MothersSM III: Pregnancy and Birth. New York: Childbirth Connection., Trends in Elective Labor Induction for Six United States Health Plans, 2001-2007. Journal of Women’s Health. Vol.23, No.11., Preventing type 2 diabetes: public health implications for women with a history of gestational diabetes mellitus. Vol.200, Issue: 365.e1-365.e8., Treatments for gestational diabetes: a systematic review and meta-analysis. BMJ Open;7:e015557., Timing of delivery and pregnancy outcomes in women with gestational diabetes. Am J Obstet Gynecol;215(2):243.e1-7., Hyperglycemia and adverse pregnancy outcomes.N. Engl.J. Med.2008, 358, 1991–2002., Treatments for women with gestational diabetes mellitus: an overview of Cochrane systematic reviews. Cochrane Database of Systematic Reviews 2018, Issue 8. Art. No.: CD012327. , Induction of labor before 40 weeks is associated with lower rate of cesarean delivery in women with gestational diabetes mellitus. Am J Obstet Gynecol;214:364.e1-8., Clinical Guideline: Screening for Gestational Diabetes Mellitus: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine; 160(6): 414-420. NICE guideline (2015). Diabetes in pregnancy: management from preconception to the postnatal period. Accessed October 19, 2018. Available online at: nice.org.uk/guidance/ng3., What is the optimal gestational age for women with gestational diabetes type A1 to deliver?. Am J Obstet Gynecol ;211(4):418.e1-6., Relative risk versus absolute risk: one cannot be interpreted without the other, Nephrology Dialysis Transplantation, Volume 32, Issue suppl_2, 1 April 2017, Pages ii13–ii18., The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol 206: 309:e1–e7., Delivery timing and cesarean delivery risk in women with mild gestational diabetes mellitus. Am J Obstet Gynecol;211(3):244.e1-7., Association of History of Gestational Diabetes with Long-Term Cardiovascular Disease Risk in Large Prospective Cohort of US Women. JAMA Internal Medicine., Consequences of gestational and pregestational diabetes on placental function and birth weight. World J Diabetes; 2(11): 196-203., Active compared with expectant delivery management in women with gestational diabetes: a systematic review. Obstet Gynecol;113:206–17.
If you want to read more about induction or Cesarean for suspected big babies (with or without gestational diabetes), you can read We would like to extend our gratitude to our expert reviewers: Shannon J. Voogt, MD, Board-Certified in Family Medicine; Courtney L.
- Barnes, MPH, MD, FACOG, specializes in Obstetrics & Gynecology in Columbia, MO; and Melissa Rosenstein, MD, Division of Maternal-Fetal Medicine at University of California, San Francisco.
- We would also like to thank for her medical editing assistance.
- Join others who also want to help bring evidence-based care to their local community.
Also, gain complimentary access to a printable library of our Signature Articles, 20+ hours of CE courses, a private community, and more. : Induction for Gestational Diabetes – Evidence Based Birth®
What week do you get induced if you have gestational diabetes?
Treatments for gestational diabetes – If you have gestational diabetes, the chances of having problems with your pregnancy can be reduced by controlling your blood sugar levels. You’ll be given a blood sugar testing kit so you can monitor the effects of treatment.
- Blood sugar levels may be reduced by changing your diet and being more active if you can.
- Gentle activities such as walking, swimming and prenatal yoga can help reduce blood sugar.
- But tell your midwife or doctor before starting an activity you haven’t done before.
- However, if these changes don’t lower your blood sugar levels enough, you will need to take medicine as well.
This may be tablets or insulin injections. You’ll also be more closely monitored during your pregnancy and birth to check for any potential problems. If you have gestational diabetes, it’s best to give birth before 41 weeks. Induction of labour or a caesarean section may be recommended if labour does not start naturally by this time.
How early do they induce for diabetes?
Planning the birth – Although many women with type 1 or 2 diabetes have a healthy birth, there are some risks associated with giving birth if you have diabetes. You will be advised to give birth early to reduce the risk of stillbirth. This will usually be during week 37 or week 38 of your pregnancy.
You may be advised to have your baby earlier than this if you have complications, such as high blood pressure or if your baby’s growth has slowed down. If your ultrasound scans have shown that your baby is large, you may be advised to have an induction (bringing labour on earlier) or planned caesarean section,
You may still be able to give birth vaginally if you want to, even if you’ve had a caesarean section before. Your healthcare team should explain your options for giving birth before you make your birth plan, It’s important that you understand the advantages and disadvantages of every option, so you can make an informed decision about what you want.
Can you go full term with gestational diabetes?
Will gestational diabetes affect my labor and delivery? – Most women with gestational diabetes can make it to their due dates safely and begin labor naturally. In some cases, though, gestational diabetes could change the way you feel or how your baby is delivered.
Blood Sugar and Insulin Balance —keeping your blood sugar level under control during labor and delivery is vital to your own health and to your baby’s health. If you do not take insulin during your pregnancy, you probably will not need it during labor or delivery. If you do take insulin during your pregnancy, you may receive an insulin shot when labor begins, or you may get insulin through a thin, plastic tube in your arm that goes into your bloodstream during labor. Early Delivery —Gestational diabetes puts women at higher risk than women without the condition for developing preeclampsia (pronounced pree-ee-KLAMP-see-uh), late in their pregnancies. Preeclampsia is a condition related to a sudden blood pressure increase; it can be a serious. The only way to cure preeclampsia is to deliver the baby; but delivery may not be the best option for your health or for the health of the baby. Your health care provider will keep you under close watch, possibly at the hospital, and will run multiple tests to determine whether early delivery is safe and needed. Your health care provider will give you more information about early delivery, should it be necessary. Cesarean Delivery —This is a type of surgery used to deliver the baby, instead of natural delivery through the vagina. Cesarean delivery is also called a cesarean section, or “C” section. Simply having gestational diabetes is not a reason to have a C section, but your health care provider may have other reasons for choosing a cesarean delivery, such as changes in your health or your baby’s health during labor.
How likely is stillbirth with gestational diabetes?
Authors list – Dr Jenny Myers, Dr Susan Greenwood, Professor John Aplin, Giovanna Bernativičius, Matina Hakim
Diabetes affects 1-2% of pregnancies and is a major risk factor for many pregnancy complications. Women with diabetes are around five times more likely to have stillbirths, and three times more likely to have babies that don’t survive beyond their first few months.
- Diabetes can also stop babies from growing normally – they are born either too small (fetal growth restriction (FGR)) or too large (macrosomia), both of which dramatically increase the risk of stillbirths.
- Babies who do not grow properly in the womb – whether too large or too small – are also at risk of serious health conditions later in life, such as obesity or diabetes.
High blood glucose levels are associated with abnormalities in fetal growth, but the relationship between blood glucose levels at different stages of pregnancy and how this relates to the development and function of the placenta is poorly understood.
What happens if you get induced at 37 weeks?
Full term is better. – A full-term pregnancy lasts at least 39 weeks. Of course, some babies naturally arrive sooner. And complications during pregnancy can make an early delivery the safest choice. But most babies need 39 weeks to develop fully. Induced or planned delivery before that time—without valid medical reason—is not in the best interest of the baby or the mother.
- Between 1990 and 2007, there were fewer full-term births, and almost twice as many babies born at 37 and 38 weeks.
- One reason for this is that it became more common for women to be scheduled for a C-section or to have labor induced before their due date.
- Some hospitals have taken recent steps to reduce unnecessary early deliveries, but too many births are still being scheduled for convenience.
Carrying an infant the full 39 weeks has important health benefits for the baby and the mother. For example, during weeks 37 and 38, the baby’s lungs and brain are still developing. The baby’s body also gains fat during this time, which helps the baby keep a healthy body temperature.
- Babies induced or delivered by C-section before 39 weeks are more likely to have problems breathing and feeding, have severe jaundice, and need intensive care after birth.
- They also have a higher chance of having cerebral palsy, which can affect movement, hearing, seeing, thinking, and learning.
- And, while the overall risk of infant death is low, it is higher for babies who are delivered before 39 weeks.
Women who carry their baby at least 39 weeks also have less postpartum depression. This may be because their infants are less likely to have problems than those born early.
Do diabetics have to have C sections?
C-Section (Cesarean Section) – A C-section is an operation to deliver the baby through the mother’s belly. A woman who has diabetes that is not well controlled has a higher chance of needing a C-section to deliver the baby. When the baby is delivered by a C-section, it takes longer for the woman to recover from childbirth.
Does everyone with gestational diabetes get induced?
You should be able to. Having gestational diabetes (GD) doesn’t necessarily mean that you can’t have your baby vaginally, You’ve got a better chance of having a birth without any interventions, such as induction or caesarean section, if you can keep your blood sugar levels stable during pregnancy.
However, your obstetrician will recommend that you don’t go past your due date, even if you’ve been able to control gestational diabetes well. She’ll recommend that your labour is induced if it hasn’t started by 40 weeks. If you’ve had complications in your pregnancy, or if you’ve needed medication to control your GD, you’ll have a check-up with your doctor at 38 weeks.
Depending on how things are going, your doctor may recommend that you have an induction, or a planned caesarean, between 38 weeks and 39 weeks. The reason for your doctor’s caution is that with poorly controlled GD, you’re more likely to:
develop pre-eclampsia have a big baby (macrosomia), with a birth weight of 4.5kg (9lb 15oz) or more
Expecting a big baby doesn’t rule out vaginal birth. Almost two thirds of big babies are born vaginally. Getting into the right labour positions can help your baby to be born without needing an episiotomy, or assisted birth, It’s sensible to have a discussion with your doctor and midwife, though, because there are risks involved in giving birth vaginally to a big baby.
- The biggest worry is shoulder dystocia,
- Shoulder dystocia happens when your baby’s shoulders get stuck behind the bones in your pelvis as she’s being born.
- This is a particular risk for mums with poorly controlled GD, because the extra blood sugar makes babies grow big around their shoulders and chest.
If your baby is over 4.5kg (9lb 15oz), there is a one in 13 chance of shoulder dystocia happening during birth. This increases to a one in seven chance if your baby is over 5kg (11lb). Giving birth to a big baby can also leave you with problems. It raises your risk of:
having a bigger tear in the area around your vagina (perineum) losing a lot of blood having damage to your tailbone (coccyx)
An advantage of having your labour induced a little before your due date is that it will stop your baby putting on too much weight in the final weeks of your pregnancy. Not all women with GD have big babies, especially when blood sugar is well-controlled. There is plenty you can do now to make sure your blood sugar stays stable:
eat a healthy diet for GD exercise regularly keep pregnancy weight gain under control
Talk to other mums who have gestational diabetes in our friendly community, Jenny Leach is an editor and writer specialising in evidence-based health content.
Will my doctor induce me at 37 weeks?
What is inducing labor? Inducing labor (also called labor induction) is when your health care provider gives you medicine or uses other methods, like breaking your water (amniotic sac), to make your labor start. The amniotic sac (also called bag of waters) is the sac inside the uterus (womb) that holds your growing baby.
The sac is filled with amniotic fluid, Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus. Your provider may recommend inducing labor if your health or your baby’s health is at risk or if you’re 2 weeks or more past your due date.
For some women, inducing labor is the best way to keep mom and baby healthy. Inducing labor should be for medical reasons only. If there are medical reasons to induce your labor, talk to your provider about waiting until at least 39 weeks of pregnancy.
Your pregnancy lasts longer than 41 to 42 weeks. After 42 weeks, the placenta may not work as well as it did earlier in pregnancy. The placenta grows in your uterus (womb) and supplies your baby with food and oxygen through the umbilical cord. Your placenta is separating from your uterus (also called placental abruption ) or you have an infection in your uterus. Your water breaks before labor begins. This is called premature rupture of membranes (also called PROM). You have health problems, like diabetes, high blood pressure or preeclampsia or problems with your heart, lungs or kidneys. Diabetes is when your body has too much sugar (called glucose) in your blood. This can damage organs in your body, including blood vessels, nerves, eyes and kidneys. High blood pressure is when the force of blood against the walls of the blood vessels is too high and stresses your heart. Preeclampsia is a serious blood pressure condition that can happen after the 20th week of pregnancy or after giving birth (called postpartum preeclampsia). Your baby has a stopped growing. Or your baby has oligohydramnios, This means your baby doesn’t have enough amniotic fluid. You have Rh disease and it causes problems with your baby’s blood.
What are the risks of scheduling labor induction for non-medical reasons? Scheduling labor induction may cause problems for you and your baby because your due date may not be exactly right. Sometimes it’s hard to know exactly when you got pregnant. If you schedule labor induction and your due date is off by a week or 2, your baby may be born too early.
- Babies born early (called premature babies ) may have more health problems at birth and later in life than babies born on time.
- This is why it’s important to wait until at least 39 weeks to induce labor.
- If your pregnancy is healthy, it’s best to let labor begin on its own.
- If your provider talks to you about inducing labor, ask if you can wait until at least 39 weeks to be induced.
This gives your baby’s lungs and brain all the time they need to fully grow and develop before he’s born. If there are problems with your pregnancy or your baby’s health, you may need to have your baby earlier than 39 weeks. In these cases, your provider may recommend an early birth because the benefits outweigh the risks.
Why do we need to induce my labor? Is there a problem with my health or the health of my baby that may make inducing labor necessary before 39 weeks? Can I wait to have my baby closer to 39 weeks? How will you induce my labor? What can I expect when you induce labor? Will inducing labor increase the chance that I’ll need to have a c-section? What are my options for pain medicine?
Last reviewed: September, 2018 See also : 39 weeks infographic