# VBAC option with gestational diabetes



## debs

I had a c-section with my first child as she was breech. We had set out hearts on a VBAC this time round but after being diagnosed with gestational diabetes and having to take insulin (as change i dlet alone did not work) I am now being told by the cdonsultant that they will want to deliver at 38 weeks. They are prepared to do a sweep at 38 weeks, and if that works try and break the waters but I was told that as I didn't go into labour with my first child that the likelihood that I would be in a suitable stage to break my waters at 38 weeks is unlikely and that they would then have to go for an elective c-section. Has anyone else had a similar experience? All the other information I have had on c-sections is that you should wait until 39 weeks to reduce breathing problems for your baby. The consultant said it is our choice but that they prefer to deliver at 38 weeks if I am on insulin due to the risks of a stillbirth. Obviously I want to do what is best for my baby but I also don't want her being delivered too early unless it is necessary.


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## Northerner

Hi debs, welcome to the forum I have absolutely no experience of childbirth, so can't answer your question, but hopefully there will be someone along who can help.


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## Twitchy

Hiya!

I had to had an "elective" C section due to severe pre-eclampsia with our little boy, at 34 wks 5 days - it was really scary as we'd been told that diabetic's baby's lungs mature more slowly than "normal" mum's by a couple of weeks or so...so maturity-wise he was 32 weeks - eek!   The good news was that they had already given me the two steroid injections that they like to give if delivering early, to help baby's lungs mature.  M was fine, despite an initial scare about a shadow on his lung (turned out not to be a problem) & quite bad jaundice.  Things like feeding were difficult, and an early baby can be exhausting to look after (very frequent feeds etc), but he was fine.  We're now pregnant again, his little sister's due date is officially 2nd April, but I've been told to expect another early one, due to my previous history & the fact I've had diabetes for 3 decades now!   So we're planning for sometime in early March!

From what I have heard of the risks, I would be much happier delivering by C section at 38 weeks (I'd be quite glad to get that far lol!) than taking a chance of a "normal" delivery and risking losing everything...sorry if that sounds harsh, it's not meant to, it's just that last time round I was so sold on all the NCT rubbish (ie if you don't have a natural, pain relief free birth you're somehow a failure as a mother!) that I was miserable afterwards...how silly of me!  I have a wonderful, feisty, rascally little boy & that's the only thing that matters.  Don't let people scare you about a c section either - ours was a really good experience - the consultant was wonderful, even prompting my hubby to check he camera was ok & take pictures!  (Not as ghastly/tasteless as they sound, promise!!)  It was all very calm & controlled, and baby was safe.  I guess I'm starting (belatedly!) to realise that maybe a diabetic pregnancy is all about pragmatic compromise in the interests of a good outcome.  Guess we are just aren't going to get the homeopathic, whale-music in a birth pool home-birth experience some deluded people think is the only valid way to have a baby!  

I know it's really hard not to stress (from my name you'll guess I'm one of the worst!), but the obst consultants seem a sensible lot & I certainly trust ours...which coming from me is very high praise!

Hope the above helps!  All the very best,

Twitchy x


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## Admin

Hi Debs - I was exactly the same as you - wanted to keep my bump for as long as possible - as it was I agreed to be induced at 38 + 3 - and things didn't go quite to plan - you can read about it in my post. With diabetic Mom's there is a high chance of still birth after 38 weeks - they don't know why and this can happen even if you have a good pregnancy like myself. I didn't think it applied to me! I fought being induced at 38 weeks - and Zac wasn't thriving on the day I went in, for no reason. Had I not have gone in he might not be here today, I am so so glad I went in when I did - the thought of him not making it just because of my principals would be too much to bear. I would not hesitate to be induced at 38 weeks if there is a next time as I would rather baby out and safe than in and struggling. It's hard decision to make especially as there is no 'facts' to base the cause of stillbirth on, but the fact is there is a very high percentage of stillbirths to diabetic Mom's after 38 weeks.


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## debs

Hi Admin,
Thank you so much for your reply. I have read your post on Stanley's arrival and it sounds like you really went through it. Congraulations of the safe arrival of your baby boy!!
I will deifintely take your advice and go with the consultants recommendation of 38 weeks. Originally he said 40 weeks would be okay if we could control my gestational diabetes through diet alone but once I went on to the insulin he said 38 weeks should be the limit. I don't know why this makes a difference but if 38 weeks is what it needs to be then I have no problem with that (the safety of my baby is the most important).
Out of interest, would you still go for a labour again rather than opt for an elective c-section at 38 weeks? Because of my previous c-section they would prefer not to induce as there is a bigger risk of scar rupture (which would end up in an emergency c-section which they, and I don't want). At the moment he is saying that they will do a sweep at 38 weeks and then see if they can break the waters. if that doesn't work they would recommend going for an elective c-section. I guess what worries me a bit is that if they do the sweep at 38 weeks, it will be a couple of days before they try to break the waters (as they leave it 48 hours to work) so i would then be over 38 weeks when they actually deliver (one way or another). Is it worth the risk of waiting those few days or should I ask them about doing a sweep a bit earlier? The consultant did say lat time I spoke to him that he would like me to labour as it is safer for me and baby at the end of the day but I think he is still expecting it to end up as a c-section anyway. To be honest, I just want my baby to be okay and will do whatever is required to ensure her safety.


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## allisonb

Hi Debs

Lots of good advice already on here but just to reassure you.  I had an elective c section with my last child, because she was transverse, not because of my diabetes.  I was also told all along that they would do it at 38 weeks but 38 came and went and because she was a 'normal' size and there were no problems they left her where she was until 39 and 3 days.  I'm currently 26 weeks pregnant with number 4 and will have a section again (because I've had two already, again not because of diabetes) and they've already hinted at 38 weeks but have said if all is well they may leave him longer.  So, I suppose what I'm saying is it's not set in stone and things can change, best not to worry too much about and see what happens!

Allison x


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## twinnie

hi there i had a emergency c section with my first i wasnt diabetic then then for my second i was tablet controlled diabetic and put on to insulin my consultant wouldnt let me try natural birth and so i had a c section at 38 weeks as my boy was big 9 .12 at birth


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