As your due date approaches, and you are suffering from gestational diabetes, you might be worried about whether a natural delivery is possible for you or not. Try not to be. It is possible to have a natural delivery with gestational diabetes. Nowadays, many pregnant women encounter the problem of gestational diabetes (GD), or high blood sugar levels during pregnancy.
Gestational diabetes has the potential to impact the health of both the mother and her unborn baby during pregnancy, but it doesn’t prevent a natural birth [1]. Obviously, unlike a normal pregnancy, the doctor has to take additional factors into account during a vaginal delivery for those with gestational diabetes. Keep reading to learn about the possibility of having a natural delivery with gestational diabetes.
Why Is Labor Induced In Pregnant Women With Gestational Diabetes?
Several factors are crucial during the labor and vaginal delivery of pregnant women with gestational diabetes. Foremost, doctors will not permit home birth due to the possible need for immediate specialized medical care in case of complications for both the mother and her baby post-delivery [2].
There are several reasons why doctors recommend induction of labor for women with gestational diabetes. A few of them are:
1. Large baby
If you have gestational diabetes, you will probably have a big baby. Macrosomia can complicate vaginal delivery and lead to injuries such as:
a) Shoulder Dystocia
Shoulder dystocia refers to a condition in which the baby’s shoulders get stuck in the pelvic outlet, being too wide to pass through [3]. Most doctors think about this as a medical emergency.
b) Perineal Tearing
Delivering a big baby vaginally increases the chances of perineal tearing [4]. Even fourth-degree laceration (a perineal tear that extends to the rectum) is common in the delivery of a big baby.
c) Damage To The Tailbone
If your baby is very large, the pressure of a baby passing through the birth canal can injure your tailbone.
d) Blood Loss
The chances of postpartum hemorrhage increase if the baby is larger than the normal size.
2. Increased Chances of Stillbirth
Preventing stillbirth is the main reason for inducing labor in a pregnant woman with gestational diabetes. The chances of stillbirth increase significantly when the pregnancy progresses beyond 40 weeks. Therefore, labor is induced around the 39 weeks, if there are no signs of natural labor [5].
3. Preeclampsia
High blood pressure characterized by preeclampsia is a very common complication of gestational diabetes [6]. It can prove to be pretty fatal for both the mother and the baby. Hence, it requires an early induction of Labor.
Is Vaginal Birth Possible With Gestational Diabetes?
For a successful vaginal delivery for women with gestational diabetes, the doctors may follow a few precautions, such as:
a) Close Monitoring of Mother
The team closely monitors the mother throughout the labor and delivery if she is dealing with gestational Diabetes.
b) Continuous Monitoring of the Baby
The team continuously monitors the baby throughout labor for any signs of distress.
c) Getting The Baby Into The Right Position
Even if you are expecting a big baby, you can still have a straightforward vaginal birth if the baby gets into the right labor position. The doctors monitor the position of the baby to ensure a smooth delivery
d) Controlling The Blood Sugar Level Throughout Labor And Delivery
Monitor the blood glucose level hourly during labor to make sure it remains under control. If the levels are high, you may receive insulin administered through a drip [7]. If your gestational diabetes remains under control during pregnancy, it is unlikely that your blood glucose level will spike.
e) Assisted Birth
If the pregnant woman becomes exhausted during Labor, if the baby is in distress, or if the baby encounters difficulty in passing the birth canal, an assisted birth might become necessary. Here, doctors use forceps or a ventouse to aid the baby’s passage through the birth canal
Does Having Gestational Diabetes Always Mean You’ll Deliver Early?
Having gestational diabetes does not necessarily mean that you will deliver early. As each pregnancy is unique, the decision to deliver early or wait till term will depend upon a number of factors. Most importantly, it depends on maternal and fetal well-being. The ultimate goal of managing gestational diabetes is to achieve a good fetal outcome without any compromise on maternal health with minimal interventions and strict blood sugar control.
What Are The Recommendations For When You Should Deliver If You Have Gestational Diabetes?
The American College of Obstetricians and Gynecologists recommends inducing delivery around 39- 40 weeks in women with well-controlled gestational diabetes, and those with some unexpected complications or poorly controlled sugar levels must be induced before 39 weeks [8]. A lot of doctors recommend inducing labor at around 39 weeks, or a little earlier in some situations, to make vaginal delivery easier. This approach is aimed at preventing the baby from gaining excess weight during the last couple of weeks.
Women with gestational diabetes need to discuss their delivery plans with their doctors, who will make recommendations based on their medical history and glycemic control. As each pregnancy is unique, the timing of delivery might differ too.
Risks Of Delivering Early If You Have Gestational Diabetes?
For most women with gestational diabetes, an early delivery is safe. As in cases of premature delivery, most of the infants born earlier remain healthy and thrive well.
Although a very small percentage of babies might develop certain issues, like:
- Respiratory distress Syndrome- Few babies born earlier might have immature lungs, posing a risk of Respiratory Distress Syndrome [9].
- Hypoglycemia- There can be difficulty regulating blood sugar levels in babies born earlier [10].
- Feeding difficulties- Babies born earlier might have feeding issues and difficulty gaining weight.
- NICU stays
- Hearing and vision issues.
- Cerebral palsy [11].
Hence, the timing of delivery must be very carefully planned after outweighing the possible risks involved with early delivery and the risks of continuing the pregnancy.
Can You Prevent Delivering Early If You Have Gestational Diabetes?
The best that a mother can do to prevent an early delivery is to keep her blood sugar levels under strict control. By implementing a good sugar control plan, this can be achieved, obviously with great family support and the guidance of her doctors. Preventing an early delivery is possible by following the below plan:
- A healthy diet, includes foods with a low glycemic index [12].
- Exercising regularly and staying active as much as possible.
- Monitoring blood sugar levels regularly.
- Taking all the glucose-lowering medications or insulin on time without skipping any dose.
Following these strategies will ensure stable blood sugar levels and reduce the likelihood of an early delivery.
Therefore, the possibility of a natural delivery cannot be completely ruled out for a woman struggling with gestational diabetes. There are many hurdles during pregnancy with gestational diabetes, but, with strict control of blood sugar levels and regular maternal and fetal monitoring, a vaginal delivery is quite possible. You can have a safe birthing experience with the positive support of your family and healthcare providers. Next time you see those tempting sugary candies, control your cravings.
FAQ’s
1. Can You Deliver Naturally With Gestational Diabetes?
Yes, it is possible to have a vaginal delivery while managing gestational diabetes. This requires good blood sugar management along with regular monitoring of both the mother and the baby. All possible complications must be ruled out to ensure a smooth and normal delivery.
2. What Are The Chances Of Normal Delivery With Gestational Diabetes?
There are fairly good chances of a normal vaginal delivery with gestational diabetes. It is important to make sure that your diabetes is well controlled and that no associated pregnancy complications are hindering a normal delivery.
3. Can A Diabetic Patient Have Normal Delivery?
Yes, a diabetic mother can give birth to a healthy baby through a normal delivery. This requires managing your diabetes well. You might have to work with your healthcare providers to manage your blood sugar levels and perform regular fetal monitoring.
4. Is It Safe To Have A Home Birth With Gestational Diabetes?
Having a home birth with gestational diabetes can be very risky. Doctors do not recommend home birth for diabetic mothers due to several potential life-threatening complications. Giving birth at home lacks all the necessary facilities and good monitoring of the mother and the baby.
References
- Dudhwadkar, Ameya R., and Michelle N. Fonseca. “Maternal and fetal outcome in gestational diabetes mellitus.” International Journal of Reproduction, Contraception, Obstetrics and Gynecology, vol. 5, no. 10, Oct. 2016 – https://go.gale.com/ps/i.do id=
- Leah M. Schuppener D.O., Robert F. Corliss M.D. Presented at the 70th Annual Scientific Meeting of the American Academy of Forensic Sciences, February 19-24, 2018, in Seattle, WA. – https://onlinelibrary.wiley.com/doi/abs/10.1111/1556-4029.14247
- Abdelwahab M, Frey HA, Lynch CD, Klebanoff MA, Thung SF, Costantine MM, Landon MB, Venkatesh KK. Association between Diabetes in Pregnancy and Shoulder Dystocia by Infant Birth Weight in an Era of Cesarean Delivery for Suspected Macrosomia. Am J Perinatol. 2023 Jul;40(9):929-936 – https://pubmed.ncbi.nlm.nih.gov/36848935/#:
- GLYNNS Solicitors – Gestational Diabetes and Severe Perineal Tears- https://www.glynns.co.uk/birth-injury-claims/gestational-diabetes-and-severe-perineal-tears.php#:
- Rosenstein MG, Cheng YW, Snowden JM, Nicholson JM, Doss AE, Caughey AB. The risk of stillbirth and infant death stratified by gestational age in women with gestational diabetes. Am J Obstet Gynecol. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3403365/
- Yang Y, Wu N. Gestational Diabetes Mellitus and Preeclampsia: Correlation and Influencing Factors. Front Cardiovasc Med. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8889031/
- Kalra P, Anakal M. Peripartum management of diabetes. Indian J Endocrinol Metab. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3830373/
- Medically reviewed by Valinda Riggins Nwadike, MD, MPH, OB/GYN, — Written by Katie Yockey on September 15, 2022 – https://www.medicalnewstoday.com/articles
- Medically reviewed by Debra Sullivan, Ph.D., MSN, R.N., CNE, COI — Written by Chaunie Brusie on January 11, 2018 – https://www.healthline.com/health/pregnancy/babies-born-at-36-weeks#risks-at-weeks
- American Diabetic Association- Corresponding author: Martha B. Kole, Diabetes Care 2020;43(12):e194–e195 – https://diabetesjournals.org/care/article/
- Elkamil AI, Andersen GL, Salvesen KÅ, Skranes J, Irgens LM, Vik T. Induction of labor and cerebral palsy: a population-based study in Norway. Acta Obstet Gynecol Scand – https://pubmed.ncbi.nlm.nih.gov/21275920/
- Rasmussen L, Poulsen CW, Kampmann U, Smedegaard SB, Ovesen PG, Fuglsang J. Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7599681/
