Gestational Diabetes

Parent Q&A

  • Gestational diabetes care at Kaiser

    (7 replies)


    I'd love to hear about any recent experiences folks have had with a gestational diabetes diagnosis while being cared for at Kaiser. 

    Kaiser Oakland is very close, but I'm willing to other Kaisers for a great provider. So far, I have been unimpressed by my experiences at Kaiser Oakland and am wondering if this is due to the providers I've encountered, or the general systems in place there. 

    A little context: This is my second pregnancy. I gave birth to my first at Alta Bates (induced, uncomplicated vaginal birth to a 9lb 5oz boy- very similar in size to his father and smaller than my father at birth). I had hoped for a homebirth, but after the dx moved forward with East Bay Perinatal and delivery at Alta Bates. I appreciated that there was a nurse midwife on staff that was able to deliver us and never pushed for a c-section, while every OB we encountered mentioned it at least once in the course of our conversations. I'm all for full disclosure of possible complications and keeping an awareness of what eventualities may come to pass, but am put off by the general GD=big baby=c-section mentality that many providers I encountered seemed to possess. 

    If you've encountered a provider at Kaiser who has been willing to look at the patient as an individual and not just a diagnosis I would be very interested in learning about them. 

    Thank you.

    I attempted a home birth for my second, while getting concurrent care at Kaiser Oakland, and felt frustrated and belittled by them as far as sizing my baby in utero. I ended up transferring to Kaiser San Leandro at 37 weeks and having a c section there (breech baby). I found that Dr Hong in San Leandro was very responsive to my concerns and listened to and believed me about what I was saying about my baby's size vs the sizing ultrasound at Kaiser Oakland. My baby ended being 8 lbs, which is not that huge. 

    The only issue is- you can see midwives in the clinic in Oakland, but for delivery they supervise residents to attend to your birth. In San Leandro, you see OBs, and midwives attend to your birth (no residents). That ended up being what we needed since we already had a homebirth midwife. Good luck to you!

    Hi, I had a very positive experience at  Mission Bay San Francisco. I loved my OB and the remote GDM care and management they provided. Also educated me about the medical risks for GDM babies and thus the desire for a C-section (not just coz they are big). But ultimately I was given a choice. BTw i’m very small. May be the provider..?

    I don’t have personal experience with GD but have a couple of thoughts. I delivered my first baby at Kaiser Oakland in June 2017 and am now 22 weeks pregnant with my second. I’ve had a great experience so far both times. I was sure I wanted an unmedicated labor with my first and the staff completely respected that, although they checked with me to make sure when my labor dragged into 36 hours. I felt like my choices were respected. Also, I have a friend who had GD a couple years ago when she was with Kaiser and she was never pressured into a c-section at all. Granted, her GD was well-managed and her baby was actually on the smaller side but my sense is that Kaiser wants to avoid C-sections whenever possible. Good luck!

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Just diagnosed with gestational diabetes

Dec 2008

I was just diagnosed with gestational diabetes with baby number two. I am twenty- six weeks pregnant - age 40. After a little over a week on the diet/exercise plan I am doing well controlling my numbers with the exception of my waking/fasting test. I am supposed to be under 95 and am consistently above 95, typically between 105 and 115. I am wondering if anyone had used acupuncture to help with this condition. Also, I would love to hear from members who were successful at controlling their numbers with diet. We had planned a home birth with a very experienced midwife prior to this diagnosis. I would love to hear from anyone who has had a home birth after being diagnosed with GD. My WC Kaiser doctor says she never recommends HB so I am not sure how much help she will be in determining the best plan. Thanks. Anon

I had the same problem when I was pregnant with my first child. I could control my blood sugar, but that fasting one was always too high. I didn't have a home birth, but considered one and was told it was fine as long as I didn't have to go on insulin. I found with my fasting b.s. that it was very effected by what I ate the day before, even if my blood sugar right after eating didn't seem to be. So, I was able to get my fasting down by really cutting down on carbs and sugars and bulking up on protein. I would eat small portions of brown rice and quinoa and a little fruit, but that was it. I ate beans, which actually help to regulate blood sugar. I also found if I went for a walk right before bed my number was lower in the morning always. I found a nutritionist that is outside of the diabetic clinic who offered me very different advice and it was much more effective for me. She had me start eating meat after 20 yrs as a vegetarian. She also had me completely cut soy out. Her belief is that G.D. is caused by a hormonal imbalance, so eating a food that adds more hormones to your body is just not helping anything. That would apply to all meat and dairy too...nothing but organic. My baby was small, my midwife always said I had room for another one in my belly. The O.B. in the practice sent me in for an ultrasound to learn what my midwife had been telling me for weeks.....My daughter was born at 5.5 lbs. So, the oversized baby was never a concern for me, but obviously can be a serious one. I have a friend who had a 9+lb baby and she got stuck in the birth canal. She was one of those barrel chested babies you hear about in relation to G.D. I did use acupuncture and believe it was also helpful. But it is hard to say....It can't hurt! I also wanted to let you know that in many areas of the country the acceptable fasting is 105. My cousin is an O.B. nurse on the east coast and she couldn't believe that they wanted me to go on insulin for numbers of 98, 100... The explanation I got for this is that the studies/research/information is determined by the ''experts'' in specifics regions. So, here ''they'' feel that the lower numbers are the safer... I felt that if I stayed under 105, my baby would be fine. I did however with the changes I made get that down to under 95 without much problem at all. I am actually newly pregnant with #2 and hoping we can do a home birth. Good luck to you! mary
I was just there. Same story. Fasting blood sugar is not controllable by diet - its because of the interaction of your hormones with baby's (or, something along those lines). I decided to use insulin as the pill option (glyburide) made me nervous. And three MD friends all said they would do insulin and not the pill. Exactly how the pill works is unclear and how much more insulin you will get is also unknown. I found doing the insulin shot was not a big deal (but I have done a round of IVF and injections in general don't freak me out.) Do not think you can control this number if you just ate better/exercised more etc. You can't. I was in perfect health, gained very little weight, exercised regularly etc etc. But, I was 42. on birth: I opted for scheduled c-section for a variety of reasons. first child was emergency c-section. very large head, face up. did not want to go there. and with gestation diabetes controlled by insulin you are considered high risk (the highest, I think). For me, having a healthy baby after a high risk pregnancy (the baby did not need any help getting her blood sugar stable after birth - high apgar scores etc) was the most important thing - how/where she got here did not concern me. We had a lovely birth experience on a monday morning and we were home by wednesday afternoon. Email if you'd like to chat further. been there
There have been some very interesting studies on the positive effects of exercise and gestational diabetes. In one, all of the test subjects (who were insulin dependent) were able to go off insulin with just 30 minutes of riding an exercise bike on most days of the week, at a moderate pace. If you'd like to read the study, email me and I'll send you a copy of it. BeFit-Mom
Hi, I also had gestational diabetes and delivered at age 40. I cannot emphasize enough that if you want a midwife or Doula, have one AT the hospital. You are now in a double high risk pregnancy, and the risk is not only to yourself. The risk is also to your baby. Your risks are your age and diabetes. Your diabetes can cause your baby to be born with abnormally low blood sugar levels that are not corrected by its immature insulin regulation. That is a serious problem for a newborn. FYI, You should also now be seeing a neonatologist, not a just a regular OB. GD can cause the baby to develop abnormal weight gain & other complications as well.

I speak from experience. We had to have an emergency C-section, and there would have been NO time for an ambulance. No exaggeration, we both would have died during the wait. They delivered him in 2 minutes flat. And still, my son was a ''blue baby.'' His first Apgars were really bad. After working on him awhile, he finally began to breathe. His blood sugars were bad, and they had to give him 4 bottles that first night.

Make sure you see a dietician for managing the diabetes. It is a VERY strict diet, more so than even for Type II diabetics. I combined the diet with gentle exercise (walking in Oakland YMCA swimming pool) to manage. The dietician at Kaiser helped me with menu choices that varied by my activity levels. One trick, for pasta, use whole grain varieties as total carbs minus dietary fiber = diabetic carbs; this way you can have more than a quarter cup of pasta! Many ''Atkins'' or ''South Beach'' diet foods will help as snacks and/or microwave meals. (FYI, You also will need to be tested for Type II diabetes annually as you will have an 40% increased risk of developing it at some later point in your life.)

I know how disappointing this all seems; I had imagined that my one-and-only pregnancy would be a wonderful ''movie-star'' pregnancy, but Life happened. The stresses of managing diabetes did cause post-partum depression for me, except I developed it during the stress. It will all turn out fine-at 2 1/2 he is now a wonderful energetic healthy toddler- but please follow your doctor's recommendation and have the delivery at the hospital.

Think of it this way, would you be able to forgive yourself if something bad happened at home and your baby was injured or even died? Be safe. Deliver at the hospital. Davey's Mummy

First of all, congratulations on your pregnancy and also on your ability to regulate your blood sugars as much as you have. I suggest you do some research on GD. Many sources give different cut-off numbers but one thing is important to know:

It is also normal for blood sugar to raise slightly in pregnancy. This serves the pregnancy and helps the baby grow. Our current medical system as set arbitrary levels for pregnancy that are even lower than normal levels. The fasting blood sugar cut off for diabetics is 115. They have lowered that to 95 for pregnancies even though it is normal to be higher. The level of 115 fasting is only borderline. I hope this helps calm your mind. Good luck. Local Doula

Elevated fasting blood sugar is sometimes from going too long on the overnight fast. It is recommended an 8-10 hour overnight fast. More than 10 hours can lead to elevated fasting levels, as the body begins to make sugar after an extended overnight fast. So be sure to have a bedtime snack that includes at 15-30g carb (milk plus starch plus protein). Some moms find that milk at bedtime leads to morning elevations, so just have the starch and protein then (1/2 a sandwich or 6 crackers with tuna, etc) .

It is also recommended to test within 15 minutes of waking up, lots of activity before doing the fasting finger stick can also lead to elevations in blood sugar.

And finally just being active during the day 30-60 minutes of walking is good for overall metabolism. perinatal dietitian

I had gestational diabetes at about 38, controlled by diet, and again at 42, controlled by insulin. Exercise is moderation is very helpful in controlling blood sugar. Following the suggested diet plan also worked well. It seems wierd to eat cheese or tuna for breakfast, but I got used to cheese omlettes, snacks of string cheese and a couple crackers, etc. At our age, home births are discouraged due to possible complications and there is a chance of death of the baby close to delivery time with G.D. (and also of a very large baby). I was the first in my family to opt for a hospital delivery. I was grateful I did as there were complications and long, hard deliveries with both children. My second child probably wouldn't have made it without last minute intervention. Of course, the final decision is yours and I don't want to alarm you with my experiences. However, for me the ultimate goal was for a healthy child at minimal danger to my life. I would be happy to discuss it further if you wanted to email me. kl
I had gestational diabetes and was successful at controlling my blood sugar with diet. My fastings were never a problem for me, but in my studying of the subject I learned that things to try include composition of after dinner snack (more fat/protein) and timing of such.

I would like to encourage you not to do a home birth with gestational diabetes, no matter how good your midwife is. When I gave birth to twins, my son's blood sugar dropped precipitously after he was born--a common complication. He had to be monitored carefully for the next several days to ensure good health. I don't think a home environment is the best setting to do such monitoring.

Also, the complications to the baby and mom around labor and delivery are different with gestational diabetes than without. Of course, healthy mom and baby are much more important than setting of birth. been there

I've had GD for both of my pregnancies. You have my sympathy--but understand that, although the diet and checks and additional testing late in pg are a pain in the butt, if you control your blood sugar and stick with it, everything will be fine. I used insulin after diet and exercise stopped being enough--I didn't try acupuncture. I also would have liked to have home births, but a GD infant is at risk of needing immediate treatment if born hypoglycemic. There are other possible complications for the baby at birth, so you want someone who has experience with that. I had hospital births with a very highly regarded midwife, Lindy Johnson, and I have to say she was phenomenal. She has had dozens of GD clients, even some who were insulin-dependent like myself. She is very knowledgeable but not alarmist about GD and it is a wonderful supportive person in every way. I got great prenatal care and had the the birth I wanted even though we were in the hospital. (I arrived at the hospital as late in labor as I dared and checked out as soon as I felt I could manage the ride home.) Because of the risks for the baby, I would be surprised if a midwife agreed to attend your birth at home. But if you do find one, ask about her experience with GD prenatal care and births to be sure you are satisfied about the care you and your baby will have access to at the birth. sweet mama
I also am an older mom (had my baby at 39) and was diagnosed with gestational diabetes at 26 weeks. I controlled it with diet and exercise throughout the pregnancy. Here are some things that helped;

* Walking (or lifting books in the air on the nights I couldn't get it together to walk) immediately after eating. 15 minutes of walking right after finishing the meal was more useful for blood sugar values than an hour at any other time.

* Getting a cheap food scale (less than $10) and using it regularly

* Julie's organic ice cream has a ''Juliette'' bar that soothed my sweet tooth while being the right number of calories and carbs (100 and 20 respectively)

Re: home birth, I suggest that you consider Kaiser Walnut Creek, they have a birthing center with mid-wives that support natural birth but then if the baby has gotten too big you don't have to be transported at the last minute. They allowed me to wait until I was between 8-9 centimeters to come in, and to bring a doula, husband, sister and friend.

Two things to be aware of post-birth, I was in the ''pre-diabetes'' range at the 6 week check-up, but fully clear by 17 weeks - it sometimes takes a while for the hormones to leave ne's system. The other is that I lost a lot of weight the week after the birth (21 lbs including the 8.7 lb baby) and that brought on a gallstone. If you have pain in your right side after the birth (mine was 7 days later) that is a likely culprit for a woman near 40, fertile, with G.D. and a sudden weight loss. Feel free to contact me if you need further support or info. Wishing you an easy pregnancy and birth! Naomi

i also had gestational diabetes w/ baby #2. i successfully controlled my sugars with diet and would be happy to talk with you about my experience. i did not, however, have acupuncture or a home birth. feel free to contact me. emily
Congratulations on your pregnancy. I wish you the best as I also had GD on top of an already high risk pregnancy. I was not able to control my sugar levels with just diet, and even had trouble while taking insulin. One of the things I found was that there were certain foods I just could not have. Although they fit into the correct number of carbs, they would still make my blood sugars go too high. My only real craving before I found out about the diabetes was bagels, and for some reason, eating half a bagel (15 carbs) would throw me over the edge - so no more bagels. Anyway, you need to keep a food diary and try to figure out if certain foods increase or decrease your blood sugar levels. There is also evidence certain foods or spices (such as cinnamon) regulate blood sugar. Will Kaiser set up an appointment with a dietician to discuss your diet, specific to GD? I was at USCF, and they switched me to a ''medial group'' who only work with mothers with GD. As to your second question, although I did not do acupuncture late in my pregnancy, I did go to Leslie Oldershaw while trying to get pregnant. I would contact Leslie and discuss it with her. She is super! Last but not least, before making the decision to do a home birth, research all of the issues that can arise with having a baby after GD. My doctor advised me (after 12 weeks of Bradley classes) that I should have a c-section. One of the issues, apparently, is not just the size of the baby, but the babies tend to have broad shoulders which can result in them getting stuck and sufficating. So although people will tell you, I had a 10 pounder - no problem - they may not know about the shoulder issue with GD. Also, UCSF wisked my daughter away for monitoring her blood sugar right after the C-section. It was heart breaking for me, but apparently necessary to insure she was OK. So again, please do the research and weigh all of the risks to you and your baby in making your decision whether to go forward with a home birth. happy mom
As a dietitian, I was interested in the responses to this question, and I found only one possible harmful error. In pregnancy, you cannot use the same lab values as when a person is not pregnant because of what we call hemodilution. A pregnant woman has about 4 additional pounds of blood, and so most lab values, including glucose are lower than a nonpregnant woman. The normal fasting levels for pregnant women range from 70-90. So the goal is for the mom with gest. db. to have the same level as other pregnant women.

What is different is sugar in the urine. Sugar in the urine is a very rough measure of sugar in the blood. However in pregnancy, sugar ''spills'' into the urine at a much lower blood sugar level than usual. So sugar in the urine does not mean one has gest db, perinatal dietitian

Got a diagnosis of gestational diabetes

Feb 2008

Just looking for any hindsight sort of advice from women who were diagnosed with GD. I have been referred to the ''sweet success'' program thru East Bay Perinatal. Any advice as I deal with this? I am really healthy, low BMI, exercise regularly but am 42 - guessing its really my age that is doing it (did not have GD with first pregnancy). I am 27 weeks along. Anything you wish you had done or known when you got this diagnosis? Or anything you wish someone had told you? Any other great resources - people/books/etc? Advice in archives is from 2003. Thanks so much.

I was also really surprised to be diagnosed with GD. I sat in the doctor's office and cried...when she asked what was wrong I sniffed, ''I just love CARBS!'' Shortly thereafter I realized I actually felt as if I'd done something wrong during my pregnancy to get this diagnosis and that it was going to hurt my baby. Neither of those things are true, of course, and my son was born perfectly perfect at 7 pounds and 2 oz.

I went through the Sweet Success program also. It's not great...I always felt like I'd rather eat a little real sugar than a lot of fake sugar, but this diet is all fake sugar. And all those nitrites you were avoiding in the beginning seem to go out the window. There are things like baloney and bacon and hot dogs on that diet. It seemed to me that they didn't care if all my arteries clogged as long as the baby was healthy!

The first day I got so dizzy from the lack of sugar that I had to pull over and sit, so be careful about cutting sugar out completely right away.

You have to test your blood 4 times a day, which isn't as bad as it sounds. Your fingers get really sore after doing it for a few weeks, so I'd suggest alternating not only your fingers for each test, but the sides you test on as well.

After a week or so you figure out what causes your sugar to rise and what doesn't. French fries, sadly, sent mine through the roof, but some nights if my sugar was really low after dinner I would have real ice cream, test, and be fine.

My only really bad experience having GD was with Dr. Janet Goldman at the clinic when I went for my diet follow-up. She was so HORRIBLE to me that I cried all the way home.

I'm happy to answer any questions if you'd like to email me. It's a pain to have GD, but it's only for a short time that you have to follow the funky diet...and it gives you a good sense of where all those hidden sugars are. AND you can eat a big old pint of Ben and Jerry's after you deliver, just like I did! ;-) Audrey

no specific help, but my sister had this, just cut out sugar during pregnancy, did just fine, normal birth, normal kid....
GD is overdiagnosed. The glucose tests have a very high false positive -- about 1/3 of the tests women who test ''positive'' do not in fact have diabetes on further testing. The ''positive'' results need to be followed up by fasting blood glucose tests (no glucola, just fasting blood sugar). Continue to watch your diet and exercise, but ask for follow-up tests.

Gestational Diabetes is often diagnosed, but not always a problem. Having a positive result on the glucose test means you need to watch your sugar and weight gain, and you also need to be vigilant about diabetes after you give birth. Having GD means you have a higher risk of having type II diabetes after you give birth.

East Bay Perinatal is a high-risk clinic. They take any and all risks (no matter how slight) seriously, and plan for the worst case scenario. In the case of your diagnosis, the risk may be small, but they will make a mountain out of it.

By the way, it's a good idea to get copies of test results from East Bay Perinatal. They had someone else's records in my chart. They did do a good job overall, they just have some filing problems. anon

I was diagnosed with GD about 6 years ago. Two pieces of advice. First, I'd go to the East Bay Perinatology program, and stick to their (somewhat draconian!) advice as closely as possible -- I did, and had a completely healthy baby. Second, given that you say you are very healthy and have low BMI, I'd watch carefully what happens after you give birth. I'm not particularly overweight, but my diabetes never went away. After a couple of difficult years of treatment for Type 2 diabetes (during which time I kept getting worse), it was finally determined that I actually have Type 1 (autoimmune). The only effective treatment is insulin. I was unaware that this could develop in adults, but it can. Once I finally started getting proper treatment, I felt a whole lot better! Karen
Sorry about your diagnosis. I'm in my second GD pregnancy at age 40 with no other risk factors. Sweet success is a great program--very helpful and supportive. They will take great care of your pregnancy. There is no hindsight in my case. Just do your best to keep your blood sugars normal (they will tell you how in your particular case). This makes your risk of complications similar to someone who doesn't have GD. As someone who has never dieted before GD, I was unprepared for how difficult it could be to stay on the diet at times. Also, in the beginning, you can experiment a little to figure out your body's particular sensitivities. In my case, for example, I can eat things with a little sucrose (dark chocolate, jam, even very rich ice cream or cheesecake) but cannot have even half a slice of white bread or any refined grain, for that matter. You can figure this out by testing after every meal and snack at first and keeping good records.

Good luck and just remember, it's only for a few months! sweet mama

I had GD with both my pregnancies, and have sometimes tested for excess sugar at other times, but have never been diabetic. My babies were very healthy, though too big (8.13 and 9.3). I eliminated sugar and ate whole grains and healthy foods and still flunked the never-ending urine and blood tests. Years later I realized that it wasn't the sugar, it was the carbs that did me in. That, and the weight gain (nearly 60 lbs with the first one). So, if I had it to do over again, I'd skip the bagels and pasta and dial up the protein and leafies and dairy. And not gain 60 pounds! Good luck!
I had GD too and just wanted to add a few things I found.

I was with Kaiser and they put me on a program of certain servings of protein or carbs or milk etc - how much and at what time. I think it was every 2 hours. I checked my blood 4 times a day - first thing in the morning and exactly 1 hour after each meal.

One thing I found during the program was food combining and food prep made a big difference. If you you are dying to eat something you shouldn't (once in a while it seems impossible to avoid) add a protein in that meal. The way you cook a food also makes a difference, a boiled egg is better than a fried egg - fried foods and fatty foods can really push up the levels. I always had the crazy craving for a chocolate croissant which seemed like an impossibility with the sugar, carbs and fat but I found I could easily eat half of one without a problem if I ate it directly after eating half a veggie sandwhich (dark bread, mustard (no mayo), pickles, lettuce, cheese and avocado (I called this my magic sandwhich). A small cheese quesadilla regularly got a horrible reading unless I added lettuce.

I read others mention substituting fake sugar for the real stuff - boy that really sounds like a bad idea.

The lucky thing for me in getting GD was that I got an ultrasound at 37 weeks to see if the baby was big from my GD. I had to insist upon this as my dr didn't think it was a problem based upon feeling my stomach but it is a common complication and if I were you I'd insist upon it. Well the size of our baby was fine but it was found I almost had NO fluid. I never would have known this or been monitored for it without the ultrasound. anon

My doc recommended the Sweet Success program at Alta Bates

Sept 2005

I recently had my glucose screening tests and though I do not have gestational diabetes, my doctor recommends that I go to the Sweet Success program with East Bay perinatal. She considers me ''borderline'' and would prefer to be safe than sorry. Have others NOT had gestational diabetes before but considered ''borderline'' and what was your outcome? What have people's experience been with the sweet success program? Any advice would be appreciated. I love and trust my ob/gyn but would like to hear other mothers' experiences. Thank you. anonymous

I had gestational diabetes with my first pregnancy (confirmed by the 3-hour test) and went to the Sweet Success program. My nutritionist was Missy and she was great. I found it very helpful to have someone who could assist me in understanding how to eat for gestational diabetes. The thing I did not like was that every appointment included a visit with an ob who measured me and did all the same things my regular ob did. I suppose I could have said something and maybe I could have skipped that part, I don't know. You might ask about that.

For my second pregnancy, my ob had me on the diabetic diet and monitoring my sugars from my first visit. As a result, I passed the one-hour test. I did not visit the Sweet Success program this time around. However, since I was monitoring my sugars, I could see that I had occasional high blood sugar readings, which it would seem I should not have if I didn't have gestional diabetes. So, we agreed that I was probably a ''borderline'' case. I must admit that I did not monitor my sugars very closely (i.e., 4x/day), although I did stick to the diet. My son was born at 36 weeks and spent a week in the NICU and although a blood test confirmed that my blood sugars had been staying in a normal range, I still worry that his early birth was somehow related. There was no explanation for why he came early.

So my advice would be to do the Sweet Success program and live like you are diabetic. It can't hurt and you may avoid problems that way. On the plus side, I only gained a healthy 25 pounds with each pregnancy and was able to lose it pretty painlessly. Erin

I, too, was considered to have borderline gestational diabetes. I went to sweet success and had mixed feelings. The dieticians were very helpful and really taught me how to navigate meal planning, carb counting, etc. I found the diet to be very helpful as far as curbing excessive weight gain and eating healthfully. I got a glucometer and checked my blood sugars four times a day, and managed to keep the diabetes under control with diet alone. However, the visits with most of the doctors there were not helpful and felt very rushed. They didn't do anything more than the regular OB visits and I didn't think it was necessary to see them so often. I suppose it might have been different had my sugars been out of control. If nothing else, it is worth a visit to the dieticians there. anon
i was considered borderline g.d. with my second pregnancy and went to the sweet success program. i religiously followed the diet guidelines and controlled my sugars only with diet. (maybe it was easier since i was borderline, i'm not sure.) it is a VERY strict diet, not even allowing catsup. i figured it was best for me and the baby to play it safe. even though it was hard and i certainly had my moments of 'why me?' it is generally a very healthy way to eat and i've since adapted some of the guidelines. one bonus was that even though i was eating 3 meals + 3 snacks / day i didn't gain a pound in the last 2 months of my pregnancy. (somehow i made up for that after i had the baby, but that's another story.) feel free to contact me with any questions. emily
I also was considered borderline and reluctantly followed my doctor's orders to do the Sweet Success program. I learned very little from meeting with the Sweet Success consultants, but I did learn a lot from the experience overall (like measuring my glucose levels and experimenting with my diet and exercise). Thanks to the program, I only gained 20 pounds during pregnancy (I am considered average-weight). However my baby was born 9 pounds 3 ounces! So it seems like if I had not followed the diet, then my baby would have been even larger. Jennifer
I strongly suggest you are following the diet. I had borderline blood sugar levels, not really gestational diabetes, but started a diet immediately. The risks for the baby are too high, not to forget your own risk of getting diabetes when you are older. My blood sugar levels turned normal after just 2 weeks. I stayed cautious even though the doctor stopped the actual diet. ,
I am a Type I diabetic and my OBGYN had me go to the Sweet Success program in additon to seeing her. I am really glad I did. Although I did not have them deliver our daughter I went to their offices regualrly to get weighed, monitored and met with nutritionists. They take great care of all the patients (I did find that I was one of the few people with health insurance in the waiting room - many were state subsidized). But they watched you closely and it was good to be watched by a group who understood diabetes. Although it was extra work to go to 2 OBs during the pregancy having diabetes puts you in the high risk category and you definitely want the ultimate care for you and your baby. We had a very healthy baby girl and I was in great control. Good luck. Type 1 diabetic mom

Cesarean vs induction w/gestational diabetes

June 2005

I have gestational diabetes, so I shouldn't go past my due date. I will start my 40th week next week. My doctor wants me to go in on Monday, he wants to induce me first, and if that fails, try for a C-section. Based on all I have read about being induced, I wonder if I shouldn't just go straight for the C-section? Any thoughts? Thanks! Nervous with GD

I too had gestational diabetes with my first child. I had a cesearian because she was also breach. I had a perfectly easy time with it and a fairly easy recovery. In fact, according to many of my friends who had vaginal deliveries my recovery was easier than theirs. So, I can only say that when it came time for me to choose with my second baby, I chose the cesearian right away. 2 time c-sectionee
Hi, I had gestational diabetes when pregnant with my first last year. I was scheduled to be induced but went into labor two days before. My labor ended being very painful, contractions really intense and close together but I totally was not dialating. So I got an epidural and potosin, which as you probably know is the basics of induction. So, because I was not progressing even after that I had a c-section and it turned out that the baby's umbilical cord was wrapped around her shoulders, therefore not descending. What I really regret is not being able to go through the actual birth process of pushing. I still wish I could go through it again and actually get to push. Without an epidural, being induced is really painful, they contractions are really intense but the pushing is shorter (as told to me by a friend of mine who was incduced once and not another). If you have the epidural there is no pain but the process can be longer and more exhausting. I think the main thing is are you willing to miss out
My close friend had a homebirth last year and she had gestational my only suggestion is to research ALL your options before making a decision. Your doctor might not be giving you the full range of options, as they think mostly in terms of worst-case scenarios, etc. It's totally possible to have a natural birth with gestational diabetes. Best of luck to you and your baby--you'll be fine! anon
I have type 1 diabetes. I was also encouraged to induce labor early or on my due date to avoid potential problems. I decided not to take my doctor's advice since I'd always wanted to experience ''natural'' childbirth. When I was 10 days overdue I decided to go ahead and get induced (much to my doctor's relief). I was admitted Friday evening to start the process. My daughter was born Monday morning when I agreed to have a C-section. Nothing went the way I wanted it to, but it all worked out in the end. (She was 9# 4oz.) I can't tell you what to do, but in retrospect it sure would have been easier in my case to just have a C- section. You could try accupuncture to induce labor - that works for some people. A lot depends on your control during pregnancy - if your blood sugars have been near normal most of the time - there are less risks. Good luck. Melanie
I would recommend trying induction first. Of course, it depends on how attached you are to experiencing vaginal birth. When you say you are concerned after reading negative things about induction, are you also considering the negative aspects of c- section? If you do go for induction, do not allow them to use the drug Cytotec (sp?) which is very dangerous; make them write in your chart that you do not want this drug. There are plenty of safer drugs to induce labor. Also, there are alternative therapies that can help with gestational diabetes such as Chinese medicine or homeopathy. Good luck in whatever decision you make. Best Wishes in your process
I was induced with gestational diabetes at 37 weeks (water broke but contractions never really started). You sound like you have heard horror stories about induction. It wasn't the most fun I've ever had in my life (contractions did come every 2 minutes for the whole 9 hours of labor, and were painful enough I got an epidural), and I was completely exhausted afterward, but on the plus side, 4-5 days later I felt absolutely great, and was taking long walks in the hills. Don't think you could do that with a C-section... Just a thought...
Hi, I was induced with my first child because of preeclampsia and everything went very well. The only negative thing about induction that I found was pitocin makes your contractions very strong and very close together so I would definitely go with pain medication! Of course, I don't have a ''normal'' labor to compare it too, but from everything that I've heard, pitocin can make it worse. I have nothing against a cesarean but do have a couple of friends who had to have one and they feel ''cheated'' out of a ''normal'' birth. I personally think any birth is normal as long as mother and baby are fine. With diabetes, your baby may be larger than average, but I say you should at least try an induction. Knowing your situation, your Dr will have everything prepared for a C-section if it looks like it has to go that way. Hope I helped! Amy
I also had gestational diabetes, well-controlled with diet alone. I was induced with pitocin at 41 weeks, and although the labor was very painful, I made it through and had a very healthy baby. All women and all labors are different, of course, but I wouldn't have done it any differently. Good luck! Been there!
Do you have any idea how much the baby weighs? My ob did a sonogram at 36 weeks to determine the size of the baby. I was told she already weighed over 8 lbs. It was estimated she would be over 10 lbs by 40 weeks so my doctor recommended that I have a cesarean. Many women deliver large babies safely, however, my ob told me that when the mother has gestational diabetes, the babies shoulders tend to be wider than usual, and that the babies tend to have more respitory problems. Therefore, there is an added risk to the baby during a vaginal delivery when the mother has gestational diabetes. I had taken the Bradley course (12 weeks of classes to prepare for a vaginal delivery), and was disappointed that I would have to have a cesarean, but I did what I thought was in the best interest of the baby. As it turned out, we did not get good information from the sonogram, at 39 weeks, my daughter was born weighing 7 lbs 10 oz. I was not upset with my ob, she made her recommendation based on looking at all the circumstances (this was my last chance to have a child, age/fertility issues). But if I had to do it over, I would still want to do a vaginal birth vs. cesarean. anon
I never saw your actual question, so I hope this helps. With my first pregnancy, I was huge (probably had gest. diabetes that wasn't detected.) After epidural and pitocin failed, I ended up with a c-section, only to then find out that the baby was breached. Needless to say, I switched doctors. My recovery after the c-section wasn't too bad physically, but emotionally, it really affected me. There's a lot I couldn't do after the c-section, and because of pain, I felt confined to home. When I became pregnant the second time, I had gest. diabetes, and was administering insulin once a day, and on a very strict diet and exercise routine. I really wanted to experience vaginal birth, and I insisted with my doctor, who was fantastic, and completely respected my decision. One day before my due date, I started leaking amniotic fluid, and any doctor would have at that point suggested a c-section. Since my doctor knew that this was my last option, she suggested I spend the night at the hospital, and administered a very very low dose of pitocin in the morning. That was enough to put me in labor, and shortly thereafter, I got an epidural shot. The baby was born that evening, after hours of pushing. She was 9.5 pounds, and completely healthy. I didn't have any problems, and recovered right away. I was up and about the second day, and couldn't believe what a difference a vaginal birth made. It felt amazing, and I felt in complete control of my body. After the c-section it had taken me at least 6 weeks to recover. Whatever decision you make will be the right one for you, but I suggest that you don't let your O.B. scare you or talk you into a c-section. Also, no matter what others say about how easy it is to recover from a c-section, just keep in mind that it is major surgery. The last thing is that you can be induced with the lowest dosage of pitocin possible, and take it from there. After just a little dialation, you can get epidural. I hope this helps. Good Luck! VBAC with gestational diabetes