Is a C-Section necessary because of my preexisting diabetes?
C-Section or Vaginal Delivery?
Women who live with preexisiting Type 1, Type 2 or Gestational diabetes might think, or have been told, that they will have to have a Cesarean to deliver their babies. Is it true?
The goal of the majority of obstetricians is for women to deliver vaginally. While this is preferred by OBGYNs, there are many factors that can contribute to a woman having a c-section or vaginal delivery. Some of these factors can be diabetes related and others non diabetes related.
Generally in women with well controlled diabetes, the chances of a vaginal delivery or c-section are the same as any other women who do not live with preexisting conditions or whom complications in their pregnancy. In uncontrolled diabetes what is known as fetal-macrosomia can occur (meaning a baby who is expected to weigh more than 4500 gm). Depending on the mother's individual body type and or potential health risks to the baby, having a larger baby can make it more difficult or possibly even prevent the mother from delivering vaginally.
What might put me at higher risk for a C-Section?
Mothers with poorly controlled diabetes are at higher risk of shoulder dystocia during a vaginal delivery, an obstetric emergency. Higher glucose values increase the percentage of fat around the baby’s shoulders and abdomen. You should carefully monitor your glucose values and discuss with your provider your risk of shoulder dystocia.
Your medical team will monitor the size of the baby with ultrasound visits throughout your pregnancy. Approximately every 4 weeks starting anywhere from 28 or 32 weeks until around 36 weeks of gestation. If your medical team feels that it is necessary for more appointments, they should make a plan with you for how often you will be seen and monitored.
Truth.
“My doctor told me I have to have a C-Section because I live with Diabetes”. Unfortunately this is something that we T1D Sugar Mommas hear as a common statement from some of our Mommas individual medical providers. The answer to this is No. Type 1 Diabetes is not an absolute indication for a C-Section. As mentioned above, most doctors today encourage a vaginal delivery. Many women who have been living with diabetes for a long time or who are more recently diagnosed, if well controlled, can have a vaginal delivery like many other women who do not live with pre-existing conditions or complications. Please consult with your own doctor to determine what will be the right path for you. And most importantly, never be afraid to ask questions of your medical team.
