Diabetes During Pregnancy: Will I Need a C-Section?


If you have diabetes during pregnancy, you are more likely than other women to have a large baby. When a baby is too large, both the mother and baby are at increased risk for having problems during delivery. For example, there’s an increased chance that the baby’s shoulders could get stuck in the birth canal (called shoulder dystocia). This can deprive the baby of oxygen.

If your baby is very large as your due date nears, your doctor may suggest you have your delivery by cesarean section, or C-section. For a C-section, the doctor delivers the baby through an incision in your belly. For some large babies, this may be the safest (and sometimes the only) way to be born.

How will my doctor decide if I need a C-section?
Your doctor will estimate the size of your baby by measuring the height of your uterus. This measurement, combined with the number of weeks of pregnancy (gestational age), gives a sense of how large the baby is.

It can be hard to know a baby’s weight before it is born. The doctor may do ultrasounds in the last trimester to estimate how large your baby is getting. A planned C-section may be recommended if the doctor thinks the baby may weigh more than 4,000 g (8 lbs 13 oz.).

Instead of C-section, a doctor might decide to induce labor a week or two before the baby is full term (full term is 40 weeks). In this way, the baby may be born before it gets too large for a safe vaginal delivery. Amniocentesis may be done first to make sure the baby’s lungs are mature enough. If not, this can cause a whole different set of problems.

In another case, an emergency C-section may be needed if you go into labor and it is long and slow or the fetal monitor shows that your baby seems to be in distress.

What are the risks of C-section?
Having a C-section will help you avoid a problem, such as the baby’s shoulders getting stuck. But a C-section is major surgery. While it is generally safe, it does have some risks.

•The mother has an increased risk of infection, bleeding and other complications of surgery. It will also take longer to recover.
•The baby has an increased chance of having breathing problems at birth, although these problems do not usually last long.
How can I help keep my baby healthy?
Taking good care of yourself during pregnancy will give you and your baby the best chance to avoid problems during delivery and afterwards.

•Keep your blood sugar under control. Test your blood sugar as often as your doctor tells you, and take your insulin shots as directed.
•Manage your weight gain. Your doctor can tell you how much weight you should gain each week. After the first trimester, this is usually one-half to one pound a week. Gaining too much weight increases the chance that your baby will be too large for a vaginal delivery.
•Eat a healthy, balanced diet. As a pregnant woman with diabetes, you need to pay special attention to what you eat.Your doctor or a dietitian can help you learn how to make good food choices.
•Be physically active. Being active will help you control your blood sugar. Brisk walking or swimming is safe for many women. But talk to your doctor before you start any exercise program.

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