Gestational Diabetes And The Average Week of Delivery

Diabetes occurs when you have too much glucose in your blood. Your body generates insulin, a hormone that regulates your blood glucose levels. Your body typically produces more insulin during pregnancy to keep blood sugar levels within a normal range. 

However, in some pregnant women, the body cannot create enough insulin, resulting in high blood sugar levels. In addition, the placenta emits certain chemicals that prevent insulin from acting as it should, making it tricky to regulate blood sugar levels.

This is called gestational diabetes (GDM), and it affects 2–10%¹ of pregnancies annually in the US. 

GDM develops during pregnancy in women who have not previously been diagnosed with diabetes. It is typical for gestational diabetes to affect more than one pregnancy.

Since gestational diabetes typically happens in the middle of pregnancy, doctors usually check for it between 24 and 25 weeks. While most mothers with gestational diabetes deliver their babies without issues, GDM increases the risk of complications for mother and child. 

How gestational diabetes can impact your pregnancy

There is a greater chance that you and your unborn child will experience complications if you have gestational diabetes and your blood sugar is not under control.

C-section (Cesarean section)

A C-section is a surgical alternative to vaginal birth when a woman has difficulty giving birth naturally. For women with uncontrolled diabetes, a C-section is one of the delivery options available. In most cases, C-sections have a longer recovery time.

Reduced blood sugar

People with diabetes may experience low blood sugar, a condition often known as hypoglycemia. Low blood sugar levels can cause severe and even fatal complications. Therefore, you should carefully monitor your blood sugar levels if you have gestational diabetes. 

Macrosomia

Macrosomia is when a newborn is heavier than 8lbs 13oz. This can be because uncontrolled diabetes raises the infant's blood sugar levels and causes insulin resistance. Macrosomia can result in the pregnant woman's discomfort and problems during delivery for both the mother and child. As a result, the only delivery option is a C-section.

High blood pressure

Significant high blood pressure after 20 weeks of pregnancy can result in preeclampsia. Preeclampsia can significantly harm the mother and unborn child. Other symptoms associated with preeclampsia are headaches, abdominal pain, and protein in the urine.

Untreated preeclampsia can cause seizures or a stroke during labor and birth. Your doctor should monitor your blood pressure consistently throughout your pregnancy. 

Shoulder dystocia

This birth injury occurs when one or both of the baby's shoulders get trapped behind the mother's pubic bone during delivery. Although babies are delivered safely in most cases, there is a risk of injury. They may sustain arm and collarbone fractures and nerve damage.

Postpartum depression

Pregnant women with gestational diabetes may develop this form of depression during the first year after birth. You may lose interest in the things you enjoy or experience feelings of sadness that interfere with your daily life. It can also make it harder to bond with your baby.

Other possible health complications for your baby after birth

Gestational diabetes can cause health complications for your newborn later in life, including:

• Developing diabetes

• Obesity

• Issues with breathing, including respiratory distress syndrome

• A high number of red blood cells (polycythemia)

• The heart muscle between the central chambers becomes thicker

• Increased bilirubin level (newborn jaundice)

Health professionals advise expectant mothers to give birth at a hospital. These well-equipped facilities have the tools to manage conditions like gestational diabetes and ensure successful delivery. 

The likelihood of a stillbirth or miscarriage increases if diabetes is not under reasonable control. If you have uncontrolled diabetes, your newborn has an increased risk of congenital abnormalities.

The risk factors linked to gestational diabetes mellitus

Any woman can develop gestational diabetes during pregnancy. Risk factors increase the chances of developing the condition, including:

• Previous history of gestational diabetes

• Being obese or overweight

• Smoking pre-pregnancy

• Rapidly growing fetus size or previous macrosomia

• Having a family background of diabetes

• Age, especially women older than 35 years

• Preeclampsia means high blood pressure during the present pregnancy

• History of recurrent miscarriages

• Fetal or neonatal death

• Polycystic ovarian syndrome

A sedentary lifestyle may also increase your risk of gestational diabetes. Increased urine glucose is not considered a solid sign of gestational diabetes.

The average week of delivery if you have gestational diabetes

The American College of Obstetricians and Gynecologists (ACOG) has guidelines for when you should give birth:

If you have well-controlled gestational diabetes and no other complications, the ideal delivery time is 39–40 weeks, no later than your due date. 

For poorly controlled diabetes, your doctor will consider potential complications. In general, the ideal delivery is as close to 39 weeks as possible. This is because babies born before 39 weeks have more neonatal special care unit admissions for breathing and other medical issues. 

You may be able to wait for a naturally occurring labor if your blood sugar levels are normal and there are no issues for you or your unborn child. But if it takes longer than the ideal time, you will be offered a labor induction or a cesarean section.

Your blood sugar level during labor

You must continuously monitor your blood sugar until you’re in labor. Bring your blood sugar testing kit and any prescribed medications to the hospital. They are crucial for your doctor to understand your condition and decide how and when you should give birth.

Your healthcare practitioner will monitor your blood sugar levels throughout labor and delivery. They may give you insulin through a drip to regulate your blood sugar levels if necessary.

If you are too worn out or your baby is in distress, your doctor may suggest an assisted birth. In this case, the doctor will use specialized equipment to deliver the baby during the final stage of labor. They will also track your infant's heart rate regularly throughout labor.

What to expect after giving birth

Gestational diabetes doesn’t prevent you from nursing your infant. Breastfeeding is the ideal strategy to give your baby the best chance at leading a healthy life. You can protect your baby from common illnesses like asthma and heart issues by breastfeeding.

So, after giving birth, enjoy holding and feeding your child. Medical professionals typically advise breastfeeding your infant half an hour after delivery and every two to three hours to stabilize their blood sugar levels.

In the initial hours after birth, doctors will check your baby's blood sugar levels regularly. If your baby has low blood sugar, they might need to feed them briefly through a tube. A neonatal unit may care for your newborn if they were premature or need treatment or eating assistance.

Your doctor will advise you to stop taking any blood sugar-controlling medications, as gestational diabetes usually resolves after delivery. Your medical team will thoroughly test your blood sugar levels to make sure they are within the usual range before you are allowed to return home.

Get your diabetes checked six to eight weeks after giving birth. Around half of women who develop gestational diabetes during pregnancy develop type 2 diabetes. You should get tested for diabetes annually, even when your results show normal blood sugar levels.

How to plan for future pregnancies

Whether you've had gestational diabetes or not, check your blood sugar if you plan to become pregnant. Gestational diabetes is likely to reoccur during subsequent pregnancies, so it’s good to deal with risk factors before getting pregnant. 

Get transferred to a diabetes pre-conception clinic if the results show high blood sugar levels. They will assist you in controlling your condition before becoming pregnant. Speak to your healthcare provider about your previous GDM experience if you have an unplanned pregnancy. 

If the result indicates normal blood sugar levels, you should still get screened earlier in your pregnancy and have a second test at 24–28 weeks if the first one is normal. Your doctor might let you use a finger-pricking tool to regularly test your blood sugar levels.

Leading a healthy lifestyle for your upcoming pregnancy can improve your fertility, lower your chance of pregnancy complications, and safeguard the long-term health of your unborn child.

How to treat gestational diabetes

Generally, gestational diabetes treatment involves managing blood sugar levels, diet, and physical activity. Your medical provider may recommend specific medications and insulin injections safe to use while pregnant.

You can manage gestational diabetes by:

Monitoring your weight

Managing blood sugar levels during pregnancy can be difficult if you are overweight. Ask your doctor about the optimum weight to gain throughout pregnancy.

Checking your blood sugar frequently

Your doctor will show you how to monitor your blood sugar level. They should also inform you of normal levels and how frequently to check. Always retain a record to show your provider.

Taking your prescription properly

Ensure you understand how to administer insulin shots or other diabetic medication. You should disclose any medicine you take for diabetes or other medical conditions. Pregnancy necessitates frequent medication reviews and medical treatment in the short term. Always keep your doctor informed of your condition.

Closely monitoring your unborn baby

Your doctor will assist you in checking fetal movements, which focuses on monitoring how regularly you feel your baby move. Your healthcare professional will explain the value of a diabetes test and how to manage the condition during pregnancy.

Maintaining a healthy diet

Your provider will outline the right foods to control your blood sugar.

Keeping active

You can manage gestational diabetes during pregnancy with five half-an-hour sessions of moderate-intensity exercise per week. Ask your doctor which activities are most suitable.

Attending after-delivery checkups

After birth and again six to twelve weeks later, your doctor should check your blood sugar level to be sure it has returned to the normal range.

All these steps help you manage gestational diabetes. The best approach is to attend your prenatal care appointments and adhere to your doctor's recommended course of action.

The lowdown

Gestational diabetes (GDM) is when your body cannot produce enough insulin during pregnancy, causing excessive blood sugar levels. Your blood sugar levels should return to normal after delivery. GDM is associated with an increased risk of complications and long-term medical conditions for both mother and child. 

Talk to your doctor if you are concerned about your birth. To be best prepared for the delivery day, continue discussing your birth plan with your obstetric team and loved ones.