Planning the birth
If your ultrasound scans have shown that your baby is large, you may be advised to have an early induction (starting labour artificially) or planned caesarean section. Even if you’ve had a caesarean section before, you may still be able to give birth vaginally if you want to.
Your team may advise you to give birth in a hospital. This is because it has all the facilities needed to look after you and your baby during and after labour.
If you have any other health problems, such as being overweight or any spinal nerve‑related problems, you may be advised to see an anaesthetist. They can talk to you about the different methods of pain relief suitable for you during the birth.
When to have your baby
If your pregnancy goes on for too long, it may increase the risk of problems for you and your baby.
If you live in England and Wales, you will be advised to have your baby before 41 weeks. If you don’t go into labour naturally by then, you will be offered an induction or advised to have a planned caesarean section. You may be advised to have your baby earlier than this if you have complications, such as high glucose levels, high blood pressure or a big or small baby.
In Scotland, most women with diabetes in pregnancy are advised to have labour induced within 40 weeks.
If your labour starts before 37 weeks
If you go into labour early, you may also be given medication to help your baby’s lungs develop.
If you’re on insulin and have steroids, your insulin dose will be increased and your glucose levels will be closely monitored. This is because steroids can raise your blood glucose.
Monitoring during labour
It’s important that your glucose levels stay in the target range during labour. This will prevent your baby’s glucose getting low in the first few hours after they’re born. This is known as transient neonatal hypoglycaemia.
When you are in active labour, your blood glucose should be measured every hour to make sure it stays at a safe level. You may be given insulin and glucose through a drip to help with this.
This is more likely to happen if you are already giving yourself insulin injections. If you managed your glucose levels through diet alone, you may need very little additional monitoring during labour.
If you are exhausted, if your baby is distressed, or if they are not moving out of the birth canal, you may need an assisted birth. This is when the doctor uses special instruments to help deliver the baby during the last stage of labour.
During labour, your baby’s heart rate should also be continuously monitored.
What happens after my baby is born?
Your baby’s health
Your baby will stay with you unless they need extra care.
There is no reason why you can’t breastfeed your baby if you have gestational diabetes. In fact, it can help protect their future health. If you’ve had gestational diabetes your baby may be at greater risk of developing obesity and or diabetes in later life. But breastfeeding can reduce these risks, as well as protect your baby against the risk of infections, asthma and heart disease.
However you choose to feed your baby, you should start feeding them as soon as possible after birth (within half an hour) and then every 2-3 hours. This will help your baby’s glucose stay at a safe level.
A few hours after the birth, your healthcare team will test your baby’s glucose level by pricking their heel to get a drop of blood. Your baby will not enjoy this but it should be very quick, so try not to let it upset you. The test is done to keep your baby safe.
Your baby may need to be looked after in a neonatal unit if they:
- are unwell
- need close monitoring or treatment
- need help with feeding
- were born prematurely.
Find out more about feeding your baby after birth.
"I was an emotional wreck afterwards for a whole week, crying all the time. I didn't like seeing my baby with tubes in him and he had jaundice as well so we weren't allowed to go home. But now, he's fabulous; constantly crawling around, he's a really busy baby!"
You’ll probably be advised to stop taking any diabetes medication straight away after your baby is born. This is because gestational diabetes usually settles after birth.
Your glucose levels should be tested to make sure they have gone back to normal before you go home. You should also have a diabetes test about 6-8 weeks after your baby is born. This is important, because some women will still have diabetes after pregnancy.
Women who have had gestational diabetes have a higher risk of developing type 2 diabetes. This means you will be advised to have a test once a year, which you can arrange at your GP's surgery.
Find out more about the long-term implications of gestational diabetes.
If you become pregnant again
If you’ve had gestational diabetes before, you are at risk of getting it again in your next pregnancy. If you’re planning to get pregnant again, trying to live a healthy lifestyle now will:
- improve your fertility
- protect your baby’s future health
- reduce your risk of problems in pregnancy.
Find out more about getting pregnant if you’ve had gestational diabetes before.
What does all this mean for you?
If your birth experience is different to what you had hoped for, this can be difficult to come to terms with. It is important to remember that labour and birth often does not go to plan, whether it is complicated by gestational diabetes or not. For many women, knowing more about induction and caesarean births helps them feel mentally prepared for what may happen.
"I'd seen a lot of my friends have children, so I had an idea that labour can change dramatically in minutes. I knew that the ideal wasn't always possible. I think that helped a bit."
If you do feel very emotional about any aspect your birth – even if it’s much later – it can help to talk about it. You can speak to friends or family, your midwife, health visitor or GP.
You can also speak to our midwives on our pregnancy line on 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].