Labour and birth with type 1 or 2 diabetes

Planning the birth

Although many women with type 1 or 2 diabetes have a healthy birth, there are some risks associated with giving birth if you have diabetes.

You will be advised to give birth early to reduce the risk of stillbirth. This will usually be during week 37 or week 38 of your pregnancy. You may be advised to have your baby earlier than this if you have complications, such as high blood pressure or if your baby’s growth has slowed down.  

If your ultrasound scans have shown that your baby is large, you may be advised to have an induction (bringing labour on earlier) or planned caesarean section. You may still be able to give birth vaginally if you want to, even if you’ve had a caesarean section before.

Your healthcare team should explain your options for giving birth before you make your birth plan. It’s important that you understand the advantages and disadvantages of every option, so you can make an informed decision about what you want. Don’t be afraid to ask questions.

Where to have your baby

Ultimately, where you give birth is your decision. However, your team will advise you to give birth in a hospital, because it has all the facilities needed to look after you and your baby during and after labour.

Pain relief

If you have other issues affecting your health, 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 best method of pain relief during the birth.

If your labour starts before 37 weeks

If you go into labour early, you may also be given steroids to help your baby’s lungs develop. If you’re on insulin, steroids may affect your glucose levels and you may need to increase your insulin dose. Your healthcare team will talk to you about this if your labour starts early.

Be flexible

Like all pregnancies, sometimes things don’t go according to plan during pregnancy or labour. You will need to be flexible and adaptable as labour progresses. Your maternity team should involve you (or your birth partner if necessary) in any decisions that need to be made to make sure your baby is delivered safely.

"I'd tried my best to avoid a c-section but I ended up having an emergency c-section – and it had nothing to do with the diabetes. I was sad, but mostly I was just glad that she was healthy."
Maria

Your glucose levels during labour and birth

It’s good to keep your glucose level as stable as possible during labour. It is thought that this will help to prevent your baby’s glucose from going low after they are born. This is known as neonatal hypoglycaemia. Your glucose level will be measured regularly throughout labour.

If your glucose levels are not kept stable, you may be given insulin and glucose through a drip to help. If you have type 1 diabetes, you may be offered an insulin and glucose drip from the start of established labour. Established labour is when your cervix opens (dilates) to at least 4cm and your contractions become stronger and more regular.

If you are using pump therapy, you should be able to use your pump during labour if you want to. You or perhaps your partner may find it easier to manage your glucose levels using your pump, rather than switching to an insulin drip.

"I was told that I’d be taken off the pump when I was ready for the healthcare team to take over. But I stayed in control of it until about an hour before I gave birth, and I went back on it an hour or two after the birth."
Zoe

After the birth

You should be able to hold your baby immediately after they are born. They will be able to stay with you unless they need extra care. Find out more about your baby after giving birth with type 1 or 2 diabetes.

You will be encouraged to feed your baby as soon as you can (within 30 minutes) to help keep your baby’s glucose levels stable. It’s important to monitor your glucose levels regularly when you’re breastfeeding. If your glucose levels are too low, you could have a hypoglycaemic episode while you’re feeding.

Find out more about feeding your baby after birth with type 1 or 2 diabetes.

Your care after the birth

The most important thing is to avoid low glucose levels after your baby is born.

If you used insulin during your pregnancy, you should expect to dramatically reduce or even stop the amount you are taking straight after the birth. Often you won’t need insulin with your first light meal.

You should also check your glucose levels regularly until you are comfortable that you are taking the right dose. This is because your body needs less insulin to manage your glucose levels after your baby is born. Your care team will help you with this.

If you have type 2 diabetes and started insulin during your pregnancy, you may be able to return to the treatment that you were on before getting pregnant. If you decide to breastfeed, your healthcare team will talk to you about which options are safe.  

Find out more about your care after the birth.

If you’re breastfeeding

It’s important to monitor your glucose levels regularly when you’re breastfeeding. If your glucose levels are too low, you could have a hypoglycaemic episode while you’re feeding.

Read more about feeding your baby with type 1 and type 2 diabetes.