What is the average week of delivery for women with gestational diabetes?
When you’re pregnant, it can sure feel like you have to take a lot of tests. Of course, there’s the initial test that tells you that you’re going to be a parent, and then there are the blood tests to make sure everything is progressing well in your pregnancy.
And, at around 24-28 weeks, you will have your blood glucose levels tested so that your doctor can determine if you are at risk of gestational diabetes. This simple oral glucose tolerance test involves having blood drawn after fasting (usually first thing in the morning) then drinking a very sugary drink and taking a second blood sample one hour later.
The reason early screening for gestational diabetes is important it can cause health complications for both the mother and her unborn baby if undiagnosed and untreated.
If you’re wondering what the average week of delivery with gestational diabetes is, then keep on reading.
What is gestational diabetes?
Gestational diabetes mellitus is, as you may have already gathered, a type of diabetes that occurs in pregnancy. It is characterised by high blood sugar levels and can affect any pregnant woman with its onset usually occurring in the second half of pregnancy.
During pregnancy, the body undergoes changes in hormone levels, and some of these hormones can interfere with the action of insulin, a hormone that regulates blood sugar.
In gestational diabetes, the body either cannot produce enough insulin to meet the increased needs during pregnancy, or the insulin that is produced does not work effectively. As a result, blood sugar levels rise.
While women with gestational diabetes mellitus can still have a healthy child, it’s really important to manage the condition so that it does not cause any pregnancy complications.
Having gestational diabetes during pregnancy can also pose a higher risk to your child of developing type 2 diabetes later in life.
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Who is at risk of developing gestational diabetes?
Anyone can develop gestational diabetes however, there are certain factors that can increase the likelihood of being diagnosed with the condition.
For example, if you’ve had gestational diabetes in a previous pregnancy you may be more likely to experience it again although it is not guaranteed. Other risks include:
Smoking
Smoking in pre-pregnancy has been shown to elevate the risk of being diagnosed with gestational diabetes.
It is recommended to quit smoking at least a year out from trying to conceive.
Polycystic ovary syndrome (PCOS)
Women with PCOS may be more likely to experience gestational diabetes mellitus because they often experience insulin resistance and may also be more likely to be prone to weight gain or even obesity.
As PCOS is characterised by hormonal imbalances such as elevated levels of androgens, it could contribute to insulin resistance.
If you have a history of PCOS and are pregnant or planning to become pregnant make sure to talk to your doctor so they can keep an eye on your blood sugar levels more closely if needed.
Age
Women over the age of 35 have been shown to have a higher risk of gestational diabetes, but even women over the age of 25 can meet the diagnostic criteria for the condition.
Family history
Perhaps unsurprisingly, if there is a family history of diabetes, particularly among close relatives like parents or siblings, the risk of gestational diabetes mellitus may be higher.
Previous large baby
If a woman has previously given birth to a baby weighing 9 pounds (4.1 kilograms) or more, there may be an increased risk of gestational diabetes.
Can I prevent gestational diabetes?
While it may not be possible to guarantee the prevention of gestational diabetes, there are steps you can take to reduce your risk and promote a healthy pregnancy.
Aim for a healthy pre-pregnancy weight, as being overweight or obese before pregnancy is a risk factor for gestational diabetes. If you are already pregnant, focus on gaining weight within the recommended range for your pre-pregnancy BMI (Body Mass Index).
Follow a well-balanced and nutritious diet that includes a variety of fruits, vegetables, whole grains, lean proteins, and healthy fats.
Practice stress-reducing techniques, such as deep breathing, meditation, or prenatal yoga. Adequate sleep is essential for overall health, so prioritise getting enough rest during pregnancy. It’s also really important to drink enough water.
If you smoke, consider quitting, as smoking is a risk factor for gestational diabetes and limit alcohol intake or avoid it altogether during pregnancy.
If you have risk factors for gestational diabetes, your doctor may recommend screening in early pregnancy. Be sure to attend all prenatal appointments and and go for the recommended test to check your blood glucose levels at around 24-28 weeks.
And, of course, engage in regular, moderate-intensity exercise, such as walking or swimming as this can help to improve insulin sensitivity and contribute to overall health during pregnancy. Always check with your doctor before starting any new exercise or modifying your workout routine when pregnant.
How gestational diabetes can impact pregnancy
Gestational diabetes can have various effects on pregnant women and their unborn babies. If not managed properly, it can lead to complications such as high blood pressure, preeclampsia, and an increased risk of caesarean delivery instead of vaginal delivery.
Babies born to mothers with gestational diabetes may be at a higher risk of excessive birth weight, low blood sugar levels (hypoglycemia) after birth, and, as we mentioned before, an increased risk of developing type 2 diabetes later in life.
So, let’s take a deeper look at some of the pregnancy complications gestational diabetes can cause.
1. Macrosomia
Macrosomia is a condition in which a baby is significantly larger than average for its gestational age. In the context of pregnancy, macrosomia is often defined as a birth weight that is above what’s considered the threshold for healthy weight, typically 4,000 grams (about 8 pounds, 13 ounces) or more. The condition is sometimes also referred to as large-for-gestational-age (LGA).
Macrosomia can be associated with maternal conditions such as gestational diabetes, where elevated blood sugar levels in the mother may lead to excessive fetal growth. However, not all cases of macrosomia are linked to gestational diabetes, and there can be other factors at play, including genetics.
Babies with macrosomia may be at higher risk of certain health complications during birth, including shoulder dystocia, where the baby’s head passes through the birth canal, but the shoulders become stuck. This situation can pose challenges for delivery and may increase the risk of injury to the baby and the mother.
2. High blood pressure
Gestational diabetes and high blood pressure (hypertension) are both common complications that can occur independently, but they share certain risk factors, and one condition may influence the development or exacerbation of the other.
Both gestational diabetes and hypertension share common risk factors, such as obesity, advanced maternal age, and a family history of these conditions. Women with gestational diabetes may also be at an increased risk of developing hypertension during pregnancy.
Insulin resistance, a key feature of gestational diabetes, can contribute to hypertension. Insulin resistance means that the body’s cells are less responsive to the effects of insulin, leading to higher levels of insulin in the bloodstream. Elevated insulin levels can contribute to the constriction of blood vessels and an increase in blood pressure.
3. Preeclampsia
Preeclampsia is a serious and potentially life-threatening pregnancy complication characterised by high blood pressure and damage to organs, most commonly the liver and kidneys.
It usually occurs after 20 weeks of pregnancy, typically in the third trimester, but it can also develop earlier or, rarely, after childbirth.
Women with gestational diabetes may have more of a risk of developing preeclampsia, and both conditions can coexist, complicating the pregnancy further.
4. Increased risk of cesarean delivery
Gestational diabetes mellitus can also result in maternal and infant health issues such as the need for a C-section.
This could be due to macrosomia (outlined above) which makes vaginal birth less of an option but also labour dystocia, which refers to slow or difficult labour. This can happen due to factors like poor uterine contractions or the baby not descending into the birth canal as expected.
In some cases, labour may not progress as expected, especially if there are challenges related to gestational diabetes, such as poor blood sugar control.
If the cervix doesn’t dilate or the baby doesn’t move down the birth canal, a C-section may be considered to avoid the likelihood of birth injury.
How do you manage gestational diabetes?
Managing gestational diabetes involves a multifaceted approach that includes continuous glucose monitoring, maintaining a healthy diet and possibly insulin injections. Let’s look at some of the ways to manage gestational diabetes in more detail.
Blood glucose monitoring
Pregnant women with gestational diabetes are often advised to monitor their blood sugar levels regularly.
This involves using a glucometer to measure blood sugar levels at specific times of the day, such as fasting in the morning and after meals.
Depending on your particular situation, you may be able to test your blood sugar at home using a blood sugar testing kit.
Healthy diet
Maintaining a healthy diet is always a good idea, even if you are not pregnant. However, it can be particularly advisable for women who have or who are at risk of developing gestational diabetes.
Controlling your carbohydrate intake is recommended as carbs can have a direct impact on your blood sugar level. Try to distribute your carbs over the course of the day (we know, cravings can make this really tough!).
Exercise and other physical activity
Engaging in regular, moderate-intensity physical activity is generally encouraged, as it helps improve insulin sensitivity and can contribute to better blood sugar control. However, it’s important to choose safe exercises suitable for pregnancy.
Another reason exercise is recommended is because it can help to maintain a healthy weight and an all-round healthy lifestyle.
While gestational weight gain does not cause gestational diabetes, it has been shown that there is a relationship between the two, gaining too much weight is typically considered one of the risk factors for developing gestational diabetes.
Insulin shots
If lifestyle changes alone are not enough to control blood glucose levels or are proving to be an inefficient form of gestational diabetes treatment, it may be your doctor’s advice to try insulin therapy.
Insulin shots help regulate blood sugar by assisting the body in utilising glucose effectively.
Closely monitored pregnancy
Women with gestational diabetes typically require more frequent prenatal check-ups to monitor the health of both the mother and the baby.
Birth planning
Having a plan for giving birth is a good idea, and your doctor will advise you on the optimal timing and method of delivery based on your health, your baby’s health, and other factors.
In some cases, labor induction or a scheduled cesarean section may be recommended.
As we mentioned above, gestational diabetes can make giving birth more complicated so it’s important to know your options and closely follow medical advice.
Close monitoring in the postnatal period
Blood sugar levels are usually tested via a blood test after delivery to ensure they return to the normal range.
However, women who have had gestational diabetes are at a higher risk of developing type 2 diabetes later in life and should undergo regular monitoring.
Average week of delivery if you have gestational diabetes
So you might be wondering if gestational diabetes can affect not only how you might give birth but when.
Are women who have gestational diabetes able to carry their babies to term? Are they more likely to have adverse pregnancy outcomes? Let’s take a look at some of the factors that play a role here.
Factors influencing the average week of delivery
The likelihood of carrying a baby to term (37-40 weeks) or having an early delivery will depend on whether you have well-controlled gestational diabetes or poorly-controlled diabetes.
Well-controlled gestational diabetes
If your gestational diabetes is considered well-controlled and you have no other known pregnancy or health complications then the guide for ideal delivery time is 39-40 weeks. So, in other words, in the usual time frame.
If your blood sugar levels are within the normal levels, you may be able to wait for labour to start naturally – so long as there are no other medical issues present. However, if you go longer than what is recommended by clinical guidelines, you may be induced or offered a c-section.
Poorly controlled gestational diabetes
In these situations, your doctor will need to look at all of the potential complications that could arise.
As a rule, it is preferred that babies, in this case, are born as close to 39 weeks in order to hopefully mitigate the chance of the baby needing to spend time in the neonatal unit as a result of respiratory distress syndrome or other medical problems.
Blood sugar during labour
If you have gestational diabetes, it will be important to closely monitor your blood sugar before, during and after labour.
During the birthing process, your doctor will monitor your blood sugar levels and potentially offer you an insulin drip. They will also track your baby’s heart rate closely throughout the labour to ensure they are not in any distress.
Does gestational diabetes affect breastfeeding?
The short answer is, no! Gestational diabetes mellitus does not affect a mother’s ability to breastfeed her child. In fact, breastfeeding is recommended in the 30 minutes after delivery (if possible) and every one to three hours after to stabilise their child’s blood sugar level.
If your doctor finds that your baby has low blood sugar, they may need to be fed through a tube for a short period of time.
The takeaway
Gestational diabetes mellitus can sometimes have more serious implications for a mother and/or her baby but most women should be able to still give birth at around the 39-40 week mark, as long as their condition is well managed.
Be sure to go in for your oral glucose tolerance test at the recommended time during your pregnancy so you can be informed early on if you have diabetes mellitus and can therefore take the necessary steps to try to manage it (such as closely monitoring your blood glucose levels, avoiding too much sugar and trying not to gain too much weight in pregnancy).
Your doctor will keep close track of your blood glucose levels throughout your pregnancy too so that they can determine if there are any factors that may contribute to your needing to give birth via a scheduled c-section or if you may need an induction if you go too far past the ideal due date.
During labour, your doctor will continue your blood glucose monitoring as well as your baby’s heart rate to ensure they are not experiencing respiratory distress syndrome.
While it can be scary to experience diabetes in pregnancy, with regular medical care and diligent monitoring of blood glucose levels as well as maintaining a healthy lifestyle, you can still have a healthy and happy pregnancy and a hopefully complication-free birth.
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