• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Statistics behind the hospital induction policies

Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Smit, you should have married a dwarf! I have also been 'helpfully' told by my sister-in-law that all the babies in my husbands family have been 8lb's and upwards ('a healthy size' she said - OUCH!) If mine is similar to his or her cousins does that mean I have to be whisked in and induced?!

More seriously, I am keeping an open mind and am also aware that things can change but asking and enquiring is never a bad thing in my view, so I'll be back asap with the answers! J
 
The 38 week induction isn't a figure pulled out of a hat, it is based on sound data collected which is an on-going procedure of periodically reviewing data collect with every new delivery.

Data and pure experience means that they know around this 38 week mark is the best time to deliver a diabetic baby for best chances of survival both inside and outside the womb..

Each mum will be treated as an individual, as they get nearer to the 38 week mark monitoring increases so that the consultant can look at mum's results, bp etc, check scan's and the presentation of the baby to decided the best time for delivery.

I wasn't diabetic when I had my oldest and she decided to arrive at just under 37 weeks. So I actually 'cooked' a little bit longer being induced both between 38-39 weeks....
 
I was going to be induced at 39 weeks as all was going well, but I had bad swelling of my legs, hands so was induced at 38.2 weeks. They dont do growth scans in my region so we had no idea that Nathan was large, 9lb 11oz. I was induced, pushed for a while, had forceps and then a section as Nathan was just not moving down the birth canal. I managed to breast feed him despite a difficult start as it took a while for my milk to come in some was topped up on formula to begin with.
I am with Twitchy on this one, I would rather have an earlier healthy baby than risk problems by hanging on another few days. A good friend of mine (not diabetic) recently had a very difficult labour with a big baby who is now permanently brain damaged. I don't mean to scaremonger but if there is a next time I will be insisting on baby coming out at 38 weeks.
 
Ellie, I am perfectly aware that they have not pulled 38 weeks out of a hat. And as I have, despite my blood results, been told I have to see a dietician 'to learn about healthy eating' a nurse 'to make sure I am testing my blood glucose' amongst other examples I can safely say that, actually, I don't feel as if I have been treated like anything other than 'a diabetic patient.'

Rachel, another thought provoking viewpoint from the 'other side', as it were. Am quite shocked they don't do growth scans in your region, I thought it would be standard practice everywhere. I was told today that while these can indeed be inaccurate, this can also mean a pound over and not just a pound under which was a very good point.

I saw the midwife this morning. It was a really good appointment. I mentioned my concerns re induction and asked what she thought. In short, she said it is often done for very good reason but my hospital does tend to book diabetics in for 38 weeks regardless. She was more than happy, growth scans and everything else allowing of course, to back me with going to 39 weeks as she says the chances of the induction being sucessful are far higher then. Also, looking at my scans and bloods so far, she said it all looks good so far but obviously it is still very early days.

I did stress to her that I was not going to simply refuse things willy nilly, but I did think it was important to be able to weigh up the pros and cons effectively. She agreed with this and said that this is really the best approach to avoid 'being processed as a diabetic and not a mummy to be.'

Have the diabetic ante natal this afternoon, and this includes an obs apt. Will see what they say and report back.
 
Bit late to this, but I don't think its a bad tihng that you're questioning the pollicies - I'm all for being as aware of possible of what decisions are being made and why!

I did opt for induction at 38weeks, so slightly biased I suppose. It wasn't a bad experience (I know that sounds odd considering the next bit!), 20hrs overall including dilating to 10cm, pushing for 2hrs and going to theatre for an emcs. But, for a first labour, I don't think that's a bad length!

One thing you might need to consider is what you would want in terms of extra monitoring if you decide to go past 38 weeks - would you request 2 or 3 times weekly scanning to check placental health/fluid levels? Would your hospital automatically offer that?

It's all really interesting - let us know how things progress, because I'm certainly keen to hear.
 
Just to reiterate that tight control does not necessarily mean you will have a small baby - I had very tight control with my first pregnancy (HbA1c 5.3%) and similar control with my second (5.7% I think) and both my babies were 8lb 3oz at birth and both born at 38 weeks, the first naturally and second induced (ending in emergency c-section).

I was told both times that I would be induced early because of baby's size and because of the placenta problems and didn't really question it tbh. With the first pregnancy I had pre-eclampsia so am thankful I went into labour naturally early anyway and the labour was quick and relatively easy. However, if I had my time over I probably wouldn't have chosen to be induced with my second pregnancy as the induction went wrong from the start and my little girl was very distressed and it ended with her being born with me under general anaesthetic as they had to save her life. I do feel that this was partly because she was being induced when she wasn't ready to be born yet.

Good on you for questioning what you have been told, I am interested to know how things work out for you.
 
Hello!

Sorry i am also coming to this conversation very late. I think you should definitely question why an induction is necessary as nothing should be prescribed blanket fashion.

My experience was that I was induced at 38w and 4 days. To be honest I didn't question this but by 38 weeks I was soooo uncomfortable I was glad to be giving birth. I was told that any baby born after 38 weeks is not classed as premature and i was also told that the feeding issue you mentioned should generally not be an issue if the baby is not premature - I have no idea if this is correct. However Callum didn't have any problems feeding.

Anyway, I tried naturally but my cervix would not dilate despite 3 attempts (induction was not a nice experience). After a day and a half of contractions and no dilation, I agreed with the doctors to give up on the natural approach and had the c-section the next day which had always been booked "just in case".

My experience of the c-section was that it was fairly uncomfortable for the first week but I was never in any real pain. The worst part was not being able to do much baby wise once the baby was here and also not being able to drive for 6 weeks.

From my experience, a c-section really wasnt too bad but I know that experiences vary greatly. What I'm trying to say is that don't be too scared of a c-section if it is required. I'm glad I tried naturally but didn't feel a failure because that didn't work as ultimately Callum arrived safely.

As others have said I would be really interested to hear what your doctors say and if you feel strongly enough, you should push for what you want.

H x
 
Hi everyone,
Right - I am about to have some very late dinner (I had to sleep for two hours when I got in from the hospital so am now running very late) but will quickly fill you all in.

The obs appt was initially supposed to be quite brief, the focus was more on the diabetic doc (just going through the motions to be honest now I am pretty clued up with the pump and can alter things myself) but I asked things all the same, and it turned into a bit of a marathon!

In short, the first obs (sorry for not writing the full word - I can never spell it!) said they induce at 38 weeks at the absolute latest 'as that is policy.' When I started to ask about the why's and wherefore's he didn't really have much other info other than 'its best for you and the baby.' But why? I kept asking so he eventually got someone else. The second bloke said they do it as a matter of course mainly due to size. I asked what would happen if size was not an issue and he said its never really come up before and 'most diabetics come in at 38 weeks if they have not before.
I explained that I was not planning on refusing anything as such, but I did want to know how relevant what I was being told was to me. I also explained that I didn't want to go through an induction with all the possible connotations if there was not a solid reason behind but it was in fact just 'what they did'. I also explained that I realised that size can go up regardless of control but also pointed out that, at 25 weeks and with my bloods the way they are at the moment, we had no sign that this was definitely on the cards and wouldn't we be better playing it by ear?

So, in short, this is currently the plan. I was told also that the vast majority of diabetic patients they have (mainly Type 2's and Gestational Diabetics) have quite poor control and they are fortunate, and it is very unusual, to have someone in with an HBA1C of 7% as it is often in the 8's or 9's (I then felt quite smug when I saw him look in my notes for my HBA1C record!) Due to this they want to get the babies out asap to avoid further problems and this is why they say they 'only let you go to 38 weeks.'

As my circumstances a different to 'the masses' (sorry to sound arrogant but think many of you are prob in the same boat sometimes, I think us Type 1's often are) we can see how things develop but 'if things progress ideally' it will be 40 weeks instead, which also stands a far higher chance of the induction being effective (and may also mean I stand a chance of going into labour myself, although I realise this chance is still slim!)

Lastly, the midwife I spoke to earlier today mentioned water as pain relief. I didn't think this was an option due to induction / monitoring etc and she said that it may well be, at least for part of the time. (The main thing she was concerned about was how waterproof the pump was.) She also was keen to emphasise that just as I am diabetic doesn't mean I have no other option but to go down the massively medical route - there was room for compromise.
 
Last edited:
That sounds positive, babysaurus. FWIW, I really felt my labour was as unmedicalised as possible, given the circumstances - yes, I was induced, and yes, I had syntocinon, but didn't have an epidural with it (which I know lots of hospitals will urge you to do) and had a fab mw who was as hands off as possible. It's all about you knowing what things you are able to control, and accepting that there are some things that aren't going to be 'normal', however much you'd like them to.

Jus to pick up on something you said earlier about suck reflex - I think there's very little difference in the development of the sucking reflex in babies born at 38 and 40 weeks. Certainly before 37 weeks (the point where you're considered premature) there can be some underdevelopment, but generally by 38 and beyond there's much less cause for concern.

And control - my hba1c was in the low 6s for the majority of pregnancy (I think a 7 towards the start) and C was born at 38+2, weighing 10lb 11oz. My diabetes consultant was absolutely astonished - I'd measured big, but no-one predicted that!
 
Good for you for questioning! I have to admit that I would do exactly the same, and the way that diabetic births seem to be so medical just puts me off of getting pregnant even though I want kids.
 
Good on you for sticking to your guns and getting answers, very interesting. Great to know try are listening to what you would like to happen. Keep us updated on how it all goes.
 
My consultant was actually against early induction saying she would monitor me very closely and play it by ear. I ended up being induced at 36 weeks anyway due to a failing placenta even though my hba1c hadn't gone above 6.2% for the whole pregnancy. He was also born 7lbs9, which i was upset about at the scans as I was under the impression that my sugars being so well controlled would've stopped this. (Big for a 4 week perm baby)
 
I just wanted to check in and see how you got on with your appointment....good on you for sticking to your guns.

At my hospital my ob was the only one that dealt with diabetes - be in type 1, type 2 or gestational - and I always felt that she put us all in the same boat without a lot of knowledge of how hard it is to keep it under control - she would circle the odd double figure and treat you like a school girl. She had the bedside manner of a wasp and I suspect she used to get really frustrated with women not caring about the effects of bad control so always seemed surprised when my husband or I would ask a reasonable question - a lot of which you covered in your appointment. There were times that we watched women come out in tears from their appointment from where she had obviously given them a b*ll*cking about their control.

Having said that, I wouldn't have changed her for the world. When I said that something wasn't right at 38 weeks, I was induced the following day. I'm just grateful that I read Twitchy's post about her placenta failing because the hospital staff (diabetic or general pregnancy) never mentioned the signs. From that point on I always wanted to be one step ahead in the knowledge of what could go wrong and then I could ask the right questions without being fobbed off - something I suspect happens to a lot of people. I get the impression that you are not easily fobbed off!!!

Also, as a lot of people have said, your perfect readings don't always produce a smaller baby. My HBA1C never went above 6.9% during pregnancy (that was the highest reading at the end) and E was born at 9lb5oz. The DSN told me afterwards that it helps but a lot has to do with the way food is stored and used by the baby so there is nothing you can do about it! My description isn't all that accurate - I'll try and remember word for word what she said. :confused:

I look forward to reading how your pregnancy progresses. I hope it runs as smoothly as it has been.

If it helps, I'm 5 weeks now and have been told that it is policy in NZ to induce no later than 38 weeks so i will be having the same conversations with this ob as I did in Essex last year! :D
 
Keyboard is behaving again! I had wiped it so some of the keys didn't work.

Becky, I am wondering if the obs tend to get irritated and frustrated as so many, according to my DSN, women (esp of the Type 2 and GD kind) don't take a lot of notice but are always more than ready to lay the blame on the HCP's if something goes wrong? I was told that the majority in the ante-natal I go to are Type 2's and GD's and they seem to be a lot more blase about control etc. I guess as Type 1's have a very different outlook (or can do anyway.)

9lb 5oz sounds eye wateringly big, but not ridiculously so for these days. It does make you wonder how big they'd be if you weren't diabetic. I didn't realise that it was to do with how the food was stored too, but that may explain why some of us with good HBA1C's have had larger babies. Bugger!
 
Babysaurus said:
Keyboard is behaving again! I had wiped it so some of the keys didn't work.

Becky, I am wondering if the obs tend to get irritated and frustrated as so many, according to my DSN, women (esp of the Type 2 and GD kind) don't take a lot of notice but are always more than ready to lay the blame on the HCP's if something goes wrong? I was told that the majority in the ante-natal I go to are Type 2's and GD's and they seem to be a lot more blase about control etc. I guess as Type 1's have a very different outlook (or can do anyway.)
!
Click to expand...
I think you may be on to something there - when i found out i was preg 2nd time i was due to start on a pump & the dsn refused to go ahead - her comment was that they would not give me a pump because "if something goes wrong you'll sue"!!!! 😱🙄 ...So i just had to stick to trying to combat DP with nightly 3 am checks & umpteen tests / tweaks a day! Nice attitude to care, eh?
 
Status
This thread is now closed. Please contact Anna DUK, Ieva DUK or everydayupsanddowns if you would like it re-opened.
Back
Top