by Lee-Ann
(Quebec)

I got gestational diabetes while pregnant with my first child. They told me that if I didn't deliver naturally before the 38-39th week then I would automatically have a c-section because otherwise the baby is too big to push. Thankfully, she was born healthy and naturally at 37 1/2 weeks, weighing 7lbs 11oz – not an oversize baby at all!

The diabetes has not completely left – despite all my efforts to maintain healthy diet and exercise, and now I am pregnant again. My blood sugar is high, but not quite at the diabetic levels yet.

My doctor is already saying c-section, without really giving it a chance to play out. Because of the diabetes, the midwife option is not possible. Because of the severe shortage of doctors in my city, changing doctors is not an option either.

I pushed my first one for 4 hours, she was slow coming out. I feel like I could push a bigger baby if i had to as well.

Is it really true a c-section is the only option for me?

Answer:

Hi Lee-Ann

From my own research, I do not see that gestational diabetes alone indicates reason for a cesarean. But dealing with an obstetrician who thinks so can make it hard to get past his or her opinion.

I definitely think, however, that you should be given a chance to have things play out. You were able to deliver your daughter, a good sized baby, vaginally, and your body will have an easier time opening for a baby this time around. Many women without gestational diabetes have bigger babies – up to nine and ten pounds.

It's hard to be accurate estimating the weight of a baby in the womb, but I would ask your doctor for an ultrasound to try and get a good weight estimate on the baby when you get close to term (in general, they can be off by two pounds either way, but it's worth a shot… doctors are notoriously off in their weight estimates too).

The wisest thing to do now is to continue to work on bringing your blood sugar levels under control via diet. Moving to a lower carb diet has been proven to bring down blood glucose levels. I wouldn't recommend doing anything drastic during pregnancy; however you need a very high protein diet during pregnancy anyways, so it's not hard to get a lot of your nutrition from protein sources.

Milk and eggs are great sources of protein and milk provides a good number of carbs for energy. I would recommend cutting back on most grains and get your carbohydrates from mostly vegetables (and your daily milk if you drink it). Fruit is ok but I would have it very much in moderation. I would get most calories from protein (and good fats) and add in a variety of veggies for extra carbs/vitamins/minerals.

I highly recommend the Weston A Price Foundation's Diet for Pregnant and Nursing Mothers. It gives you all the information on healthy proteins and fats for pregnancy and there are links for further information on many of the recommended foods.

You are probably already monitoring your blood glucose levels regularly, and I would say to watch the correlation between what and how you are eating carefully, noting what causes spikes and what you can eat that doesn't cause much of a spike. A food log is probably a very good idea.

Let me know if I can help with anything further and best of luck to you with this pregnancy.