Planning Labour and Delivery
Reviewed by CDE Mehandi Sharma · Updated
GDM affects delivery planning, and it is much better to have the conversation at 34 weeks than during labour.
Timing usually comes up first. GDM can lead to a recommendation to deliver at or slightly before term rather than waiting, particularly if your baby is measuring large or your glucose has been difficult to control. Induction may be discussed for the same reasons.
Mode of delivery is the second question. GDM increases the chance of caesarean delivery, largely because of the baby's size and the risk of the shoulders being difficult to deliver. That is a possibility to prepare for, not a foregone conclusion — many women with GDM deliver vaginally.
Your glucose is monitored during labour itself, because both very high and very low readings matter for you and your baby. If you are on insulin, the plan for labour is different again, and doses usually stop or change abruptly at delivery.
Questions worth asking in advance: are we aiming for a particular week, what would make you recommend induction, what happens to my insulin during labour, will a paediatrician be present, and will my baby need their blood sugar checked afterwards.
Write the answers down. Labour is not the moment to be recalling a conversation from six weeks earlier.