Moms with gestational diabetes DO appear to have a higher cesarean risk

???

Many childbirth educators and other childbirth professionals have suspected it for a long time, but now there is peer-reviewed proof (if there was not any already): just having the label of having gestational diabetes mellitus (GDM) raises a woman’s risk of having a cesarean section.

In the study, “Gestational diabetes mellitus: A risk factor for non-elective cesarean section,” which has been published in the online version of the Journal of Obstetrics and Gynaecology Research from the Japan Society of Obstetrics and Gynecology, researchers showed that even though the rate of cesarean indicators was not significantly different, mothers with GDM had a statistically significant higher rate of non-elective cesarean. The study authors think it may be knowledge of the diabetes itself influencing doctors.

You could argue that these are Japanese doctors in the study, not American, so the results don’t apply in this country. I think it is reasonable to use caution here (and around the world), because human nature is pretty much an international language. 

The best thing is always to try to reduce your risk of getting complications such as gestational diabetes (or as it is now sometimes called, “gestational glucose intolerance”). If you do have or end up with GD/GDM, talk with your birth attendant. Find out his or her parameters for when they would consider cesarean or other interventions necessary in your case. Ask for the doctor’s cesarean rate to see how it compares to other doctors, hospitals, and areas. If you don’t like what you find, it’s ok to switch practices. You may want to consider using a midwife, as they tend to treat pregnancy and birth as more of a normal occurence than a disease. Additionally, do what you can to keep the gestational diabetes under control with low-glycemic eating, regular exercise, and any other recommendations made by your health care professionals. Having well-controlled diabetes gives you a lot more options.

So what can you do if you are pregnant and would prefer to avoid cesarean?

The best thing is always to try to reduce your risk of getting complications such as gestational diabetes (or as it is now sometimes called, “gestational glucose intolerance”). If you do have or end up with GD/GDM, talk with your birth attendant. Find out his or her parameters for when they would consider cesarean or other interventions necessary in your case. Ask for the doctor’s cesarean rate to see how it compares to other doctors, hospitals, and areas. If you don’t like what you find, it’s ok to switch practices.

You may want to consider using a midwife, as they tend to treat pregnancy and birth as more of a normal occurence than a disease. Additionally, do what you can to keep the gestational diabetes under control with low-glycemic eating, regular exercise, and any other recommendations made by your health care professionals. Having well-controlled diabetes gives you a lot more options.

References

Gorgal, R., Gonçalves, E., Barros, M., Namora, G., Magalhães, Â., Rodrigues, T. and Montenegro, N. (2011), Gestational diabetes mellitus: A risk factor for non-elective cesarean section. Journal of Obstetrics and Gynaecology Research. doi: 10.1111/j.1447-0756.2011.01659.x

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