The Birth and Afterwards

Some women with diabetes go into labour on their own and others need to have labour induced. This is a decision your doctor will make with you. Your doctor will take into consideration the baby's size, your blood glucose level, blood pressure and overall health. Labour is induced for the majority of women with diabetes around 38 weeks, at which time the baby is mature. Waiting until 40 weeks means that the baby grows larger and this can increase the likelihood of a caesarean section.

Insulin needs during the birth vary. You will be given insulin intravenously if you have type 1 diabetes. Some women with type 2 diabetes do not need insulin at this time. Often during active labour, no insulin is necessary for women with either type 1 or type 2 diabetes.

After the birth, insulin is not usually restarted until blood glucose rises approximately above 10mmol/L. You and your doctor can determine this.

A caesarean section is more likely if your baby is large. However, about 50 percent of women with type 1 diabetes are able to give birth vaginally.

Once your baby is born, the baby's blood glucose level will be checked. If the blood glucose is low because the baby has had to produce more insulin in response to your elevated blood glucose levels, sugar water (by bottle or intravenous), breast milk or formula will be given to raise the baby's blood glucose to normal. Your baby's pancreas will soon adapt and produce less insulin. Often the baby is kept in the nursery or neonatal intensive care unit until the blood glucose reaches a normal level.

If your baby is born prematurely or is very large, he or she is more likely than full-term or smaller babies to develop Respiratory Distress Syndrome. This means the lungs may be immature and the baby may need to go to the neonatal intensive care unit for assessment and oxygen. There is also an increased risk of higher levels of bilirubin or jaundice in babies born to women with type 1 diabetes. This situation is not life-threatening and is easily treated.