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September 13, 2000

Family Planning

Question from Santee, California, USA:

I am a new childbirth educator. I have a mom in class that has diabetes. She wants to know the reasons she is more likely to have a cesarean. Other than the possibility of the baby being larger, I wasn't sure what other reasons may apply. Are there other factors, such as how her numbers are doing at the time of labor?


The same indications for a cesarean section apply to mothers with diabetes as to those without: abnormal presentation, placental complications (abruption or previa), failure to progress in labor, evidence of fetal distress. Blood sugar control is not a direct criteria. However, some physicians will lower the estimated fetal weight criteria to 4000 grams as an upper threshold for not allowing labor. This is due to the increased risk of the baby’s shoulder becoming stuck behind the pubic bone (shoulder dystocia) at the end of labor.