I have had type 1 diabetes for 13 years and am on a insulin pump. I have very good control with my diabetes. I am 15 weeks pregnant. I also have a three year old. I went into labor one month early with my first. The labor was stopped, but my blood sugar was so out of control because of the drugs the obstetrician had given me that I stayed in the hospital overnight. I have a new obstetrician who believes that I shouldn’t be allowed to carry a baby full term. He wants so schedule another c-section for my current pregnancy, with a couple of weeks before my due date. Is it normal for type 1 diabetic women to go into labor early? Should I be allowed to carry a baby full term?

Diabetes does not appear to cause pre term labor directly. However, most mothers with type 1 diabetes end up delivering before their due date because of other indications: preeclampsia, poor fetal growth or worrisome fetal testing are examples. Traditionally, doctors electively delivered babies early because of an increased risk of fetal death. With improved fetal surveillance, this risk has been reduced significantly. My approach is to get a mother as close to her due date as possible, not past, as long as both she and the baby are in good health. If you are planning a repeat cesarean section anyway, documenting lung maturity and delivering at 37-39 weeks is a reasonable approach. Be sure to discuss this further with your own obstetrician so you are comfortable with the plan.

OWJ