Delivery

The aim for women with diabetes is to have a vaginal birth at between 38-40 weeks as this is considered the safest time for birth.  Unfortunately, women rarely go into spontaneous labour prior to 40 weeks, so women with diabetes often face a higher risk of induction and therefore a higher risk of caesarean section.



Question

It is important for women with diabetes to be managed using a sliding insulin scale during labour and birth. Can you explain what a sliding scale is?


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Managing a mother with diabetes in labour:

  • Multidisciplinary team involvement
  • Delivery in a unit with neonatal unit attached – inform neonatal unit when mother in labour
  • Management with sliding scale of insulin
  • Continuous cardiotocograph monitoring
  • Awareness of potential risk of shoulder dystocia at birth
  • Paediatrician present at birth
  • Early breastfeed if possible after birth (this lowers risk of newborn hypoglycaemia)