Labour and birth

See other NICE guidance for NICE information for the public on care for women and their babies during labour (intrapartum care), induction of labour and caesarean section.

Planning the birth

You should be advised to have your baby in a hospital that has special facilities to care for sick babies 24 hours a day, in case these are needed.

During your pregnancy (and especially in the last 3 months), your care team should explain about your options for giving birth. This should include information about the benefits and risks of having your labour induced compared with letting the pregnancy carry on, and of having a 'normal' (vaginal) birth compared with a caesarean section. This is especially important if you are having a large baby. If you have had a caesarean section before, you may still be able to have a vaginal birth this time.

If you have certain health problems (such as being very overweight or having spinal nerve‑related problems such as sciatica), you may be advised to see an anaesthetist to talk about the best method of pain relief during the birth.

When to have your baby

Timing of the birth is important, because if your pregnancy carries on for too long this may increase the chance of problems for you and/or your baby.

If you have type 1 or type 2 diabetes

You should be advised to have your labour induced, or a caesarean section if this is the best option for you, during week 37 or week 38 of pregnancy. You may be advised to have your baby earlier than this if there are complications (such as high blood pressure or a slowing down of your baby's growth).

If you have gestational diabetes

You should be advised to have your labour induced, or a caesarean section if this is the best option for you, before 41 weeks of pregnancy if you have not had your baby by this time. You may be advised to have your baby earlier than this if there are complications (such as high blood pressure or a big baby).

If your labour starts before 37 weeks

If your labour starts early, you may be offered medication to delay the birth. You may also be offered medication called steroids to help your baby's lungs to mature. If you are on insulin and have steroids, your insulin dose will need to be increased and your blood glucose monitored closely, because steroids can raise your blood glucose.

Your blood glucose levels during labour and birth

It is important that your blood glucose is well controlled during labour and birth, to help prevent your baby's blood glucose becoming low after she or he is born (known as neonatal hypoglycaemia).

Your blood glucose should be measured at least every hour to make sure it stays at a safe level, or every 30 minutes if you have a general anaesthetic.

If there are problems with blood glucose during labour and birth, you should be given insulin and glucose through a drip to help with this. If you have type 1 diabetes, you may be offered a drip from the start of established labour (which is when your cervix is at least 4 cm dilated and you are having regular painful contractions).

Questions you might like to ask your care team about labour and birth

  • How can I make the birth of my baby as normal as possible?

  • What kind of pain relief can I have during labour?

  • What are the possible risks of waiting for labour to start on its own?

  • What are the possible risks of being induced?

  • Am I likely to need a caesarean section?

  • What are my options for controlling my blood glucose during labour? What will happen if my blood glucose is too low or too high?

  • Information Standard