If your doctor is concerned about you not being able to have a vaginal birth (for example, if they suspect your baby is large or there are other obstetric problems), they will discuss this with you when you are making a plan for your baby’s birth. This is usually towards the end of your pregnancy at around 35 - 36 weeks.
If a caesarean section is advised, it will be according to your obstetric needs, not just because you have diabetes. Birth by caesarean section is not a decision taken lightly, as there are risks involved with such major surgery. The medical decision to perform a caesarean section should be discussed with you in detail, so your doctor can explain the risks and benefits involved.
If you are having a caesarean section, you will usually have to fast for about six hours beforehand. You will need to discuss the options for managing your blood glucose levels and insulin doses during this time with your diabetes in pregnancy team. It is a good idea to make a management plan with your team well before the birth.
In some circumstances a caesarean section is undertaken as an ‘emergency’. This might happen if there are problems with you or your baby, or because the labour is not progressing the way it should.