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When planning a VBAC with gestational diabetes feels like swimming upstream
If you’re planning a VBAC with gestational diabetes and feeling unheard, dismissed, or worn down by repeated pushback, you’re not imagining it, and you’re certainly not alone.
Many of you are quietly nodding along as you read this.
You’ve done your homework.
Your gestational diabetes is well managed.
Your baby is growing normally.
You’ve made an informed decision about wanting to birth vaginally after caesarean.
And yet you’re being met with resistance, distrust, and what feels like a fixed narrative that gestational diabetes automatically equals “too risky” for VBAC.
That’s exhausting.
And it’s not how maternity care is meant to feel.
Gestational diabetes is not a blanket “no” to VBAC
Gestational diabetes is a spectrum, not a single diagnosis with a single outcome.
There is a world of difference between:
Yet in practice, these distinctions are often blurred, and GDM becomes a convenient justification for increased intervention, surveillance, and pressure toward repeat caesarean.
This is not evidence-based care. It’s risk-averse, policy-driven care.
Researcher and academic Dr Rachel Reed has written extensively about gestational diabetes and how fear-based narratives often overshadow the actual evidence. Her work is a grounding antidote to the idea that a GD diagnosis automatically removes physiological birth from the table.
Doula and Childbirth Educator Shelley Langford’s article “The gestational diabetes dilemma” explains that gestational diabetes is diagnosed when blood sugars rise during pregnancy. She highlights how the rise in diagnoses hasn’t always been matched with better outcomes, and that the context of diagnosis and management matters. Rather than treating GDM as a one-size-fits-all condition, Langford encourages women to understand how GDM is defined, how blood glucose targets are set, and how management decisions (such as diet, monitoring and medication choices) can affect both maternal experience and birth outcomes. Her article emphasises the importance of informed discussion with care providers about what the diagnosis means for individual pregnancies, rather than accepting fear-based interpretations of gestational diabetes.
Another excellent resource for understanding gestational diabetes from a balanced, evidence-informed perspective is Dr Sara Wickham’s articles on gestational diabetes and pregnancy. Dr Wickham explores how GDM is diagnosed, what the numbers really mean, and how different approaches to management can impact your pregnancy and birth experience. Her writing can be especially helpful if you’re feeling overwhelmed by clinical language or fear-based messaging, it gives you information you can take into your appointments, ask questions about, and use to feel more confident in your decisions. You can read more here:
“Partnering with women” isn’t optional – it’s policy.
In Western Australia, maternity services are meant to operate under a shared decision-making framework.
That’s not a feel-good slogan, it’s an expectation.
The King Edward Memorial Hospital Partnering with the woman who declines recommended maternity care guideline clearly states that:
You should not be leaving antenatal appointments feeling distressed, disheartened, or bracing yourself for the next argument.
You can, and should, advocate for yourself for your wants and needs.
Simple language can be powerful:
“I understand your concerns. I’ve considered the risks and benefits carefully, and I am choosing to plan a VBAC. I would like this appointment to focus on how we can support that safely.”
You are not asking for permission. You are stating a decision.
One of the most valuable things you and your partner can do is attend independent childbirth education classes. These classes are not hospital-run and are designed to give you a solid understanding of how the maternity system works, what questions to ask, common interventions, and what to realistically expect during labour and birth. When both partners are informed, it becomes much easier to navigate appointments, weigh up recommendations, and make decisions together with confidence.
https://vickihobbs.com/back-to-basics-birthing-classes/
Why doctors often aren’t enthusiastic about VBAC (and why that matters)
This part is important and often misunderstood.
Obstetricians are experts in surgical procedures and pathology.
They are trained to identify, manage, and respond to things that go wrong.
They are not trained in supporting normal physiological birth, and VBAC, at its core, is simply vaginal birth after a previous surgical birth.
That doesn’t make doctors “bad” or uncaring.
But it does explain why:
It also explains why many women are shocked to discover that doctors have no personal stake in whether you birth vaginally or surgically but you and your baby do.
You are the one who lives in your body afterward.
You are the one who parents in recovery.
You are the one who carries the emotional weight of the experience.
You are allowed to listen and still decide differently.
You can:
All at the same time.
Consent is not consent if it’s given under pressure, fear, or emotional exhaustion.
And while clinicians are required to provide care even when your choices differ from their preference, it’s also important to be realistic about roles.
Doctors are not there to be your cheerleaders.
That’s not their job, and they rarely will be cheering you on from the sidelines.
This is where support matters
If you want someone who:
That role is not filled by the medical system.
That role is filled by continuity, advocacy, and emotional support, often through a doula or a privately practising midwife.
Supportive birth doesn’t come from one final antenatal appointment.
It comes from feeling seen, respected, and backed, especially when the system feels heavy.
To the women who question their ability to birth
Feeling overwhelmed doesn’t mean you’re weak.
Feeling disheartened doesn’t mean you’re wrong.
Feeling distrustful is often a sign your intuition is asking for space, clarity, and support.
You are not unreasonable for wanting your birth plan taken seriously.
You are not reckless for choosing VBAC with well-managed gestational diabetes.
And you are not alone, even when it feels like it leading up to that final appointment.
Your body, your baby, your birth.
And you deserve care that reflects that, not care that wears you down until compliance feels easier than choice.
If you need a cheerleader?
Find one.
Best place to start is with a doula.
The system won’t give you a cheerleader, but when you find the right one, that cheerleader will be by your side the whole way.
The next best thing is to attend independent childbirth education classes with a focus on VBAC.
https://vickihobbs.com/back-to-basics-birthing-classes/
All the best
Vicki
Additional Gestational Diabetes Resources:
http://www.fullcirclemidwifery.com/2009/02/gestational-diabetes-information/
https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/
Gestational Diabetes: the baby… – The Midwives’ Cauldron – Apple Podcasts
9 Gestational Diabetes Myths – Lily Nichols RDN
https://www.birthsavvy.com.au/gestational-diabetes/
Here is a birth story from a previous client who had gestational diabetes:
Other Stories
Emily’s VBAC covers a woman who had gestational diabetes, challenging first birth, then a supported VBAC (including homebirth transfer) and shares reflections on preparation, support, and intuition.
Freyja’s VBAC story includes insulin-dependent gestational diabetes in the first pregnancy and a powerful, supported VBAC after advocating strongly for her choices.
There’s a published birth story on Pregnancy.com.au from an Australian mum who managed gestational diabetes and went on to have a successful VBAC with her second son. Her first birth was a long labour ending in an emergency caesarean; this time she managed GD with diet and insulin, worked with independent midwives, and had the vaginal birth she hoped for, celebrating a smooth postpartum and baby whose sugars were fine after birth.
https://www.pregnancy.com.au/successful-vbac-with-gestational-diabetes
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki