Written by the Progyny Editorial Team. Reviewed by the Progyny Clinical Team — April 2026.
If you have gestational diabetes, you’ll have special considerations for childbirth.
We’ll walk through some general things to think about. Your healthcare team is always there to answer questions and help keep you and your baby safe.
What kind of delivery can I expect?
Most people with gestational diabetes can reach full term (39 weeks) if their blood sugar levels are in their target range. Vaginal delivery is possible, although gestational diabetes can increase the chances of needing a C-section, especially if the baby is expected to be large.
You and your team will come up with a plan based on:
- Your blood sugar levels during pregnancy and at delivery
- Your baby’s expected size
- Other risk factors or complications you may have
- Possible concerns for your health or the baby’s health
Preparing for delivery
Blood sugar often goes up in the weeks before delivery, so your healthcare team may adjust your care plan over time. You may use physical activity, healthy eating, and medicine (which may include insulin) to manage your blood sugar.
It’s helpful to talk with your healthcare provider about your birth wishes, concerns, and questions. This can help you feel more prepared and make decisions together. For example, you may ask:
- What can I expect during delivery?
- What can I expect after delivery?
- Am I at risk for any complications, and what is our plan to manage risk?
- What is the plan for my medicine, such as insulin, during and after delivery?
- How can we plan to feed my baby right away? (Tell them if you plan to chestfeed or bottle-feed.)
Delivering the baby
Your healthcare team will monitor your blood sugar while you’re in the hospital.
- If your blood sugar is high, you may receive insulin.
- After delivery, it’s common for your blood sugar to go down. Sometimes, it can drop too low, especially if you’re on insulin. Your team will check for this.
Your team may also monitor your baby for low blood sugar. Low blood sugar is a risk because:
- When the baby is exposed to high blood sugar in the womb, they make extra insulin to lower their blood sugar.
- After birth, the baby is no longer exposed to high blood sugar. The extra insulin can cause blood sugar to become very low, and this can be dangerous.
Low blood sugar for the baby is most common in the first 1 to 2 hours after birth. The risk goes down after 2 to 3 days.
If your baby has low blood sugar, they may receive special care. Feeding your baby soon after birth may help prevent low blood sugar, so talk with your provider about your feeding plan.
Tell a nurse right away if the baby has any warning signs of low blood sugar:
- Trouble breathing
- Bluish or pale skin
- Loose or floppy muscles
- Shaky or sweating
- Doesn’t feel warm
After delivery
For most people, gestational diabetes is temporary, and blood sugar starts going down after delivery. Be to sure to ask your provider about how your treatment plan will change. Most people with gestational diabetes don’t need medicine after delivery.
Your team may check your blood sugar while you’re still in the hospital. Rarely, some people continue to have high blood sugar after delivery, which may require medicine or checking blood sugar at home.
Gestational diabetes raises the risk for diabetes in the future, so your team may recommend additional blood sugar testing, often at the 6-week visit. Let your primary care provider know that you had gestational diabetes as well. They can help you with ongoing diabetes screening.
Feeding your baby
If you’re able to chestfeed, it has benefits for both you and your baby.
Talk with your provider or lactation specialist about any medicines that may cross into your milk. Insulin does not cross into milk.
Emotional support
Supporting your emotional wellness after birth matters. It’s important to know that people with gestational diabetes have a higher risk of postpartum depression. Signs include feeling very sad, withdrawing from others, or having thoughts of harming yourself or your baby.
If you have any of these signs or are concerned about your risk, speak to your provider. They can work with you to get the help you may need.
Going to your first postpartum checkup is one of the best things you can do to support your physical and emotional health after birth.
Your takeaway
It’s common for blood sugar to rise in the last weeks of pregnancy. Following your care plan helps keep your blood sugar in range and reduces the risks that come with high blood sugar at birth.
Your healthcare team will help you get ready for delivery. You can also reach out to your Progyny Care Advocate for information and support.
Disclaimer: The information provided by Progyny is for educational purposes only and is not medical advice. Always consult a qualified healthcare provider for medical guidance.