41 weeks pregnant, no doctor, can i be induced still?

Patient

Q: I'm 41 weeks pregnant and no longer have a doctor because of insurance problems. I havent been seen in 2 months and I'm still waiting on Medical to finalize. I have gestational diabetes and fear I'm over baking my baby. What can I do? Can i go to the hospital/women's center to get induced? I have very mild. .contractions and haven't noticed my mucous plug come out yet, can I just go to the hospital?

Symptoms:  Mild contractions, back pain, pelvic pain
Doctor

A:   Hello,
Thanks for contacting askthedoctor.com
As you are already 41 weeks and post dated with gestational diabetes as a high risk factor , the primary concern is that the fetal movements are still perceived or not. In a case of gestational diabetes, the pregnancy is never allowed to cross 40 weeks and preferably delivered by induction of labour at 39 weeks itself as chances of Macrosomia is high and also there is a dreaded chance of unexplained still birth.
It is important for you to monitor fetal movements and visit your physician now to contemplate induction of labour only after an ultrasound for fetal growth parameters which would ascertain that the baby is not macrosomic and that vaginal delivery is possible or not. Only once the fetal parameters are conducive should a vaginal attempt by induction should be made else there can be chances of shoulder dystocia during delivery and fetal morbidity.
If the baby is found to be big , then you should be prepared for an immediate planned cesarean section for delivery as risks to continue the pregnancy further are higher than the benefits. Also make sure that there is an NICU facility in the center as there are high chances that the baby may develop hypoglycemia which is common in GDM mothers.
So please visit your physician for an immediate delivery even if natural labour process is not starting.
I hope i have answered the query in detail,
wishing you safe outcome,
regards

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