UKMidSS Diabetes Study results support choice of place of birth for women with well-controlled gestational diabetes.

Published on Thursday, 12 December 2024 Post

Women with well-controlled gestational diabetes may safely plan birth in midwifery units (birth centres) on the same site as obstetric and neonatal services.

A new study, published in BMJ Open and carried out as part of the NIHR Policy Research Unit in Maternal and Neonatal Health and Care, has shown that, for women with well-controlled gestational diabetes, planning birth in an alongside midwifery unit (AMU) can be just as safe as for women who do not have diabetes.

Working with a network of midwives in all midwifery units across the UK, as part of the UK Midwifery Study System (UKMidSS), researchers at the NPEU, led by Associate Professor Rachel Rowe, identified and collected information about all 420 women with diabetes (pre-existing or gestational) who were admitted for labour care to a midwifery unit (alongside or freestanding) between October 2021 and September 2022. Similar information was collected about a comparison group of 411 women without diabetes who were admitted to the same units.

Of the 420 women with diabetes in the study, 417 had gestational diabetes and only 3 had pre-existing (Type 1 or Type 2) diabetes. Almost all (411 out of 420) were admitted to alongside midwifery units, with only 9 women with diabetes admitted to freestanding midwifery units. Some of the women with gestational diabetes (64 out of 417) were on medication to control their blood sugar levels, but most had 'diet-controlled' gestational diabetes. The results of the study therefore best apply to women with well-controlled gestational diabetes considering the option of birth in an alongside midwifery unit.

For women with diabetes in this study, there was no evidence of significantly increased risks, for the woman or her baby, associated with planning birth in a midwifery unit, compared with women who did not have diabetes.

For example, just under 6% of the women with diabetes in this study had a caesarean birth, compared with just under 5% of the women who did not have diabetes. The chances of their baby being admitted for specialist neonatal care were also similar for women in both groups (3% for women with diabetes and 2% for women without diabetes).

Rachel Rowe said:

We know that many women with diabetes would like more choice about aspects of their care, including where they can give birth. Women with gestational diabetes, and their midwives and doctors, now have more information about the risks and benefits of planning birth in a midwifery-led setting to help inform their decision-making. Birth in a midwifery unit is not suitable for everyone, but planning birth in an alongside midwifery unit or birth centre could reduce interventions and lead to better outcomes for some women with gestational diabetes. Women who think they might be interested in this option should talk to their midwife or doctor and make a care plan which suits their own individual circumstances.

Amber Marshall, who contributed to the study as a 'lay member' of the UKMidSS Steering Group, said:

This is wonderful news for women and birthing people with diabetes in pregnancy. For too long there has been a blanket assumption that such pregnancies should be precluded from entry to Midwifery Led Units - we now have the data that shows this is not the case! Hopefully this will give caregivers the confidence to grant more people a real choice and agency over where they plan to give birth.

Download our infographic explaining the results of the study: