Gestational Diabetes and Birth Injury

Gestational diabetes is a condition in which a woman without diabetes develops high blood sugar levels during pregnancy. It typically arises in the second or third trimester and can affect up to 10% of pregnancies in the United States.

While many mothers with gestational diabetes deliver healthy babies, appropriate monitoring and timely intervention are crucial to ensure safe outcomes.

The condition occurs when hormonal changes during pregnancy interfere with insulin’s ability to regulate blood glucose levels. This results in elevated blood sugar, which, if left untreated, can affect both the mother’s and baby’s health.

Gestational diabetes places mothers in the high-risk pregnancy category, as it poses an increased risk for complications during pregnancy, labor, and delivery. With proper monitoring and care, however, many of the risks associated with gestational diabetes can be mitigated, resulting in a healthy baby.

Monitoring may include non-stress testing for fetal well-being, ultrasounds for fetal well-being, fetal size and amniotic fluid levels and Doppler flow studies.

Currently, the American College of Obstetricians and Gynecologists (ACOG) and the American Diabetes Association recommend screening all pregnant patients for gestational diabetes  between 24 and 28 weeks of pregnancy. Women with risk factors, such as obesity, a family history of diabetes, or previous pregnancies with large babies, should be monitored even earlier.

Due to the multiple, serious complications that can arise from gestational diabetes , rigorous testing and monitoring is important. According to a 2008 study that spanned multiple countries, the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) trial, even subtle defects in maternal glucose metabolism during pregnancy may lead to health problems for mother and baby.

When doctors and nurses fail to identify or properly manage gestational diabetes, the risk of complications increases significantly. These failures can take many forms, including:

• Failure to test for gestational diabetes during routine prenatal care
• Misinterpretation or mishandling of test results
• Delayed or inadequate treatment and monitoring
• Failure to adjust labor and delivery plans based on the baby’s size or health risks

Negligent management of gestational diabetes can lead to a host of complications during labor and delivery, many of which are preventable with proper care.

Uncontrolled gestational diabetes exposes both mother and baby to a range of serious risks. For the baby, these risks can be particularly severe and include:

Babies born to mothers with poorly controlled gestational diabetes are at increased risk of macrosomia, meaning the baby weighs more than 8 pounds, 13 ounces at birth.

The high blood sugar levels associated with gestational diabetes are often passed on to the baby through the placenta. This extra amount of energy is put towards growth and can result in a baby being too large.

Macrosomia significantly raises the risk of a traumatic birth, like getting stuck or injured in the birth canal. Babies with macrosomia are most safely delivered via C-section. If macrosomia goes undetected or cesarean section is not performed, this may result in a prolonged or arrested labor, traumatic injury to the baby, or HIE.

In some cases, doctors may attempt vaginal delivery despite the risks, leading to traumatic births, birth injury, and potentially long-lasting consequences.

Gestational diabetes can lead to abnormal blood flow or oxygen levels during delivery. Too little oxygen during delivery can lead to a brain injury called Hypoxic-ischemic encephalopathy (HIE).  HIE is caused by a lack of blood and oxygen flow to the brain.

This injury can happen due to complications associated with diabetes, such as prolonged labor or traumatic delivery due to macrosomia or placental insufficiency.

HIE is a medical emergency and requires prompt recognition and treatment, often through cooling therapy. If the healthcare team fails to act quickly, the brain damage can be severe and permanent, often resulting in cerebral palsy, developmental delays, or intellectual disabilities.

After birth, babies born to mothers with gestational diabetes may experience low blood sugar levels, a condition known as neonatal hypoglycemia.

Once babies are born, they begin to produce their own glucose and energy stores. When babies from a gestational diabetes pregnancy are born, the amount of insulin they produce does not drop as quickly as their glucose supply does. If they don’t take in enough energy as newborns, their blood sugar can drop dangerously low. 

Without prompt treatment, this can cause seizures, brain damage, and other long-term health concerns. Hospital staff must monitor these infants closely in the hours and days after birth to prevent injury.

Unmanaged gestational diabetes can also increase the risk of preterm delivery. Premature babies often require specialized care in the neonatal intensive care unit (NICU) and are more vulnerable to breathing problems, infections, and neurological issues.

In many cases, it is safest for babies of mothers with gestational diabetes to be delivered in a scheduled delivery prior to 40 weeks . If a mother’s diabetes is poorly controlled, delivery is recommended as early as week 36. Although premature birth does have associated risks, in the case of diabetes, the benefits of early delivery outweigh the risks, especially with proper postnatal care.

Neonatal seizures are one sign that a baby has neurological abnormalities. Seizures are abnormal electrical discharges in the brain and are common in neonatal hypoglycemia. Neonatal hypoglycemia can damage brain cells, which in turn can cause seizures. It is very important that medical professionals bring seizures under control because continuing seizures can make underlying brain damage worse.

It is common practice to induce labor prior to 40 weeks for women with gestational diabetes as a strategy to reduce complications, especially those related to macrosomia. Labor induction is often planned at 38 ½ to 39 weeks’ gestation and can occur when the baby’s lungs are mature, antepartum tests are normal, diabetes is under control, and the mother doesn’t have vascular disease.

ACOG recommends consideration of C-section delivery in diabetic women when estimated fetal weight exceeds 4500 grams, though some researchers recommend C-section delivery between 4000 and 4500 grams, after evaluating obstetrical history and clinical measurements of the pelvis. Physicians should be alerted to the possibility of cephalopelvic disproportion if dilation or descent stops during labor, and the baby’s estimated weight exceeds 4000 grams. These researchers also suggest consideration of C-section delivery in diabetic women who demonstrate significant protracted labor and failure of descent – in other words, they are slower to dilate and the baby does not descend down the birth canal.

Gestational diabetes is not rare, and modern medical guidelines offer clear protocols for managing it. When healthcare providers fail to follow these standards, and a baby is harmed as a result, this may constitute medical negligence. Examples of negligence in gestational diabetes-related birth injury cases include:

• Not screening for gestational diabetes at the appropriate time
• Failing to recognize and treat maternal risk factors
• Ignoring warning signs during pregnancy or labor
• Delaying emergency interventions like a C-section
• Failing to properly monitor the baby after birth

These errors are not just unfortunate outcomes but preventable mistakes that can result in life-changing injuries. Families have the right to hold providers accountable when substandard care causes their child harm.

Parents may not always receive immediate answers about what happened during labor and delivery. In many cases, the signs of a birth injury related to gestational diabetes may only become apparent days, weeks, or even months later. Some common red flags include:

• Baby was blue, limp, or unresponsive at birth
• The need for resuscitation, intubation, or mechanical ventilation
• Low APGAR scores
• Seizures within the first 48 hours
• Baby was admitted to the NICU for an extended stay
• Cooling therapy was administered after birth
• Feeding difficulties or abnormal movements
• Head imaging (ultrasound, MRI) was conducted shortly after birth
• Developmental delays or missed milestones as the child grows

If your baby experienced any of these issues, it’s essential to investigate whether medical negligence may have played a role. A thorough review of the medical records by professionals familiar with both obstetrics and neonatal care is often needed to uncover the truth.

When your child suffers a preventable injury due to mismanaged gestational diabetes, pursuing a legal claim is about more than assigning blame. It’s about securing your child’s future. Children with conditions like HIE or cerebral palsy often require:

• Lifelong medical treatment
• Physical, occupational, and speech therapy
• Assistive devices and home modifications
• Special education services
• Around-the-clock care in severe cases

These costs can be staggering, and insurance rarely covers everything. A successful birth injury claim can provide compensation for these expenses, ensuring that your child receives the care they need for the rest of their life.

But the impact goes beyond financial relief. Holding medical professionals accountable also promotes patient safety and helps prevent similar tragedies from happening to other families. For many parents, a lawsuit is one way to seek justice, get answers, and ensure no other child suffers the same fate.

The consequences of a preventable birth injury don’t stop at medical diagnoses. For many families, the emotional and psychological toll is just as profound. Watching your child struggle with motor function, communication, or developmental delays can be heartbreaking. Parents often grapple with feelings of guilt, frustration, and helplessness, especially when the injury could have been avoided with proper medical care.

Additionally, parents may experience:

• Post-traumatic stress after a traumatic labor or NICU experience
• Strained relationships or marital challenges due to caregiving stress
• Financial stress from lost income, reduced work capacity, or ongoing medical bills
• Isolation, as families with medically complex children may find it harder to maintain social connections

Seeking mental health support, joining support groups for families of children with disabilities, and building a community around you can make a major difference. Local and national organizations exist to connect parents with the resources and support they need to adapt and thrive.

If you suspect that your child’s birth injury was due to medical negligence involving gestational diabetes, timing is critical. Every state has a statute of limitations, a deadline for filing a medical malpractice or birth injury lawsuit. These statutes vary significantly depending on the state and circumstances, but typically range from one to ten years.

In birth injury cases, some states allow extra time to file due to the nature of childhood injuries and delayed diagnoses. However, delays can still limit your ability to pursue justice. It’s vital to contact a legal professional as soon as possible so they can investigate your case, preserve evidence, and meet critical deadlines.

For many families, contacting an attorney is a difficult and emotional step. But a good legal team will guide you through the process with compassion, clarity, and a focus on your child’s long-term well-being.

Here’s a general overview of what to expect:

1. Free Consultation
   Most birth injury law firms offer free consultations with no obligation. During this meeting, attorneys will listen to your story, gather basic information, and explain whether they believe you have a viable claim.
2. Case Investigation
   If you decide to proceed, your legal team will begin gathering medical records, consulting with medical experts, and analyzing the events surrounding your pregnancy, labor, and delivery.
3. Expert Review
   Medical experts play a vital role in identifying whether the standard of care was breached and whether that breach caused your child’s injuries.
4. Filing the Lawsuit
   Once a solid case has been built, your attorneys will file a lawsuit against the appropriate parties. This may include OB/GYNs, nurses, hospitals, or healthcare systems.
5. Settlement Negotiations or Trial
   Many birth injury cases settle before trial. However, if a settlement cannot be reached, your case may go to court. Your legal team will advocate for full and fair compensation to cover your child’s lifetime needs.
6. Securing Resources for the Future
   A successful claim can provide your family with the financial means to pay for therapy, equipment, education, and ongoing medical care for years to come.

An experienced legal team will handle the technical details while keeping you informed and involved every step of the way.

At ABC Law Centers: Birth Injury Lawyers, we understand the profound impact a birth injury can have on your entire family. For over 25 years, our team has worked exclusively with families affected by birth-related medical negligence. This focused experience allows us to provide the clarity, compassion, and determination that families need during their most difficult moments.

We have handled countless cases involving gestational diabetes-related birth injuries, including HIE, cerebral palsy, and brachial plexus injuries. We work alongside highly experienced medical experts, forensic analysts, and life care planners to build powerful cases on behalf of the families we represent. Our in-house registered nursing staff adds another layer of medical insight to each case we investigate.

We charge no fees unless we recover compensation in your case, and every consultation is free and confidential. If you believe your child’s birth injury was caused by negligent care related to gestational diabetes, we encourage you to reach out to us at (248) 593-5100 or through our online form and share your story. Let us listen. Let us help.

You don’t have to walk this journey alone. Justice, answers, and resources for your child’s care may be just a phone call away.