If blood glucose levels are close to normal during pregnancy, and there are no other complications, it is ideal for the mother to deliver at term. It is generally recommended that pregnancies complicated by GDM do not go beyond term. There is continuing debate about whether induction of labor or expectant labor is more efficacious, and it is not clear which is better with regard to the outcomes of cesarean delivery incidence, birth injury, or neonatal morbidity and mortality.
There are no contraindications for epidural analgesia, spinal anesthesia, or, if indicated, general anesthesia. Insulin is rarely needed during delivery. Typically, a normal saline infusion is all that is required for the patient to remain normoglycemic. Blood glucose should be monitored the day after delivery to ascertain that the mother is no longer hyperglycemic according to the criteria for nonpregnant individuals. In general, no further insulin is required postpartum for patients with GDM. Among women with GDM, 95% will return to a completely normal glucose status postpartum.