Bloodwork Q & religion

[frugalmama]

Just wondering - has anyone claimed that bloodwork was against their religious beliefs to get out of doing GD testing and HIV testing during pregnancy?


I'm thinking on TTC, but don't want to go through the fiasco that was my last pregnancy for bloodwork - they had me testing for gestational diabetes every 4 weeks from 6 weeks pg on via the oral glucose stuff {which makes me sick!}, and HIV tested me three times because I was on medicaid.

I spot check my own sugars - nothing ever out of line, and none of the lab tests came back off either but they still insisted it due to my race {native american} and weight.

[MsBlack]

The glucose testing you could skip on an evidence basis--there is no evidence to prove efficacy of prenatal testing on a routine basis. I would think that you could just say 'no thanks, I'll test only if I become symptomatic' and then let them know you do home glucose testing. As for HIV, I doubt you could get out of that. And much as I hate for anything to be mandatory, well, as a birth care provider I would like to know if HIV is in the mix! I think we have to stay mindful that something like HIV, which is both fatal and uncurable, is not something you can claim any right to privacy toward--because at birth, blood and body fluids are going to be part of things--they won't remain 'private' at your birth but could very much effect other people.

[anj_rn]

I do not think you could get out of the testing all together, but you should not have to get it that often. HIV (as well as other STDs) should be checked at your first OB appt, and then HIV will be rechecked at or right before delivery delivery. You should not hae to be retested, and can refuse for no reason at all to be tested outside of those circumstances. Most providers do a 1 hr glucose test, if it is abnormal or borderline, the will repeat and do a 3 hour test. As long as you don't have sugar or ketones in your urine, they should not need to test again. If you don't want to do it twice, ask for the 3 hour test up front. (Some ob gyns do it twice because they do one early, and then need to repeat).

I would start by talking to your provider about testing at your first visit. Explain you want to minimize it, and ask for an explanation of any test they want to run. If you can find a nurse midwife, even better. In my experience, midwives want less testing than MDs.

[frugalmama]

Originally Posted by MsBlack

The glucose testing you could skip on an evidence basis--there is no evidence to prove efficacy of prenatal testing on a routine basis. I would think that you could just say 'no thanks, I'll test only if I become symptomatic' and then let them know you do home glucose testing.

I did as above last time - they refused to go with it. Threatened to call CPS at the birth, discharge me from care {and this is the only local practice that takes medicaid}, and force me to weekly visits for non-compliance.


I'd go with a MW if I could, but coming up with the $5k for it just isn't in the books.

[GoldmanBaby09]

I got concurrent care with a CNM at an OB practice and my HB midwife. I refused the GTT when the CNM brought it up. She didn't know I was having a homebirth and that I already did a postprandial with my hb midwife. She "counseled" me about it and I had to sign a medical release saying I understood the implications of not being tested. That was fine for me. I would also go with a midwife as many obs are pretty stringent about such things, evidence-based or not.

[Peace+Hope]

Originally Posted by MsBlack

The glucose testing you could skip on an evidence basis--there is no evidence to prove efficacy of prenatal testing on a routine basis. I would think that you could just say 'no thanks, I'll test only if I become symptomatic' and then let them know you do home glucose testing. As for HIV, I doubt you could get out of that. And much as I hate for anything to be mandatory, well, as a birth care provider I would like to know if HIV is in the mix! I think we have to stay mindful that something like HIV, which is both fatal and uncurable, is not something you can claim any right to privacy toward--because at birth, blood and body fluids are going to be part of things--they won't remain 'private' at your birth but could very much effect other people.

bolding is mine

really? i passed up getting tested for any STDs b/c i knew i didn't need to be. this was not a problem at my annual exam, and my MWs have not questioned it either.

OP, i would think you could forgo any testing you thought was unnecessary. however, depending on the caregiver you have, they may say something like, this is a requirement of this practice. if you do not wish to be tested for XYZ, you will need to find another provider. do you have options? maybe you could be looking now?

[rachel65655]

I refuse all STD testing also because it isn't necessary. I am in a loving monogamous marriage where there is no need to worry about STD's. I didn't even realize that the routine first visit blood work was mostly for STD's until I had my fourth child and received a bill for $250 for an HIV test that I didn't even know I took. I now refuse all routine blood work but usually have the 28 wk diabetes screening. I have never had to retake the glucose test.

[Freud]

You can refuse anything except those that are mandated by law unless there's a religious exemption. Some states, like mine, don't have religious exemptions for things like HIV, which I just found out about (and posted about too). This infuriates me! I'm not sure there's a way around this at all. If anyone knows, let me know! I think homebirthing with a midwife would be a good way to be able to make decisions about your blood work, etc.

[Freud]

Originally Posted by MsBlack

The glucose testing you could skip on an evidence basis--there is no evidence to prove efficacy of prenatal testing on a routine basis. I would think that you could just say 'no thanks, I'll test only if I become symptomatic' and then let them know you do home glucose testing. As for HIV, I doubt you could get out of that. And much as I hate for anything to be mandatory, well, as a birth care provider I would like to know if HIV is in the mix! I think we have to stay mindful that something like HIV, which is both fatal and uncurable, is not something you can claim any right to privacy toward--because at birth, blood and body fluids are going to be part of things--they won't remain 'private' at your birth but could very much effect other people.

I completely disagree. Pregnant women are not tested for other blood bloodborne illnesses, such as hepatitis. A woman can refuse an HIV test during her pregnancy, no matter what, but they will test the infant without consent at birth. This is flawed for many reasons. Testing the newborn after the birth doesn't prevent possible contamination with blood products during the birth. Not to mention that a test given to the newborn is actually just a test of the mother's HIV status, as the newborn carries her antibodies for some 6 months or so.

[nia82]

In CA they ran not only HIV, but also HepB and HepC tests along with a pap smear for the regular culprits. I knew I had none, yet it is routinely done. I didn't care at the time, just found it a pain in the neck for the extra blood. I knew I had none. And I didn't have to pay extra so I was like whatever.

[Kidzaplenty]

Why would you have to be tested for GD SEVEN or EIGHT times?

I have never heard of being tested more than once unless there was cause, and even then only the longer test.

And testing for HIV THREE times? Why? I mean, really, I could see testing at the beginning, and maybe at the very end, but what reason could there be to test THREE times? I have only ever been tested once per pgcy, and every single time I had to sign a consent form stating that I understood what I was being tested for and what a positive result would mean (like being reported to the heath department or something like that).

It all seems very fishy to me. And for the record, I have usually been on Medicaid for my pgcies, but never had such excessive tests.

[Astraia]

If that is your ONLY option for prenatal care in your area....

well, have you considered UP? Or going to VERY limited appointments? Like, make one at 12 weeks and do their usual run of tests. If they want to do more say, "sure, I can do that!" and then don't go back for 2-3 months and then when you make your next appointment just be lke, "oh, that bloodwork? So sorry, I forgot completely! I'll do it this time."

2 months later, "oh geeze, wouldn't you know I forgot again? Haha, silly me."

Dr's are much more understanding of "dumb" patients then they are of resistant ones, I think. I think I could have gotten away with never doing a GD test by claiming forgetfulness, but I went and said "no" and suddenly I was "refusing everything" and "wasting his time."

You test your glucose. All you need now is urine test strips, fetoscope/doppler if you're nervous, and something for monitoring blood pressure.

[soso-lynn]

Originally Posted by Freud

I completely disagree. Pregnant women are not tested for other blood bloodborne illnesses, such as hepatitis. A woman can refuse an HIV test during her pregnancy, no matter what, but they will test the infant without consent at birth. This is flawed for many reasons. Testing the newborn after the birth doesn't prevent possible contamination with blood products during the birth. Not to mention that a test given to the newborn is actually just a test of the mother's HIV status, as the newborn carries her antibodies for some 6 months or so.

They do a viral load and check for antigens to diseases for the newborn. The presence of antibodies will also be cause to give anti-retrovirals and other drugs to prevent the baby from becoming HIV-positive. This is actually very effective. Same thing goes for hepatitis.

It is routine to test for HIV, hepB, hepC, syphillis, chlamydia and gono.

[Momily]

Wow, lots of misinformation about HIV on this thread. First of all, any responsible provider would be taking universal precautions to prevent things like needle sticks, so arguing -- knowing that a client has HIV shouldn't change anything that a healthcare provider does to protect themselves. It might change the way the healthcare provider provides care to the mama, in that she might suggest ARV's or other measures.

On the other hand, knowing that an infant is HIV exposed, does have a dramatic effect on outcomes. An untreated newborn born to an untreated HIV+ mother will have about a 1 in 4 chance of contracting the virus. If you treat the same child during their first 6 weeks of life the risk drops pretty close to zero, so knowing whether a child is HIV exposed is important.

While the newborn does carry the mother's HIV antibodies for up to 18 months, there are other tests, such as the PCR which can identify HIV positive (as opposed to antibody positive) infants at much younger age. Tests can give a false negative, especially ones given to newborns, but by 4 months they're almost completely conclusive (unless the child is continuing to be exposed to the virus, such as through breastfeeding).