Weekly Non Stress Test? Is this normal? Necessary?

[Kikibell]

I'm 32 weeks. MW, who so far has been fabulous, no unnecessary tests, etc. told me at my appt. today that I have to go on for a NST every week now. I guess I wasn't expecting that unless there had been problems - and there haven't been any.

Is this routine, even with midwives, for twins? If it's normal and necessary than that's fine, I'll do it no problem. But today it just seemed to cause more problems than anything else. The girl (baby b) hates the doppler. I mean, seriously, she moves really slowly and gently usually and is pretty stationary, but with the doppler on her she makes these quick, jerky movements all over the place. She was doing her best to get away from the sound, which of course resulted in her heartbeat getting continually lost, which meant not a 20 minute test but an hour and 20 minutes! The whole thing made me very stressed out.

Anyone have any experience with this? TIA!!!

[tanana25]

I am seeing an OB, but she is fairly relaxed about things. I have been going for NST's twice a week since 32 weeks and when I tried to get out of it I was told emphatically that it was something I had to do. It wasn't so bad at first, but now, at 38 weeks, I am so uncomfortable up on that table I want to scream. But, as all the other pregnant twin moms around me have had their babies early, I am happy to see that mine are doing so well.
Anyway, that has been my experience, and once a week doesn't sound so bad, except that your little one doesn't like it. But at least it means she is reacting well--you'd think that would reassure the midwives.

[Llyra]

I had them. And a biophysical profile at 36 weeks. It was presented to me as "the standard package" that they insist on with multiples. In my case, with multiple maternal complications (I have a congenital heart problem, plus I developed cholestasis during pregnancy) it seemed genuinely useful to have the information each week that the babies were active and reactive. I would think though that offering them routinely leads to a lot of "false alarms" and unnecesssary inductions and c-sections, because somebody decides the babies "aren't doing well" based on what is really just a screening. Do you think you could talk them into every second week?

[CalaRei]

Toward the end, I had NSTs every week and U/S every other week. I know I sound like one of "those" people who are "so glad for the monitoring units or else blah blah blah..." but seriously, the "standard U/S" on our 37th week discovered cord blood flow problems to my Baby B, coupled with a drastic size differential (that had cropped up in just the two week span) - and we decided to do a c-section that day. I trusted my midwives, who were until that point very relaxed and go with the flow ("Wait as long as possible, Baby A might turn still, etc") But their reactions to the results of that scan made me feel very comfortable that it was necessary. It turned out that all of the U/Ss had overestimated B even then and he was much smaller than his brother, so something definitely wasn't working right with his cord.

Get the scans and NSTs. Like a PP above, if they make you that terribly uncomfortable, perhaps you can work out a way around them.

[4Marmalade]

If I remember correctly my OB recommended NST's every 2 weeks after 28 weeks and every week after 34 weeks. I ended up hospitalized for 3 days for contractions around 32 weeks. After I was released I was on modified bed rest and had NST's and ultrasounds every week from 32 weeks until 37 weeks when I birthed my babes.

[Gena 22]

Just for comparison, my peris and OBs never sent me for NST. I dropped them for a planned HB at 37 (birth at 39 weeks.) I thought the docs were thorough, and don't fault them for not sending me for NSTs. No indications that it was needed. But I can't say for sure in anyone else's case.

[queenofchaos]

Hi DDC buddy!
My OB hasn't mentioned a word about NSTs. I never even thought to ask either. I have had no problems, movement has been fine. I've had an ultrasound about once every 6 wks or so to check growth and babies are within a couple oz of each other. I see my OB next wk and I'll ask him about it and if this is part of a standard of care. I ask him about stuff all the time so he won't think I am off the wall or actually requesting them.
That's funny about the doppler. My twin B doesn't like the doppler either. So my OB uses one of those weird stethoscope things he puts on his forehead. I think it's called a fetoscope.

[Julia'sMom]

My midwives recommended them every week after 37 weeks. I actually went into labor later on after the first appointment I went thru one. I had an u/s whenever they weren't completely 100% confident that the doppler picked up two distinct heartbeats.

[Kikibell]

Originally Posted by tanana25

I have been going for NST's twice a week since 32 weeks and when I tried to get out of it I was told emphatically that it was something I had to do. It wasn't so bad at first, but now, at 38 weeks, I am so uncomfortable up on that table I want to scream.

Me too! Lying on my back is so uncomfortable. But I am at least glad to hear it is standard with twins for many of you - even with midwives. I'll be sending you distracting thoughts for your tests!!

Originally Posted by Llyra

I had them. And a biophysical profile at 36 weeks. It was presented to me as "the standard package" that they insist on with multiples. In my case, with multiple maternal complications (I have a congenital heart problem, plus I developed cholestasis during pregnancy) it seemed genuinely useful to have the information each week that the babies were active and reactive. I would think though that offering them routinely leads to a lot of "false alarms" and unnecesssary inductions and c-sections, because somebody decides the babies "aren't doing well" based on what is really just a screening. Do you think you could talk them into every second week?

That's exactly my concern - about them being over-reactive. I guess I'll have to wait and see.

Originally Posted by CalaRei

Toward the end, I had NSTs every week and U/S every other week. I know I sound like one of "those" people who are "so glad for the monitoring units or else blah blah blah..." but seriously, the "standard U/S" on our 37th week discovered cord blood flow problems to my Baby B, coupled with a drastic size differential (that had cropped up in just the two week span) - and we decided to do a c-section that day. I trusted my midwives, who were until that point very relaxed and go with the flow ("Wait as long as possible, Baby A might turn still, etc") But their reactions to the results of that scan made me feel very comfortable that it was necessary. It turned out that all of the U/Ss had overestimated B even then and he was much smaller than his brother, so something definitely wasn't working right with his cord.

Get the scans and NSTs. Like a PP above, if they make you that terribly uncomfortable, perhaps you can work out a way around them.

Thank you for this! When you're a non-interference mama like so many of us it's hard to get behind routines that we don't see as necessary - but your story made me remember that things can and do happen, and better to be safe than sorry. At least that's what I'll be telling myself.

[Kikibell]

Originally Posted by queenofchaos

Hi DDC buddy!

Right back atcha!! When are you due?
I'll have to ask my midwife about the fetoscope. She checks their heartrate at every appt. with the doppler, and it always startles the little girl, but it's only for like 30 seconds, so it's not a big deal. It was being on the monitor for an hour I couldn't deal with. And the hospital (not the midwife - but she has to follow hospital policy) says continuous EFM for twins during labor, no exceptions. That is gonna be one peeved little one being born.

[Intertwined]

I had di/di twins and so chose to not do NSTs in absence of an indication and did far less sonos than originally suggested to me. My midwife was fine with both decisions. I gave birth at home though, which I'm sure makes a difference. My twins and I all stayed healthy and we only had one extra sono to check position.

[babyproject]

How many of you who had the NSTs had mono/di twins? I feel like I have consented to much more testing and monitoring for my mono/di twins than I would if they were di/di. Ultrasounds every two weeks and bi-weekly NSTs feel a bit excessive, but I am really paranoid about TTTS.

[queenofchaos]

Originally Posted by Kikibell

Right back atcha!! When are you due?
I'll have to ask my midwife about the fetoscope. She checks their heartrate at every appt. with the doppler, and it always startles the little girl, but it's only for like 30 seconds, so it's not a big deal. It was being on the monitor for an hour I couldn't deal with. And the hospital (not the midwife - but she has to follow hospital policy) says continuous EFM for twins during labor, no exceptions. That is gonna be one peeved little one being born.

July 14th. I know it is wrong, but I hope I deliver a bit earlier, around 37 wks. I actually predict June 26th. We'll see. I can't remember if this is your 1st pg/babies, but when they monitor you with one of those belt things, sometimes baby will kick the heck out of the monitor. I had one that was like that. She'd kick it and move out of the way of it so we'd lose her heart rate. It was for NST and I said, "Well, I guess she's reactive enough, huh?" lol

[turnquia]

Originally Posted by babyproject

How many of you who had the NSTs had mono/di twins? I feel like I have consented to much more testing and monitoring for my mono/di twins than I would if they were di/di. Ultrasounds every two weeks and bi-weekly NSTs feel a bit excessive, but I am really paranoid about TTTS.

With Mono/Di I would also consent to the same thing.

We are having Di/Di twins planning a homebirth but seeing an OB for parallel care. We will start NST every 2 weeks at 32 or 34 weeks. And ultrasounds once a month (mainly for cervical length checks starting at 16 weeks). The NST he said if all is going well and I'm comfy with it and ultrasounds are showing up good then we can skip them.

I think a big heart to ehart with yoru MW may be needed on WHY she feels they are needed so often and can you do them once a week? Or once every two weeks? Maybe there is something else thats making her want to do them?