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What tests will you get, if any? - Page 3

post #41 of 51

I'm sorry if my post was interpeted as offering advice for particular situations, or a blanket recommendation. I was trying to point women towards information about the tests, and I did say "it can be important to look at the research, weigh the benefits and risks and your particular circumstances, and make an informed decision about your care." I also tried to provide links to articles with research so that women can look at the information for themselves to make an informed decision, rather than taking my (or anyone else's) word for it.

 

I also realize that this particular viewpoint (the nocebo effect and the ineffectiveness of routine testing for all women, without taking into account their particular circumstances and weighing the benefits and risks in that case) is not particularly popular, and does not sit well with many health care professionals. Nevertheless, there are midwives and doctors who do agree with it, and in fact those are the health care professionals that I have learned from. I am not a health care professional, so I am not qualified to offer advice to women about their particular situations. As a childbirth educator I can offer information, and I think it is important that women are aware that there is not unanimous agreement on these issues, and that some of the most respected voices for improving maternity care question the validity of routine prenatal testing.

 

I agree that "There are many valid reasons that a heath care provider would recommend any one of these tests to their patients." What we have been discussing is routine testing.

 

It seems that my information about urine strips may need to be assessed, which I will look into. A midwife I know uses this as part of her screening protocol for gestational diabetes, so I will ask her about it and look at the latest research.

 

The key here, which I think we are all trying to promote, is informed choice for each woman in her particular circumstances.

 

I think that my 'advertiser' identification is also detracting from this discussion, and I am not particularly impressed with mothering.com's recommendation that this would be a good way for me to let people know about my services. I will not be posting any more comments to the October 2011 DDC, as I can see that this is not the right place for me.

 

 

Quote:
Originally Posted by LAWoman View Post

I, for one, appreciate the ddcc WildKingdom and NashvilleMidwife.  Asheya, I'm sure you mean well and it's obvious that you care greatly about woman's birthing experiences and helping them make informed decisions which is great. But if you are posting to this DDC in your capacity as a birth educator, I think you are majorly overstepping your bounds with your posts here. Pointing people towards information so they can make their own informed decisions with the help of their health care providers is great. Saying, "Here are some studies you may want to look at and bring up with your doctor" is fine. But trying to interpret medical studies and reviews and then give advice based on them is just not something a childbirth educator is qualified to do. There are many valid reasons that a heath care provider would recommend any one of these tests to their patients. 

post #42 of 51
Thread Starter 


 

Quote:
Originally Posted by Asheya View Post

I think that my 'advertiser' identification is also detracting from this discussion, and I am not particularly impressed with mothering.com's recommendation that this would be a good way for me to let people know about my services. I will not be posting any more comments to the October 2011 DDC, as I can see that this is not the right place for me.

 



I cannot comment on who recommended that this is a good way for you to let people know about your services, but you might consider posting your info in the regular "pregnancy" forum and not the ddc. It is seen almost as an intrusion to have someone who is NOT part of this ddc to come in here and attempt to tell women what to do. If a person posts in the pregnancy forum then they are generally more open to different opinions OTHER than what they would find in their ddc. I would find your comments much more appropriate in the pregnancy forum rather than in the ddc.

post #43 of 51
Quote:
Originally Posted by StephandOwen View Post


 



I cannot comment on who recommended that this is a good way for you to let people know about your services, but you might consider posting your info in the regular "pregnancy" forum and not the ddc. It is seen almost as an intrusion to have someone who is NOT part of this ddc to come in here and attempt to tell women what to do. If a person posts in the pregnancy forum then they are generally more open to different opinions OTHER than what they would find in their ddc. I would find your comments much more appropriate in the pregnancy forum rather than in the ddc.


I agree. It isn't the advertiser flag, it's the lack of awareness of MDC culture. Asheya, generally, DDCs are pseudo-private, meaning that although they aren't truly private (this is, after all, a public forum) they function as if they were. Generally, people only post in them because they are due in that month. That's why others who aren't in the DDC are prefacing their posts with DDCC -- it means DDC crashing and is a sign of respect for the group dynamics.

 

I should also say that although I personally find Asheya's posts intrusive and agree that a number of her statements are factually incorrect, she isn't wrong on everything. There are genuine academic debates over, for example, whether everyone should be screened for gestational diabetes or whether screening should only be initiated for those with particular risk factors. The nocebo effect is a real phenomenon (though the term is typically used to apply to drugs administered, not to screening tests), and there can be value in considering what you actually will get out of a particular test. No tests have perfect sensitivity and specificity, meaning that they all have false positives and false negatives, and it's also worth considering whether the knowledge gleaned from a test will change your actions or outcomes in any way.

 

Anyway, as for the original question, I am over 35 and type 1 diabetic, so I will get most standard tests plus some extras, like a level II ultrasound at 18-20 weeks and regular biophysical profiles at the end of pregnancy. I am leaning towards skipping a few of the early screening tests (CVS, nuchal translucency), as they have somewhat high false positive rates, don't give a clear diagnostic one way or the other, are a pain in the butt for me to do, and wouldn't change my actions, but I am leaning towards an amnio. Haven't decided for sure yet either way.

post #44 of 51

One last thing--I checked with the midwife I know, and I was wrong about the urine strip being used as a good marker for gestational diabetes. I am sorry for that misinformation, thank you for pointing it out to me, and in the future I will make sure to check before I post!

 

The midwife I know does not, however, routinely screen all her clients for GD, but only those who have risk factors. She does this either by having the woman use the glucometer at home or by doing the sugar drink/blood draw, depending on the circumstances.

 

post #45 of 51

meh I usually skip most testing and vaginal exams. If a midwife wants to test my blood cell count as part of being willing to be my midwife or backup to a UC I'm okay with that. I try to eat a healthy diet that I would be put on if I had GD, but I only have one risk factor for that so it's unlikely anyway. Would like an ultrasound because I've done the 'let's be surprised' thing twice and felt horribly guilty for being disappointed at the birth. An ultrasound let's me warm up to the idea of having another boy.    

post #46 of 51

I would like to get a 3D u/s later in the pregnancy and for that we need an anatomical u/s first.  Grrrr!  We don't want to know gender so would like to avoid all other u/s.  I am Rh-, but haven't been tested for antibodies before.  If I do that, I guess it will only be for peace of mind.  Other than that, no tests.

 

post #47 of 51

I am too afraid to have any of the genetic screenings or tests done.  I got a false positive with my now youngest and was counseled to terminate without even testing further (she had a cystic hygroma aka a grossly abnormal nuchal fold).  She is smart happy and healthy except for asthma 2 1/2 year old right now.  I am also coming out of a second trimester loss and cannot even contemplate terminating not that I am opposed to it theoretically.  I simply could not risk the baby with a cvs or amnio no matter how small the chances of harm.  I had a cvs with my daughter and can't believe I put her life at risk because of some stupid measurement on her neck.

post #48 of 51
I've already had 6 betas and 3 ultrasounds. I plan to keep the testing to a minimum for the rest of my pregnancy, though. We'll do the 20-week anatomy scan (although we DON'T want to know the gender) and the GBS test. I'm skipping the GTT this time around (I had GD while pregnant with my DS) and instead will be monitoring my blood sugar at home (currently 4x a day) for the duration of my pregnancy.
post #49 of 51

Change of plans here. I decided to get the integrated prenatal screen after talking it over with DH. If he didn't care, I would skip it, but he does, and I am fine to go his way on this one. The u/s and first blood test are scheduled for next week.

post #50 of 51

I am getting CVS (I will be 39yo when this bebe is born) and plan on 2 USs total if I can help it.  This is a personal decision and one discussed with my husband over many months (even before getting pregnant).

 

I hope everyone has a blessed pregnancy and the birth that they want.

 

 

post #51 of 51
Thread Starter 

Interesting all the different responses! mythik- you are correct in that it is a very personal decision and what one person/couple decides isn't what's right for everyone thumb.gif

 

I think we decided that we would get the early ultrasound (had it done at 7w1d and saw the heartbeat) and we will get the 20 week ultrasound. I will do the gestational diabetes screening as well. Other than that, I think we'll skip everything else. DH didn't care one way or another on the early testing and we both decided that we wouldn't terminate anyway so we're just skipping them. I do want the 20 week ultrasound so that we can be prepared if there is anything special the baby will need when it's born. If anything else pops up then we'll make the decision at the time.

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