Wanted: Advice, Knowledge, Opinions

[bloominmamas]

This is my 3rd pregnancy/baby so I would have hoped that I would feel more confindent in my decision making abilities but apparently the closer I get to things the more doubt crowds in and the less I "feel" I know. Also I have been having alot of worries about the baby. I just finished reading Spiritual Midwifery and one of the last stories in it just got my emotional side rolling and started making me doubt my decision to not have an ultrasound. Would it be better to be mentally prepared for something than to not be? Does that make sense? I am just feeling so paranoid, I guess I am just feeling like I want to know my baby is healthy sooner rather than later.

Also I wanted other mamas opinions on this stuff:

Gestational Diabetes Screen- I am thinking about declining this since I didn't have it with the other 2.

Group Beta Strip Screen- this seems harmless enough, but doesn't seem conclusive

Antibiotic Eye Ointment- Don't have gonorrhea or chlamydia so don't see the point in making baby's vision blurry for no reason

Vitamin K- Just on the off chance the baby needs surgery or gets injury in the first few days of life?

Newborn Metabolic Screen- My other 2 didn't have any issues, would it be any different with this one?

Thanks for any input!

[SamuraiMom]

You know it's funny, but by the time I got to my 3rd pregnancy, I was no longer as confident as I had been, and I had the best MW who had the utmost faith in me and my baby. Since then I have had to m/c so you might think that I would be more inclined, without question, to have moe testing done. However I am on the fence about having an US, my logic is this, would I rather sit and fret over the results for the next 6 months if I were to learn there was something wrong, or would it be O.K. to be in "ignorant bliss" for the duration and enjoy my pregnancy. I chose the latter. As for the testing, I did not do any of the things that you listed as I did not feel any of it was necessary and the eye thing was just so intrusive. However, you have do do what you feel is right, as well as what will put your mind at ease.

[Lolafanana]

I am popping over here from the March ddc. I was not planning ANY testing but had a nagging "feeling" that I couldn't shake that I should get a sonogram to just make sure everything is fine. I felt that if there is something going on, I'd like to know so that i could educate myself and if everything is great, then I'll have great piece of mind. That's at least what made sense to me.

Do what you FEEL is the right thing to do. I always say follow your gut.

[MamaBBrown2003]

I totally understand. I felt the same when I was pregnant with my third. With my first, I was clueless and did all the tests my Dr. suggested. With my second, I was much more confident, but only did the tests that were "required" by my midwives' office. With my third, I suddenly began worrying about everything, but still did the same as with my 2nd -- just worried more.

This time, I have much more autonomy with what I have done, and I will probably request a 20 week U/S only if my gut tells me I need it. (I've had lots of twin thoughts with this pregnancy, and I would really like to know how many are coming!). If there's any question about the position of the placenta, then I may have it done as well. Also, if my Midwife has any concerns and feels that she needs the information, I will consider it.

As for GD, I've always been negative, and am not worried about it.

GBS is something I've always tested ++ for but never been "effectively" treated for. (Meaning I wasn't in the hospital long enough for the 2 doses of antibiotics, 4 hours apart, prior to delivery. Heck, I was asleep 4 hours before dd2 was born!). I believe this midwife is willing to just take a culture of my baby's skin post-delivery to see if he/she has been colonized and then decide on treatment for the baby from there.

I plan to skip the eye stuff and Vit K for this one, but I will probably do the PKU test because I would want to know about any metabolic disorders while it's still early enough to treat them. I fully expect it to come back fine, but I know myself, and I would probably spend my first few months postpartum convinced my baby had some crazy rare disease. LOL! So much easier to just take a few drops of blood and know for sure.

All that said, I tend to trust my instincts. If I had a gut feeling that something was wrong that one of these diagnostic tests would fix, then I'd do it. Same with the eye junk or vit. K.

[nausicaamom]

The only one I wouldn't skip would be the newborn screening/PKU. I know my state and the hospital I'm delivering at tests for a lot more than just PKU and Galactosemia (?sp), it's a panel of 25 different conditions. While all of these conditions are rare, the consequences of them going undiagnosed can be extreme.

[PlayaMama]

boy, i'm in the same boat. just had an appt with my midwife yesterday and she said that having an ultrasound is my decision and that while she would recommend it she's not going to push me. one thing she said was that if something shoes up then it kind of leads to other diagnostic tests. not that the ultrasound is definitive and they are going to recommend an abortion if something shows up. which is good, since i was kind of like, i'm not going to abort if the u/s shows something just in case there was a mistake.

i'm more worried about false positives making me worry needlessly than anything else. i'm probably going to do it anyway, mostly because i'm a researching fool and i figure that i'd rather be prepared for something (even if the problem doesn't happen) than end up trying to figure out what to do in the situation.

my ds was born with extremely low blood sugar and i had done no research on it so i felt like i had to listen to the hospital staff because i didn't know enough to argue with them. it turns out their advice was right on but i felt really helpless at the time because i didn't have any information. does that make sense?

go with what you feel, chances are your baby is fine and all the worry will be forgotten whatever your decision.

[flapjack]

FWIW, last time round I was having a big discussion with some other mums pregnant with a third baby. The general consensus is that once you get above the standard 2.4 kids, there is this magic switch in your mind that flips and goes "I'm pushing my luck, something must be wrong with this one" and so you worry more. It does seem to be a third baby thing...
Anyhow. I have sued a hospital for a urine test for group b strep without my consent (withdrew the case when they apologised), we don't get routine GD blood tests over here or antibiotic eye ointment. We do choose oral vitamin K, though I'm aware it isn't proven to have any efficacy whatsoever- I think this time we may just be declining full stop. Oral is NOT an option if you're vegan or vegetarian, btw.
Metabolic screen, otoh, I will be doing. Can't see a good reason not to.

[bloominmamas]

I do feel like I am pushing my luck since I have had 2 healthy babies...But if I truly listen to my intuition I feel like the baby is OK, so I think I will follow my intial decision before I had a freak-out and not do the ultrasound. What I did remind myself is that me declining it now doesn't mean I couldn't change my mind later and that made me feel better. That would be the same with almost any test, so that is empowering in itself knowing that I have the right to change my mind.

[LoveChild421]

I know what you mean, sometimes its hard to distinguish between intuiton and paranoia.

As far as the tests you have listed, we all have different philosophies and reasons to decline or consent to them. I'll go through my opinions on them one by one.

Ultrasound- I feel more comfortable having one short ultrasound around 20 weeks just to make sure that there is nothing grossly abnormal since I decline all other testing for fetal abnormalities. I would never have one in the first trimester or consent to multiple scans for no real reason, but that's where my comfort level lies.


Gestational Diabetes Screen- I insist that they do a blood draw and check my sugar after a normal meal. I don't eat sugar, don't drink sodas and definately would never be able to choke down that awful orange glucose crap they want you to drink that has tons of sugar in it. From all of the research I've come across, the most accurate test for diabetes is to do what I do, and have them draw blood after a normal meal. It makes sense that chugging a ton of sugar would make you have high blood sugar readings, especially if your body isn't used to that much sugar at one time. If your blood sugar is elevated after eating, say a sandwich, then that does indicate there might be a real problem.

Group Beta Strip Screen- I get this one, but I do everything I can do get a negative reading, including soaking tampons in yogurt (I open up a couple probiotic capsules and add that to the yogurt for added beneficial bacteria) and wearing them overnight for a week or so before the test.

Antibiotic Eye Ointment- I probably will allow this for this babe. The STD swab they do won't show all cases of gonorrhea or chlamydia and since I have had multiple partners in the recent past I can't be sure I don't have something dormant. If you know you and your partner are both low risk then it seems totally unnecessary.

Vitamin K- I would have this only if the birth had been physically traumatic for the baby or the baby required surgery. We will never circumcise any of our children so we see no need to get the Vit K. barring other circumstances

Newborn Metabolic Screen/ PKU- I see no harm in this one at all and definately will be getting it done at the pediatricians office about a week after birth (the ped. suggested waiting til my milk has come in for a few days). We also will be getting the newborn hearing screening.

[bloominmamas]

I wanted to let people know what our decisions were on this stuff in case anyone cared
We are not going to the ultrasound but with the knowledge we could change our mind if we wanted to.

Gestational Diabetes Screen- declined

Group Beta Strip Screen- going to do this especially since with both previous births my water broke before labor started

Antibiotic Eye Ointment- declined

Vitamin K- declined shot but going to do drops over 12 weeks, once a week instead

Newborn Metabolic Screen- since my mw would do the test at home while I am nursing using gravity etc we decided to go ahead with it.[/QUOTE]

Thanks for the great responses it really did help for me to get a grip on what was important etc.

[lovetobemama]

Kate,
So glad that you guys found the right answers for you for your questions! I love when a thread is updated and things are working out for the poster! Thanks for sharing!

[flapjack]

Curious- why are you giving the oral vit K over 12 weeks? Are you giving a smaller dose each week, or have you got something suggesting that a longer course is more effective?

[loraxc]

I am declining prenatal testing, but doing one u/s at 20 weeks to check for major anomalies.

Gestational Diabetes Screen- yes, but honestly I am not worried about it as last time I was not even close to having a proble,

Group Beta Strip Screen- yes, because if I transfer there will be a big hullaballoo about not doing it

Antibiotic Eye Ointment- No

Vitamin K- Undecided

Newborn Metabolic Screen- Yes

[5kids4me]

I'm undecided on all but diabetes and GBS MY 3rd son was born with GBS and we almost lsot him so it scared me into testing although I will always get antibodics anyway since I have had a GBS + child with it in labor.
I also had GD for 3 of my 4 pregnancies so again something I dont mess
around with

[bloominmamas]

Originally Posted by flapjack

Curious- why are you giving the oral vit K over 12 weeks? Are you giving a smaller dose each week, or have you got something suggesting that a longer course is more effective?

My mw has a study from Sweden and some other country that suggested that the countries that did only 3 doses of oral vit K had more had later onset problems and that doing 6 doses has eliminated the problem. She's going to get me the study the next time I see her, I could post it or pm it to you if you want me to. But it just made more sense to me to do smaller doses over 12 weeks than a ginormous shot at birth. Anyway, I hope that doesn't sound flaky.

[flapjack]

Given that all of the concern around vitamin K is "flaky"- i.e., one scientist found a problem and our governments aren't stumping up the funding to find out if it's a big problem or a little problem- I don't think you're being flaky at all. I'd love to read the study some time, that's info I didn't have. The UK's one of the countries that does three doses, which is possibly one of the reasons why we get disclaimers warning that oral isn't as effective?

[MamaBBrown2003]

Originally Posted by loraxc

Group Beta Strip Screen- yes, because if I transfer there will be a big hullaballoo about not doing it

My first daughter came at 36 weeks, a few days before I was to have the GBS test done. There was no big hullaballoo. If they don't have test results, I think they just assume you are ++ and give you antibiotics.

[loraxc]

If they don't have test results, I think they just assume you are ++ and give you antibiotics.

But if you don't get them in time (4 hours before delivery, and they prefer two doses) they may insist on a CBC and keeping baby 48 hours. I know this is the protocol at the hospital where we'd transfer.

[camille76]

Hello, I haven't read thru the replies, so maybe you've already reached a conclusion... Anyway, here's my view on it. Keep in mind, I'm a natural-birthing mom, no pain meds, but I do birth in the hospital. Breastfeed & use disposable diapers.... so I guess that puts me somewhere in the middle. haha

Ultrasound... I don't think it's a big deal to have this done. With a couple of my babies, I had many, and they are fine. I know some folks are really against it, but I say in moderation, it should be fine.

Gestational Diabetes Screen... Again, not a biggie, at least not in my book. So they test ya for something. big deal! i doubt it hurts the baby any.

Group Beta Strip Screen... I just do the test. It's just a little sample. Doesn't hurt the baby. Plus, I've heard stories (true stories) about how baby can get meningitis, etc, if you're GPS+.

Antibiotic Eye Ointment... You may not have gonorrhea or chlamydia that you know of, but what if, unknowingly, your husband is unfaithful and got it somehow. The ointment might not be natural, but I don't think it hurts the baby any.

Vitamin K... This one I'm not too big on. I don't think it's necessary. I still let mine have it though, but really, I hardly think it's necessary.

Newborn Metabolic Screen... Is this the one where they fill up the circles on test strip by squeezing blood out of the baby's heel? If so, I don't like that. I'd like to know too if the others didn't have something, would this one be just as likely not to have it. Seems like a lot of trauma for a little one. Mine have had that, but I wonder how much of a stink that'd cause to oppose it.

You didn't mention vacs, but I thought I'd slip in that I don't do them at birth and am currently struggling with whether or not to do them at all. It's been a while since we've been for boosters. S

Hope you're able to find some peace. I say if an ultrasound will help you feel better, do one. I really don't think it's that big of a deal.

[MamaBBrown2003]

Originally Posted by loraxc

But if you don't get them in time (4 hours before delivery, and they prefer two doses) they may insist on a CBC and keeping baby 48 hours. I know this is the protocol at the hospital where we'd transfer.

Yes, this is true. I've tested ++ the last 2 times, and both of those children were born within 2 hours of arriving at the hospital. They did the antibiotics anyway. With Dd2, it was fine, but the protocol changed after she was born. With ds, I had to stay for 48 hours after delivery, and I hated it! I don't think they did the CBC, though. I think it was and either/or thing. I'll be homebirthing this time, and I'll have to see how my midwife wants to handle my GBS.