Cross-post..GD test and bullying midwife

[NJ*Doula]

I'm corss-posting this from Pregnancy because I'd really like the opinion of some professionals.

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I had a midwife appointment today, my second in a row with the one midwife (out of three) that I don't get along with at the office. Last time I told her that I didn't want the GD test - I'm 27, never had sugar issues, I'm thin, my weight gain has been right on track - and she tried to convince me to get it by playing the shoulder dystocia card. She told me that instead of a fasting glucose or having to drink that nasty stuff they'd give me a breakfast, then test my sugar. I told her I still didn't want it.

Today she started in on me again. This time she went past threatening shoulder dystocia (and she does threaten it like it's going to happen for sure if I don't take the test) and started with the dead baby stories. She basically told me that if I don't get the test my baby will end up in NICU on a glucose drip and will have brain damage. She told me about the time "the biggest, healthiest baby in the NICU" died one night because of low glucose, omitting the part about the mother being a type 1, not gestational, diabetic (yes, I called her on it). She tells me that they can't just not do any kind of GD testing. So...is this true? What will happen if I refuse completely? Can they drop me? Is there legal recourse or something? What can I do? Also, should I send a complaint after the birth? This isn't the first time this midwife has made outrageous statements to try to scare me into doing what she wants.

I've made my appointments through January and made sure I won't be seeing her again (though I'd love to see her face when she hears that I'm refusing the GBS test, too). She's just better not show up at the birth, because she won't be coming into the room. I'm beginning to see why some women UC. :

[Reha]

Do you have any way of finding a new midwife (different practice)? Especially if there is no way of knowing who will be on call when you give birth. And care providers who are using scare tactics at this point in pregnancy often act much the same during the birth. :

I'm sorry you are dealing with this. You should absolutely be able to refuse the test. However, I do know I have heard of some practices who will threaten to drop you as a client if you refuse 'X' test. I don't know how much legal recourse there is if this were to happen, but would you really *want* them as your care provider if they would do such a thing?

Personally, I would definitely send a complaint in after your care is completed with them.

[BeckiCNM]

Originally Posted by GathererGirl

She tells me that they can't just not do any kind of GD testing. So...is this true? What will happen if I refuse completely? Can they drop me? Is there legal recourse or something? What can I do? Also, should I send a complaint after the birth?

I'm sorry you're having a rough time. I work with two doctors, and we have a few people who refuse GD testing. If you don't want the glucola (nasty stuff), we'd offer you the jelly beans, or just doing a fasting glucose. But if you turned those down, we wouldn't drop you. Especially a low-risk person.

Yes, they can drop you, as long as they give you 30 days notice. Only if they didn't give you 30 days to find a new provider would you have legal recourse.

It's hard when you find a group practice that has that one person that you can't stand. And hoping they won't be on call when you give birth. Any other options where you are?

[NJ*Doula]

Not very many options here, no. There are lots of midwives around, but most of them aren't terribly natural birth friendly, and neither are the hospitals (I'm in New Jersey, which pretty much says it all, doesn't it?). My only other option if I'm dropped is to try to find a homebirth midwife who will take me on this late. I'm guessing that's doubtful, would be expensive, and my husband wouldn't be pleased.

I've been told from the first appointment on that if I have a request for who I want at the birth they'll do their best and can usually acommodate. This midwife is the head of the practice though, so if she really wants me to get the test and I continue to refuse, it's possible the other two won't be able to go against her wishes no matter what they might want to do.

I think I'll call one of the homebirth midwives up here tonight and see what she has to say about taking patients late, just in case.

[SublimeBirthGirl]

Is this a hospital practice? Switch and stay home. Best bet. I've said it a million times: nothing is more important than your birth attendant. Don't stay with one that is less than perfect. If you do, you stay at your own risk (and your baby's).

[time4another]

I'm willing to bet that you'll be quite pleased with what the HBMW says...

[melanie_rabbitbarn]

I don't know about whether they would or could drop you, but I do know that my midwife group is not requiring the glucose test. They offered me the options of jelly beans or apple juice or even whole wheat bread, but my objection is that I NEVER eat carbs/sugars on an empty stomach without proteins to balance because I KNOW it is bad for me. So they would be testing me in an unhealthy state that never 'occurs in nature'--what are they going to find out from that?!!! I did buy a glucose monitor myself because I am hypoglycemic. I also feel that IF there is a risk from chronic high blood sugar, testing myself weekly or whatever would be a better test than a one time glucose tolerance test.

Also, depending on the midwives, some will take new patients up to several days before the baby is born. People do switch because they just finally get fed up with their current provider. Or, the 'nearness' of the event brings out the worst in the provider that was not apparent before. I am currently in the process of thinking through a switch just because I'm not comfortable with the hospital.

[Mamabeakley]

During my last PG w/5 CNMs in a homebirth practice, I felt that some of them were not exactly transparent about the GD or GBS tests. So I thought through my questions - basically, what happens if I fail the test vs. what happens if I don't take it - and talked to my favorite MW about it. And decided to decline the GD test and decline the ABX if I "failed" the GBS test, which I did.

There was also a MW in the practice I was NOT comfortable with at all - and she was one of the owners of the practice. I found, though, that it is not particularly uncommon for someone to dislike or just not want a certain MW around at their birth, and that all 5 MW were accustomed to this fact. They just put a note in my chart that said "No A." and that was that. They did ask why, and because in my pg state I didn't feel like addressing it directly w/A., I declined to say why - I thought it would be rude to discuss her behind her back if I wasn't willing to talk to her about it directly. It was not a big deal, really. If she had been on call, I could have simply said, "I want to have whoever's on backup," and that, too, would have been that. I had a chart saying who was on call when, and they had an answering service, so I wouldn't even have had to say that to her - just told the answering service to page whoever was on backup.

Good luck!

[NJ*Doula]

Well, I've gotten in contact with a homebirth midwife and we're meeting with her Saturday morning. The more I think about my experience with this service and the more I think back on episodes of Baby Story that they've been on, the less comfortable I am with having any of them at the birth. My husband isn't sold on homebirth, and I'm not entirely converted, but I'm willing to listen to what the homebirth midwife has to say and take it from there. We've talked about homebirth before, so this isn't a totally new thing for us to think about.

Thanks for all the advice. I'm not sure what I'm going to do yet, but at least I have some options.

[kelly1827]

Originally Posted by GathererGirl

Not very many options here, no. There are lots of midwives around, but most of them aren't terribly natural birth friendly, and neither are the hospitals (I'm in New Jersey, which pretty much says it all, doesn't it?). My only other option if I'm dropped is to try to find a homebirth midwife who will take me on this late. I'm guessing that's doubtful, would be expensive, and my husband wouldn't be pleased.
[snip]
I think I'll call one of the homebirth midwives up here tonight and see what she has to say about taking patients late, just in case.

If the HBMW you have the appointment with doesn't seem like a good fit either, try contacting one of the ICAN leaders in NJ (I'm the one in southern NJ). They might be able to suggest a few names.

Hope you get it worked out!

[courtenay_e]

My concern with staying with this practice would be that they will stick your baby over and over again after birth because they "don't know your status"...so they'll be "looking for" low blood sugar in the baby and then force formula on you/baby, separate you and baby, and generally make your immediate post partum quite difficult.

I also don't know the HB midwives practicing in your area...but I do know a good share of the HB midwives in MY area, and in my experience they will take a client on at 23-25 weeks, easy! I know plenty who've taken 34-35 week clients, some even later. It is generally a thing we have going on in our psyches...if a client finally comes to the conclusion that they want what a homebirth has to offer and the probability of forming a strong relationship and learning a good history is there, then we'd rather the mother get the birth she's looking for. And for goodness' sake, it's not as if you have a life threatening disease--you're turning down the GTT!!

AS far as the GTT goes...some time ago I posted most of Anne Frye's response to Docs requirement of the GTT. It is pretty interesting. I think a forum search of Glucose Tolerance Test or Gestational Diabetes should probably find it.