gestational diabetes questions

[bookwormommy]

I'm planning a home birth with my first child. I had declined the gestational diabetes test because it seemed unneccesary and not always accurate, from what I've read. I happen to know my blood sugar is low to normal, because I was playing around with a glucometer at work.

My midwife told me that if I have to transfer to the hospital for the birth, and haven't taken this test, that they'll assume I could have it and make my baby be tested multiple times in its first few hours of life.

Does anyone know what the risk of false positives with this test are? I don't understand why I can't refuse the tests for my baby if I don't want them - is this true everywhere or just here in Washington state?

What are other home birthers doing about this - does everyone just get this test?

Erin, due 9/10/06

[mothercat]

Yes, the peds will probably assume you are an undiagnosed GD if you have a bay the is large, say over 9#.

Henci Goer's book, The Thinking Woman's guide to a better birth" has a detailed chapter about GD and the accuracy of the test. Some have described it as a diagnosis in search of a disease. Even the US Public Health Task Force says that the test is not specific or sensitive enough that it should be routine. They recommend that women have the test if they have risk factors such as immediate family member that is insulin dependent diabetic. Or previous baby greater than 10 #.

[BelgianSheepDog]

I had my blood glucose tested after normal meals in the first and third trimesters and those numbers were on record in my chart. I got to have my homebirth, but I'm pretty sure if I had to transfer care those numbers could have been used to convince the staff to leave baby alone.

As it was I had to take the baby in 3 days postpartum for a heart murmur and they asked me a zillion times about my group b strep status...I am SO glad I got tested for that and had my negative results on record, because of that circumstance. So I'm in favor of having these things on record just in case.

[boscopup]

I had my blood glucose tested after normal meals in the first and third trimesters and those numbers were on record in my chart. I got to have my homebirth, but I'm pretty sure if I had to transfer care those numbers could have been used to convince the staff to leave baby alone.

Yeah, I would tell the midwife what your numbers are when playing with the glucometer at various times, and have her put those in your chart. I'm doing the glucometer thing instead of the GTT, and my OB will just put those readings in my chart, so if I have to go to the hospital, it will be clear that I don't have GD.

[sreese68]

My third weighed 9lb, 8ou and was born in the hospital. Since he was over 9lbs, the hospital's policy was to test his blood sugar in case I had GD EVEN THOUGH I had tested negative for it through routine OB testing and had no symptoms. The pediatrician did have to get my consent for it. Unfortunately when she came to talk to me about it all, I had had a very tiring 34-hour labor where I walked a good portion of it (to get my sluggish labor going after water breaking), I had a cold which made the exhaustion worse, and the hospital personnel kept waking me up and disturbing me after birth!!! I was completely exhausted and not thinking clearly. Also, fear of NICU (which we went through with our second) played a factor. My dh was at home with our other kids, so I had no one else there to help me with the decision. Anyway, I agreed, but I regretted it afterwards. Fortunately he was a laid back baby, and he rarely cried when they took blood.

All that to say that if you have a large baby, a previous negative GD test will NOT keep the doctors from wanting to test him.

This time, I refused the GD test. If we have to transport for some reason and we have another large baby, I will refuse any blood sugar testing for him. My other two children were a little over 8lbs, and my dh was 10lb, 11ou even though they induced his mother early, so big babies seem to be the norm over here!!

Oh, and the constant testing and the constant disturbing of my peace and slumber after my last birth both have played a big part in my wanting a homebirth this time.