Refusing the glucose test-how did it go? - Mothering Forums

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Old 02-18-2006, 12:15 AM - Thread Starter
 
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I've decided not to do the glucose test this time around. I didn't know better the first two times. Besides I eat well, excercise, and passed with lower than usual results before. So what is the best way to say no without seeming like a pain, and sound like i know what I am doing. For those of you who have done this before, how did your MW react? I'm hoping it won't be too bad because my MW are pretty uninterventionist, but I want to be prepared,
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Old 02-18-2006, 01:17 AM
 
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I said no and got dumped by my midwife. It was the single BEST thing that happened to me all pregnancy. Found out she was not at all what she sold herself as. I switched at 30 weeks and got a WONDERFUL midwife who attended a peaceful perfect homebirth.

-Angela
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Old 02-18-2006, 01:46 AM
 
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I did the glucose test, but I did not drink that crap drink, I did a special breakfast, that was yummy! Can I ask why you do not want to do the glucose test?
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Old 02-18-2006, 03:22 AM
 
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Quote:
Originally Posted by BabyDakota
Can I ask why you do not want to do the glucose test?
I did my own research and could not find anything that proved that:

1. it is actually a condition that can be defined
2. that "treatment" helped
3. that there was any purpose to the label.

add to that that you will get slapped with a "high risk" label quite probably and be pressured to induce, no thank you. For more info do a search on GD and Henci Goer.

-Angela
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Old 02-18-2006, 03:52 AM
 
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I'm receiving concurrent care from my family practitioner (one more appt) and a homebirth midwife. My homebirth midwife is fine with it and, surprisingly, my FP was fine with it too. I saw my FP on Wed and we were talking about when my next appointment would be (I'm 18 weeks). She suggested 27 weeks for the GTT and I told her I was not doing it unless, for some reason, I started showing signs of GD. She just nodded and said I was obviously well-informed.

OTOH, she was very concerned about the "dangers" of a vaginal birth without knowing if the baby had a neural tube defect because I declined the quad screen.

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Old 02-18-2006, 11:35 AM - Thread Starter
 
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BabyDakota, I just don't see the point. From the standpoint that it is as serious a problem as the medical community believes, I eat well excercise, I'm a healthy weight, diabetes doesn't run in my family, and both my preivious girls were born fullterm, uninduced at around 6.5 pounds. Oh, I passed two times previously with lower than average blood sugar.

However, from my research, I don't believe that it is anywhere near the problem that it is made out to be, and I don't want to put that sugary crap in my body. I really wish I knew what kind of sugar is used in the drink. I haven't been able to find that info. If it is high fructose corn syrup,I wouldn't go near it. The test sets women up to fail. And while I can see the possible problem to having a "large" baby, nine or ten pounds isn't that large. And it seems the most docs think that that is huge. I think that is more of a labor possition problem than a GD problem. I just don't want my pregnancy to be medicalized when I know how to take care of myself and am very low risk.
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Old 02-18-2006, 01:45 PM
 
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Well, how did it go?
Not that great!

First, at my first appt I got the "bad" midwife at the CNM practice I am using (unfortunately homebirth is not an open option for me at this time). She doesn't attend births, and she is a TOTAL Med-wife. She harassed me about my "dates" told me I needed an ultrasound ASAP to "confirm" my dates, even though I TOLD her I was charting, knew exactly when I got pregnant, etc. When I asked why having exact dates was such a big deal, she said so they could do the glucose test at the right time, for one. She told me my only options WRT the test were to eat jelly beans or drink the sugar crap. By this time I was about to walk out the door and never come back...

Thankfully the midwife came in after this, and talked with me. She's been a true midwife so far every time I've seen her. She asked me to do a blood sugar screen 2 hours after a meal, which is MUCH more reasonable, and makes sense to me. I agreed, that is a compromise that keeps her OBs happy, and that I can live with. (She has to work with the OBs due to the way the laws are in my state)

So, I didn't totally refuse it, but I didn't drink the sugar stuff either.

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Old 02-18-2006, 01:58 PM
 
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The sugar is glucose. That's why it's called a Glucose Tolerance Test.
But that doesn't matter. You don't need the test.

Before I even became pregnant and I was interviewing MW's, I lined out the tests I would not be allowing, GTT (GD) being one of them. My MW told me that nothing I had said was out of the ordinary. Specifically, she does not request the GTT for low-risk, healthy weight-women. And as a HB MW, all she sees are low-risk healthy women.

It's a pointless test unless you have some risk factors, and even then it can mostly be managed with diet and excercise.
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Old 02-18-2006, 02:22 PM
 
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It does have high fructose corn syrup in it. It basically has the same ingredients as an orange flavored soda. That is why I asked for an alternative and they let me eat some bacon, eggs, toast and drink some orange juice, only a certain amount in 15 minutes the 1.5 or 2 hours before the test. I really did not have a problem with doing the test. In fact, besides one ultrasound, it was the only test done. I had an U/S done to get my date more accurate, I was off by 17 days! I am glad I did it, or I would have probably gone into labor while at work, and not taken off 2 weeks early to rest and catch up on some stuff.
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Old 02-18-2006, 02:51 PM
 
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I talked about this at the first midwife appointment. I said I wouldn't be doing any test, except the GBS test, and if the GBS test came back positive, I would treat it naturally. She was surprised that I thought it would be a problem. She said it is her job to offer me whatever tests, explain them fully, and support any decision I made. She was surprised when I told her I know of lots of people whose midwives dumped them after they refused the GD or some other test.

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Old 02-19-2006, 11:11 AM - Thread Starter
 
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Really any sugar can be used to test glucose because the liver converts all sugars we consume into glucose. I believe that most plant based sugare are glucose, including HFCS. I assume that the drink is HFCS because that is the cheapest and easiest to acquire form of sugar. It's what's in all sodas, and btw it doesn't break down in your stomach. It hits the liver in the same form that it was consumed. Because of the wierd way it metabolizes it's being linked to obesity, diabetes, and high blood pressure, etc. No thank you.
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Old 02-19-2006, 09:40 PM
 
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How'd it go? Well the usual doc I was seeing, she and the doc that she had to check out with seemed to be fine with my refusing the GTT. I had refused just about every one of the tests offered me and they said they could see that I viewed birth as a natural event and all, so do we, but wanted to make sure that I would still be open to the idea of a section, etc. if the need arose. Um, no, I don't want all your extra tests and interventions but if it came down to a literal do or die situation where my life or my child's life were in danger, yeah, I'm going to fight you if a section is absolutely necessary b/c I certainly cannot be capable of making an informed decision. Silly patient...

I had to see a different doc next prenatal and she seemed to be fine with my decision as well but the doc that she had to check out with was ridiculous. And that she kept trying to pressure me into it really cheesed me. She said some pretty stupid things to me, one being that when I said that I totally trust my body to grow and birth this baby and I wasn't worried about him or her, she goes and says well I am. : WTF? All this after I had given my reasons (all of which I'm sure have been mentioned here on the I'm PG forum at some point or another ) to 3 different docs before dealing with her.

So of course I'm getting pretty flustered and frustrated at this point and my poor PG brain is smoking. So I just flat out said I just don't want it and she finally dropped it. We were discussing this in the May DDC as well and I think that the best course of action is just to be short and sweet.

Dealing with OBs and the hospital has definitely been an excellent learning experience for me. Not that I don't think there is without a doubt a time and place for medical care , I now know 1st hand why I've always wanted a HB with a good MW. And if I have to scrape together every penny I find from now until the next time DH and I conceive, God and good health willing, I will get the : that we could not afford this time.

Look at me, I'm still agitated when I think about it!

I hope your MW does not give you too much static mama. Good luck!

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Old 02-19-2006, 09:48 PM
 
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I had refused the test and told my midwife why. She insisted that I get it. I just haven't gone to get it done...so this past apptointment she told me that if I do not get it in two weeks that I will be labled "non-compliant" and high risk. This means I will have to see one of the OBs, possibly not be allowed my VBAC, and drug tested. (??wtf) I have no idea why being drug tested has anything to do with a Glucose test....

So after talking it over with DH I am going to get the test done. But we are actively looking for a new midwife and I am 34 weeks along......
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Old 02-20-2006, 03:38 AM
 
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Wow. sounds like a medwife to run from. FWIW though you can refuse to let them take blood/urine to drug test....

-Angela
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Old 02-20-2006, 10:57 AM
 
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I just had a babe 6 wks ago & did not want the GTT test. The mw was fine with this and we compromised (she works with an OB) by doing the blood draw 2 hours after eatin a meal. I just told her the drink always made me sick and from the reading I had done I wasn't convinced the test was called for. She supported me 100%. I also refused to be weighed which drove the nurses nuts but my mw supported 110%! She was wonderful! I would say search until you find one who supports your choices....it's your pregnancy.

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Old 02-20-2006, 01:19 PM
 
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You can always say that you checked your blood sugar after a heavy meal. I don't think that's a bad idea actually, I tend to think that this information would be far more interpretable than the glucose test because it;s an artificially induced situation.
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Old 02-20-2006, 02:30 PM
 
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I just wanted to post this article I found, and I plan to use it this time around when I refuse the test.....

The American College of Obstetrics and Gynecologists (ACOG) said in a recent statement to the media that there is not one certain method to be used to effectively screen the pregnant population for gestational diabetes. They do not, however, know what screening is best or agree on when the screening should take place.

One of the most intriguing recommendations is that a woman may not need laboratory testing to screen for GDM if she meets all of the following criteria:

less than 25 years old
not a member of a racial or ethnic group with a high prevalence of diabetes (eg, Hispanic, African, Native American, South or East Asian, or Pacific Islands ancestry)
a body mass index (BMI) 25
no history of abnormal glucose tolerance
no previous history of adverse pregnancy outcomes usually associated with GDM
no known diabetes in first-degree relative

Women who are at a higher risk for GDM usually have one of the following risk factors:

age
ethnicity
obesity
family history of diabetes
past obstetric history
While diet and exercise are the mainstays of treating GDM, there are not a lot of concrete studies indicating that one way is best for anyone. While it has been popular in the past to place women with GDM on restrictive diets, particularly caloric intake, ACOG now advises that this may not be desirable. In fact, they state quite clearly that even if one chooses to restrict caloric intake no more than 33% of the calories should be removed from the woman's diet. Though the focus should definitely be on proper nutrition and eating habits. When conventional therapies involving diet do not bring about the desired changes in glucose levels insulin should be considered.

Other things that were long held in popular belief for women with GDM includes routine early induction simply because they had GDM. "When glucose levels are under control, and no other complications arise, there is no strong evidence to support routine delivery before 40 weeks of gestation," says the report issued on August 31, 2001. They gone on to report, "Although cesarean delivery rates are higher in women with GDM, ACOG notes that there are no data to support a policy of cesarean delivery purely on the basis of GDM."

by Robin Elise Weiss, ICCE-CPE, CD(DONA), CLD

http://pregnancy.about.com/cs/testin.../bl100101a.htm
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Old 02-20-2006, 03:08 PM
 
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So how about you ladies who are wary of taking the test or don't believe treatment helps, but have one or more risk factors...do you still waive the test? Through my own research and by following links posted on this and other MDC forums, I've found that (1) being labeled with GD will increase my risk of a c-section, (2) fasting for twelve hours in preparation for the test will send my body into starvation mode, (3) I don't think the screening method that is often used is the most effective way to screen for GD if it does in fact exist, (4) it is overdiagnosed, etc.....

On the other hand, diabetes runs in my family. My aunt, uncle, and grandmother (all on my father's side) have (or had) diabetes. My dad doesn't have it. I took the GTT with my first pregnancy and BARELY failed the 1-hr screening, then passed the 3-hr with flying colors. I didn't take it in my last pregnancy mainly because we were cash patients and I couldn't afford it, plus I have strong anxiety about needles and I almost had a panic attack during my first screening...which I don't think is good for me or my baby, especially when I'm also hungry, woozy, etc. After I took the GTT w/ Preg #1 I was sick for days...it took me a long time to recover from fasting and then having all that nasty sugar in my body.

At my OB appointment this Friday they are hoping to schedule it. I am 95% sure that I won't be taking the test, but 5% of me is concerned that diabetes does run in my family. I have been on a good diet w/ exercise lately. I guess I'd just like to know what others have done or would do in my situation.

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Old 02-20-2006, 03:10 PM
 
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If I had risk factors, then I would act as if I did have it and adjust my diet accordingly. I would also monitor my blood sugar.

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