gestional diabetes testing ? (esp. for moms not really testing at all for anything) - Mothering Forums

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#1 of 8 Old 08-31-2006, 12:07 PM - Thread Starter
 
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Hi there! Due to legal issues in my state (which I think are very crummy), I am required to have 3 OB visits in order to have a midwife-attended homebirth. My DH doesn't feel comfortable with UC even though this will be our second HB. Anyhow, that brings me to my question...

I want to comply and be a "good patient" b/c there is only one HB midwife in the area. I think that I will get the birth that *I* want b/c I believe baby will arrive before the midwife gets here (she is a little over an hour away and I am FAST!)

OK, I seem to have a hard time getting to the question!

At 28 weeks, they want me to take the test for gestational diabetes, which I don't want. Help me find some good info! First of all, my first DS was 7 lb 3 oz, born on his due date. I gained about 40 or so pounds with him, and I started this pregnancy at 148 lbs, and I am 5'8". Plus, I was excercising every day pre-preg. I am not exercising much now (still extremely nauseous at 19 weeks). I plan to exercise more when I can.

Let's say I did test positive. Well, one of the risks is large size -- I have *very* wide "birthing" hips, and I believe I could have a 12 lb baby with no problem (even smaller ladies do this!). I have also read about respiratory issues. What else is there, and is it *necessarily* related to G-diabetes?

My MW in Texas was fine with skipping the test, but this time... I feel I have to defend myself. It is not an ideal situation (all the medical stuff), but I want my DH to feel comfortable, and in the end, it will be the birth that we both want so...

What do you ladies have to say?

Jean, happy HS mom to Peter (5), Daniel (9) and Lucie (2) and also someone new... baby.gif
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#2 of 8 Old 08-31-2006, 12:32 PM
 
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Do a search for GD and Henci Goer. She has the best information out there on GD.

Can you do your 3 OB visits all before 28 weeks?

-Angela
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#3 of 8 Old 08-31-2006, 12:33 PM
 
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Get a glucometer and measure regularly at home if you're concerned.
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#4 of 8 Old 08-31-2006, 02:05 PM
 
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as i understand it, the "test for gestational diabetes" is merely a screening test for your body's ability to tolerate glucose in your blood. it is usually called the glucose tolerance test or GTT. it is not a diagnostic test, meaning it would not lead them to give you a label of "having gestational diabetes" if your test results fall outside the parameters, but they would require further testing (a 3 hour test after the 1 hour test) and they would look for further markers for gestational diabetes, such as greater than usual weight gain (which you may fall into if your pregnancy is similar to your previous one) and a larger than average baby (as viewed on ultrasound, which is highly variable and can be +/- 1-2 lbs beginning in the early third trimester).

i can understand the "wanting to be a good patient" to preserve your homebirth option, but it sounds like completing your ob appointments prior to 28 weeks might be a good option. if part of the requirements stipulate you must have an appointment in the third trimester, you might consider waiting until close to that date to broach the subject of the GTT with the ob's office. call them up a few days before the appointment and say something like, "i understand the dr. would like me to have the GTT at this next appointment, and i have some questions for him/her. could they call me back?" then when they call back, ask "i have some questions about the GTT that you would like me to have at this next appointment. as i understand, it's only a screening test for people who might have problems with glucose levels in their blood, and i don't believe i fall into this category. my diet is very healthy, my weight gain is normal, and my baby is growing well. are there any other options for testing my blood glucose instead?" if the doctor seems hesitant or insistent that you do this test, ask them why they prefer doing this test and what information it helps to give them. don't hint on the phone that you are going to refuse the test in a few days but tell them thank you for the information and that you have some more thinking to do. if the doc is open to other options, great, tell them you would like to do that instead if they sound like feasible options.

~claudia
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#5 of 8 Old 08-31-2006, 03:11 PM - Thread Starter
 
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Wow! Thanks ladies, for the great replies. I was hoping I'd hear from you, Angela. From your other posts, it seems like we are like-minded.

To clarify, I am not worried about GD. I want to refuse the test while still cooperating with my MW. I hate seeming like the kind of b*tchy and hard-to-deal-with client, but this is way more medical than I am comfortable with.

I *so* wish that I could just do everything prior to 28, but the visits are supposed to be for 20, 28, and 36-weeks. And then, they schedule one for 41 weeks "to discuss my options for going overdue." I hate to tell them, but my "option" is going to be to sit at home and twiddle my thumbs! I just didn't say anything as my intuition tells me that I won't even go to my due date.

I just now looked up the Henci Goer info, and it is just what I wanted! I recommend it to everybody. And Claudia, thanks so much for providing me with a script!

Jean, happy HS mom to Peter (5), Daniel (9) and Lucie (2) and also someone new... baby.gif
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#6 of 8 Old 08-31-2006, 03:13 PM
 
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It'd be good to know why you want to refuse the test (if you also want to be a "good patient.") I took the test last pregnancy, and am not opposed in principle to testing--I just didn't want to drink the nasty stuff and spike my blood sugar this time, so I asked my midwife if I could avoid that. She said she'd do a fasting blood draw, and then send me out for a hearty breakfast, and then do another, so they could see how my body deals with the regular sugar levels I'm encountering. Actually, I'm pretty sure she'd allow me to refuse the test completely (she seemed open to me refusing anything at my first appt.) But since I don't at all mind needle sticks and love to go out for breakfast, I thought that sounded like a good alternative .

So is it the whole idea of GTT testing, or is it the particulars of how it's generally done by OBs that makes you not want it?
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#7 of 8 Old 08-31-2006, 03:33 PM - Thread Starter
 
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Quote:
Originally Posted by simcon

So is it the whole idea of GTT testing, or is it the particulars of how it's generally done by OBs that makes you not want it?
Hey Simcon, like you, I am very much in favor of a big breakfast out!

I don't want the test b/c if I were to show "glucose intolerance" I would become high risk and my MW would not attend my homebirth. For many reasons, I do not believe the "test" assesses true risk of anything.

I think that I am on the conservative side in terms of risk-taking and I think that this test does not offer any benefit to a very healthy woman at a healthy weight. Especially one who has a history as good as I have.

Maybe as a good alternative, I will compromise by eating a huge, delicious breakfast and then refusing the test!

And by DS' request: : : :

Jean, happy HS mom to Peter (5), Daniel (9) and Lucie (2) and also someone new... baby.gif
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#8 of 8 Old 08-31-2006, 09:53 PM
 
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it's not an in-office test, but a thing where you go to a lab, have a drink, wait an hour, do the draw...
therefore, at 28 weeks, they'll write the lab order. You could lose it and not mention it to anybody until the next visit, where they'd be annoyed with you but too late to do anything.

But maybe you should just do it- failing the test doesn't give you a GD diagnosis, just an order for the 3 hour test. So ask your midwife, maybe she'd attend you as long as the 2nd round turned out OK (or was skipped)

Berkeley mom of 3 and President of Tender Cargo Baby Gear
and The Nurture Center Store and Resource Center 3399 Mt Diablo Bl Lafayette CA 888-998-BABY
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