Any thoughts on the glucose screening? - Mothering Forums

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#1 of 18 Old 04-03-2010, 01:17 AM - Thread Starter
 
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I am wondering if anyone else is planning on refusing the glucose screening and if so what that conversation with your provider might be like. I have a an excellent midwife but she told me at our first appointment its a routine test her practice performs which really surprised me. She does natural childbirth and waterbirth so I really thought she would be less routine with testing. She is definitely a type "A" and I don't want to step on anyone's toes and sour the relationship, however I really think it's a waste of time. With my last pregnancy I was literally sick from the test and ended up testing positive and taking the three hour test. Everything was fine in the end, which I hear is quite common, and that is one of the reasons I think the test is unnecessary. I just don't want to put myself through the hassle and worry again! Any thoughts would be appreciated, I want to be able to back up my reasons!

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#2 of 18 Old 04-03-2010, 03:46 AM
 
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When my midwife wanted to do the glucose testing during my last pregnancy, horrible thoughts of that nasty drink filled my head from my first pregnancy (which I failed the first and then had to take the three hour test)... I was sooo bummed, but then she told me that she takes the blood herself at my house and I don't have to drink the "yuck". I just had to fast for one or two hours (can't remember which). It was very easy. So, maybe your midwife does testing like mine does?

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#3 of 18 Old 04-03-2010, 09:20 AM
 
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My birthing centre is the only place I've ever heard of that does NOT do this test routinely. Instead, they inform all women of healthy habits and the risk factors for GD. Only those with risk factors or symptoms are recommended for testing. I really appreciate this preventative and educational approach.

I have a serious sweet tooth and a lot of trouble eating well during pregnancy and my blood sugar levels are all over the place at the best of times (though usually on the low side) so I would consider the testing. However, my DH has type 2 diabetes so I just use is finger-prick testing kit every once in a while instead. With DS, I was always fine.

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#4 of 18 Old 04-03-2010, 11:27 AM
 
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I could have written this post. I also plan on refusing it but not really sure how to bring it up. I think I will bring my midwife an article that I read about it that pretty much says it is an unnecessary test. Here is the link: http://www.childbirthconnection.org/pdfs/gecpc3ch11.pdf

it comes from "A Guide to Effective Care in Pregnancy and Childbirth"
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#5 of 18 Old 04-03-2010, 12:49 PM
 
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I wouldn't refuse it. I had no symptoms with Ds besides peeing alot, but what pregnant woman doesn't do that. I was borderline with the one hour test, and totally failed the 3 hour. At one hour my sugar was 194, 2 hours it was 213 and 3 hours it was 212. 180 being the magic number for an insulin shot. I am not overweight and diabetes does not run in my family. In fact I was the first woman to have GD in my family. DS was 6lb 10 oz at 35 week gestation and my numbers had been good (130ish two hours after I ate) with only once my sugar spiking to 180. I'm pretty sure I delivered early because I had too much amniotic fluid which is common with GD. The test sucks but had I not had it I wouldn't have known. Too much sugar just makes big babies who's lungs are even more immature at birth (which is why ds was in the nicu for 2 weeks even though he was 35 weeks complete and the nurse informed me even full term babies of mom's with GD end up in the nicu for sometime b.c the GD prohibits the lungs from maturing). but if you are passing ketones that can damage the baby and cause a lot of problems which is why if you have GD you have to pee on the ketone strips every morning. But everyone is educated and knows the risks, I myself will be doing the test at 14 weeks and again at 28. I do not want another nicu baby and knowing won't necessarily prevent that but at least I will be prepared.
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#6 of 18 Old 04-03-2010, 03:14 PM
 
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My M.O. for refusing any test is to wait until they offer it.

I would also want to hear the details.

With the one hour test, I would do it if it did not involve the sugar drink, so if they offer me that, I'll ask for the alternative, and if I don't like the sound of that, then I'll say "You know, I really don't want to do it, do you feel there's a strong medical reason for me to do it?"

And there may be. If the answer was "It's routine in our practice." that wouldn't be good enough for me.

If the answer was "I think you're measuring a bit ahead, maybe because you have a lot of amniotic fluid, which can be a symptom of GD, and you're overweight, which is a risk factor for GD..." then I might take it.

It strikes me that any midwife who isn't practicing within an informed choice model of care (as opposed to informed consent) is more of a medwife than a midwife.

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#7 of 18 Old 04-03-2010, 03:22 PM
 
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I plan on doing it. If you weigh the risk vs. benefit I see no reason to skip it. I passed the 1-hour with flying colors with both kids but will still do it again.

FWIW, the glucola just tastes like orange pop. I don't know why everyone thinks it's so nasty.
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#8 of 18 Old 04-03-2010, 04:40 PM
 
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Here's a post that I found helpful about GD testing. It also talks about alternatives to the standard 1hr screening test and 3hr diagnostic test.
http://www.themidwifenextdoor.com/?p=747

With my MWs, we do a urine dip at every appointment, we keep track of my weight and fundal measurements, and I am conscious of what I eat. I do not have any of the standard risk factors other than being slightly older (though not AMA). I will probably not do the standard tests at all. If we do become concerned we will monitor my blood sugar with finger sticks.

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#9 of 18 Old 04-03-2010, 05:19 PM
 
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I'll be refusing the test, but I home test every day! I had GD with DD and have already had some higher fasting (morning) numbers (at 14 weeks) so I'm keeping a close eye on things. I tried not to worry much about it through the first tri just because eating a GD diet with morning sickness is REALLY hard.

When I was diagnosed with DD I had no symptoms (which is typical). At 33 weeks after trying to control with food and exercise I ended up on insulin. I couldn't keep my fasting numbers down. DD was born (after induction) at 38 weeks and had some oxygen problems right away and then was really jaundiced - numbers so high that she was admitted at 5 days. Both problems are typical of GD babies.

I would ask your midwife if you could do an alternative version of the test - checking your typical fasting numbers (should be under about 90) and then eating a high carb breakfast with a big glass of OJ and coming back 2 hours after beginning that meal to see if your number is in range.

The link that Eresh posted might have the typical routine for the alternate testing.

My Dr is happy to have me self-test and also do a A1C blood test every 12 weeks (to check average glucose levels over a 10-12 week period). She is also going to let me go to 41 weeks this time as long as everything looks good.

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#10 of 18 Old 04-03-2010, 05:39 PM
 
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I planned on refusing it last time and ended up agreeing because I was measuring ahead. I'm absolutely not doing it this time because the glucola was just as awful as I imagined it would be and I tend to have abnormally low blood sugars anyway.

I will offer to do any alternative blood tests that don't involve the glucola. (i.e. I'd be fine with normal food or even something gross like a can of Coke.) I'll even offer to test at home...as many times per day as my doctor wants. There is no way in hell though that I'm drinking the glucola again.

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#11 of 18 Old 04-03-2010, 06:37 PM
 
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GD can cause serious complications and I don't feel the test is invasive, so I always do it.
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#12 of 18 Old 04-03-2010, 06:45 PM
 
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crashing your DDC, saw this on new posts. I had my second child past the magic age of 35 where numerous tests become standard. I refused them all. I had been under the care of a Nurse Practitioner and the glucose test was the only one she fought me on. Reminded me that she didn't pressure me on any other test she offered, she let me trust my body and my ability to know if something didn't feel right. But the glucose test was one she was really going to push me for. For some of the reasons stated above. So the long and the short of it is, I went ahead and had the test. Now my 3 year old came with me to every prenatal appointment I had, but I was warned to get someone to watch him for this, because I would have to sit and wait.

Let me tell you, that hour where I sat there on a comfy chair with my feet up just quietly reading a book was the most relaxing enjoyable hour of my entire pregnancy. By the end I was secretly hoping I would fail so I could come back for the three hour test. I turned out to be okay though.
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#13 of 18 Old 04-03-2010, 07:46 PM
 
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I'm w/prettyuglybefore - I will do my own finger stick tests and if those look off, then what? I'll go on the diet and continue to monitor and then if it became necessary I'd of course get treatment.

But a test to purposely make yourself sick and your body react to something completely abnormal for most people!?!?! - that is stupid IMO. Hippocratic oath anyone? Do no harm? I mean I drink pop so I don't personally find the glucola all that gross, but fasting and drinking large amounts of sugar make me seriously ill when pg and I've always failed the first test and passed the 3hr with flying colors when I did take it...after being extremely ill. I fail to see the point of that when I can finger stick and check for anything abnormal in a "normal" way. That makes a lot more sense to me personally, so that's what I do.

I have a friend who is diabetic that I can borrow the meter and pay them for the sticks or one time I bought the $19.99 kit at Walgreens which was enough to do regular testing for a week.

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#14 of 18 Old 04-03-2010, 08:30 PM
 
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With my last pregnancy, I was offered the sickly orange drink or, a nice alternative of eating some eggs and toast and juice (or something along those lines). Maybe I was "off" eggs at the time or the drink just seemed easier, but I chose the drink. It went down fine, but I nearly threw up before the testing. I'll be doing the test again this time - just with the alternative option.

See if you can do something similar. I'm surprised that it wasn't actually offered to you as an option.
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#15 of 18 Old 04-03-2010, 11:17 PM - Thread Starter
 
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Medwife, hmm, thanks FtMPapa, hadn't heard that one before
I will ask about an alternative test when she brings it up and if she doesn't agree...well, then we have a problem.
I do think that it's strange to make myself sick on a huge dose of refined sugar when I never ever eat like that. Okay, maybe on Easter I will

Anyway, thanks for the links and advice, very helpful!

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#16 of 18 Old 04-05-2010, 02:25 AM
 
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I am going to ask about eating my own "diet" and going in for testing, I'm not going to ask for it unless I start to show sign/symptoms. I have my own meter, and may test on my own, too.

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#17 of 18 Old 04-05-2010, 04:56 PM
 
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I don't do it. It's not standard in my homebirth midwife's practice. I love homebirth.

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#18 of 18 Old 04-05-2010, 06:17 PM
 
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My midwife does it if you want and it's the eat real food version. I'll probably have it done b/c I'm a worrywart. If I would have to do the orange drink though there's no way. That made me sick all day last time.

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