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Biophysical Profile

1K views 8 replies 5 participants last post by  lovelylisa 
#1 ·
So apparently, since I'm chubby, the drs have decided that I am the perfect canidate for weekly biophysical profiles. I don't have any HBP or GD or anything... they solely decided it on my weight. Sigh. I suck it up and go because I suppose the extra testing comes with the territory. Next time I'll stick to my diet before I get knocked up. One of the midwives insisted that I go because "they aren't a medical facility" so they have to defer to the drs. I get was she was saying but I wasn't sure I liked the answer.

Anyway. I go, even though it's super annoying and pretty stressful because I have to drop my husband off at work every week, drive an hour to to the test, bring my 2 year old son who does NOT like to sit down for any amount of time, chase him around and then he cries through most of the test. I think it's even more annoying because I don't know what they are testing for, they just want to check the baby's heartbeat and movements and such.

I don't want to opt out of something that's good for my baby because I hate it, but on the other hand, my instincts are telling me that this is stupid and a waste of time, and the dr is going to see something that is maybe not perfect and insist I be induced which will cause a c section. I know this comes from a place because something similar happened when I was pregnant with my son. I was induced due to low fluids and basically it was stubborness on my part why I didn't have a csection.

So this ranting brings us to today. I was in a rush, didn't eat and failed the profile. Little baby was sleeping and didn't want to wake up, so we failed the movement part of the test. Then I had to have a NST, which we passed. So I have to return to the office today for another bio profile. If I fail they said I have to go to the hospital for continuous monitoring.

I'm scared. I know part of this is me freaking out because of my experience last time.

I don't know if anyone has had these tests before. Does this happen? What is your experience? Am I gaining anything by these tests?
 
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#2 ·
lovelylisa: I haven't been put through the tests you're doing, but I definitely sympathize with you being labelled because of your weight. That has been my constant battle with my midwife as well. I'm being half forced half guilted into having a consult with an OB - "just in case" which I think is absolute bull. I passed my GD test with flying colors and only once have I had an abnormal BP reading. But I'm overweight so clearly I must be unhealthy and endangering my baby.
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Are there some risks that are a bit higher with an overweight woman? Yes, there are. But being overweight does not by definition make you high risk. When (and I do mean when, not if!) you pass the profile today, ask them for a reason why you are having this extra testing run. If they have no reason for it besides your weight, I personally would tell them thanks for the concern, but no thanks on the tests. If they have a valid medical reason for them, then fine, but weight-phobia is NOT a valid medical reason.
 
#4 ·
I think it's up to them to prove beyond a reasonable doubt that there's a medical indication for the testing. If they can't practice evidence-based medicine other than discriminating against you because of your weight, I'm not sure why I see the reasoning for you to submit to the testing. The burden of proof should be on them. Scaring you into more testing without a valid reason is not good enough. It would appear that they're doing exactly what you suspect them of, which is to railroad you into unnecessary interventions. The choice to resume testing or go for more frequent testing is ultimately yours and should be respected by your care providers.
 
#5 ·
The MFM doc I saw a few times at the beginning of this pg told me I would need biophysical profiles and NSTs starting around 30w based solely on my age. I'm 41. I did my own research and learned that I did not meet any of the health or medical risk factors that justified this extra testing. I talked to my MW about it and decided I wouldn't do it. It's not entirely true that just having the ultrasound doesn't come with it's own risks. There could very well be risks when exposing a baby to so many ultrasounds. The fact is that no one knows for sure that it is absolutely, 100% safe. There are the risks you have brought up that the docs might find something they think could possibly be a problem. That could lead to a cascade of medical interventions and the next think you know you are in the hospital being induced early, which could lead to major surgery and who knows what else. And it may all be completely unnecessary. That's what my MW was most concerned about with me if I agreed to the testing. She said it was basically setting myself up for the docs to find something wrong.

So, my point is that if you aren't comfortable with it and you don't think it's necessary, you can (and probably should) decline it. Don't let the docs push you around and coerce you using fear into something that may be completely unnecessary as well as possibly dangerous
 
#6 ·
Thanks ladies. The letter that they sent to my midwife said that it was solely because of me being overweight. And like you ladies said, I'm truly aware that there are risks with being overweight. I know that, and I have been eating very well (not perfect, but no one is perfect) and I haven't gained but 7 lbs this pregnancy. Which, if we assume the baby weighs almost 5-6 lbs now, I'd say I'm doing OK. I also don't have any medical issues, and I really don't have any complaints with this pregnancy that aren't pregnancy related- like nasuea and pelvic pain, that sort of stuff.

I did pass the profile when I went back today... this little girl kicks and moves, but she's not a big roller around in there. One of the criteria of the test is that the baby gives 3 whole body moves during the duration of the test. They also have been trying to complete the anatomy scan from 20 weeks (when you find out the gender). The girl is comfy and she doesn't want to show her face so they can complete the scan. I really don't see what the big deal is, and what seeing her face would be able to determine anyway. If she has something like a cleft palate, I don't think there is anything they can do until she is born anyway. But still, they had me come back every 4 weeks to try and get a picture of her face- which she still hasn't shown... and now I'm going weekly for these tests.

I have an appointment with the midwives tonight, and I'll discuss this more with them. I wish I had read your suggestion earlier to talk about it at the 2nd appointment today. I really just wanted it over with so I spent my time sending her "please move" thoughts. I don't really think that I could win any argument with them regarding the testing....it's apparently what they do. I see the same ladies there every week for the biophysical profiles, and while I don't know what their history is, I can see that they are also in my weight division ;)

Sigh. I hope that this was just a one time thing and I don't have to fight every week. I'm much better expressing myself in writing than I verbally sometimes, especially with drs.
 
#7 ·
Quote:
Originally Posted by MarineWife View Post

The MFM doc I saw a few times at the beginning of this pg told me I would need biophysical profiles and NSTs starting around 30w based solely on my age. I'm 41. I did my own research and learned that I did not meet any of the health or medical risk factors that justified this extra testing. I talked to my MW about it and decided I wouldn't do it. It's not entirely true that just having the ultrasound doesn't come with it's own risks. There could very well be risks when exposing a baby to so many ultrasounds. The fact is that no one knows for sure that it is absolutely, 100% safe. There are the risks you have brought up that the docs might find something they think could possibly be a problem. That could lead to a cascade of medical interventions and the next think you know you are in the hospital being induced early, which could lead to major surgery and who knows what else. And it may all be completely unnecessary. That's what my MW was most concerned about with me if I agreed to the testing. She said it was basically setting myself up for the docs to find something wrong.

So, my point is that if you aren't comfortable with it and you don't think it's necessary, you can (and probably should) decline it. Don't let the docs push you around and coerce you using fear into something that may be completely unnecessary as well as possibly dangerous
Yeah! That too! I read a whole bunch of articles about ultrasounds which also freaked me out.

I will discuss this some more. I have to remain strong and stick to my concerns.
 
#8 ·
Quote:
Originally Posted by lovelylisa View Post

I don't really think that I could win any argument with them regarding the testing....it's apparently what they do.
It shouldn't be an argument. They should give you evidenced based medical reasons other than just a generic, "you're overweight", why YOU need this. If they can't, you just decline. They can't force you to come in. You are not required by any kind of law to receive any medical maternity care at all and definitely not extra testing/screening/monitoring when there's no good reason for it. They won't come to your house, kidnap you and strap you to the bed so they can monitor you. Frankly, when stuff like this comes up, the first thing that comes to my mind is that the docs are just looking for ways to bill the insurance companies more money.

You do have to be forceful and stick your guns because they may (sounds like with these docs, they probably will) try to persuade you otherwise. I got a call back from the MFM doc's assistant after I canceled my appointment for the first biophysical profile. She tried to persuade me that I needed it but I just told her again, "No thanks." I haven't heard from them since. I made it clear to the doc the 2 times I saw him earlier in my pg that I wasn't interested in nor did I think that extra monitoring was necessary unless I had a specific problem. My MWs are perfectly capable of detecting problems like IUGR.
 
#9 ·
So I talked to the midwife this evening (the only I love and find it very easy to talk to) and she was with me 100% on the testing and she agreed that I didn't really need to go. She said some of her patients opt to go every 2 weeks, so I could consider that but she said that a lot of people decide not to go at all . So I think I will at least cancel next weeks appointment and consider going every two weeks... if I decide to go at all.

Thank you all for your input!
 
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