Blood work

1114 Views 32 Replies 13 Participants Last post by JennyClaire, Aug 12, 2006

chemE_momE

Discussion Starter · Aug 9, 2006

Has anyone declined all blood tests during pregnancy? I'm just curious. There is usually blood work done at the first appointment and then later for gestational diabetes (I know the GD test can sometimes be avoided depending on how much pressure the midwives put on you). What exactly do they test for in the initial blood draw?

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super kitty

· #2 · Aug 9, 2006

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paisley

· #3 · Aug 9, 2006

I'm not sure what they might be testing for in an initial draw. Probably things like blood type, rubella immunity, and so on. Maybe if you already have had bloodwork with #1 to establish these things, could they just use those results? The only other things I can think of would be if you have a history of loss and they want to check on your hormone levels. I would definitely ask and see what kind of flexibility there is. I hope you get the answer you want!

tika

· #4 · Aug 9, 2006

I think it also may depend on your state, they often have "required" tests that the mw is obligated to perform...however, you can refuse even the "required" tests, you just may have to sign a waiver or something but maybe not. I think it also depends on how cool your mw is with it, some may be laid back about it while others may have a cow. Regardless, you have the right to refuse any treatment/testing.

Mavournin

· #5 · Aug 9, 2006

This will be my first pregnancy refusing all tests, but it shouldn't be a problem - my HB midwife is really flexible.

Looking through my old maternity records, the first blood draw tests for CBC, probably HcG, rubella, hepatitis C, HIV (you have to consent for that one), T-4 Free, and TSH. I can't find my records for my second pregnancy right this moment, but I'm sure it's all the same - plus a few extras I had them add in like a test for... oh the thing you can get if you change the cat's box... I'm blanking right now.

Basically it's all just a baseline. You can refuse it, it may not be taken really well, but you can refuse anything.

MrsTC

· #6 · Aug 9, 2006

I will do the finger stick to get a starting place for iron (I feel like this is especially important since I'm still nursing), but I will try to decline the blood draw, since they did it last time and as far as I know they typed my blood, which hasn't changed, and did the rubella thing...maybe.

The birth clinic where I go does a very kind to the mother way of testing for GD...you don't eat after midnight and then eat a prescribed breakfast, which last time for me was 2 pieces of whole wheat toast with a thin spreading of butter or margerine, 2 eggs cooked any style but plain (no cheese), and 4oz of juice. Then they draw blood one hour after the last bite. MUCH better than the sugar shake, I hear. So I'm okay with that one.

Blood work, to me, is not that invasive. Pap smear? No. Routine pelvic checks (they don't do them anyway beyond the first appointment and then after 37 weeks)? No. Amnio? No.

chemE_momE

Discussion Starter · #7 · Aug 9, 2006

Quote:

Originally Posted by super kitty
I won't be having any blood work done this pregnancy but then I'm not seeking any medical assistance for this birth. I hate getting blood work done also! I feel for you!!

Why would it be hard to refuse?

I have brought up declining the GD test twice with my midwives. The first time I was told, "Oh, everyone does that test." The second time the woman just made it sound like they'd give me a really hard time about it. With #1 I was pressured into it even though I KNEW I didn't have GD and I really didn't want to take the test. I had no signs of GD and when the test came back negative I was pissed that I didn't listen to my gut. Some midwives are a real pita about it.

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colobus237

· #8 · Aug 9, 2006

I'd like to know if I have Rh antibodies (lots of placental hemorrhaging at my last birth, hopefully the rhogam kept it in check)...quite sure I don't have syphilis or HIV, but if somehow I did I'd want to know. Blood count and rubella titer are harmless and all told, the information is worth a minute or so of pain to me.

But, you are within your rights to refuse anything you choose to refuse. It's your body. When I have been offered tests or procedures I didn't want, I have said "thanks for that information, I'll take that into consideration, but I'm going to pass today." Repeat as necessary.

colobus237

· #9 · Aug 9, 2006

Also wanted to say that http://www.plus-size-pregnancy.org has great, comprehensive information about GD and GD testing. Highly recommend it.

Mavournin

· #10 · Aug 9, 2006

I will only consent to a GD test if it is based on real food and not that overly sugary fake orange goo. My midwives have you drink a certain amount of OJ and then do a finger prick with a diabetic monitor.

Quote:

Originally Posted by MrsTC
Blood work, to me, is not that invasive.

I think the point is that many people do find bloodwork to be invasive. And the OP has said on another thread that needles and bloodwork really freak her out, so this can be a really big deal. I personally feel like the more bloodwork they do, the more tests run, the more interference you have with a pregnancy that doesn't really need it. Bloodwork results are used all the time as justifications for interventions that harm. Particularly by breaking down our own self-confidence as mothers. I don't want to discount your feelings, which are valid, I just got a little defensive. Sorry.

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tika

· #11 · Aug 9, 2006

To me, it's not about bloodwork being invasive.
It's between what is actually necessary and what is overkill and out of my comfort level. I'm pregnant, not dying.

chemE_momE

Discussion Starter · #12 · Aug 9, 2006

I'm just trying to figure out how necessary the blood work actually is. Is it just a formality, is it just to get baseline numbers, or is it something that could possibly be beneficial to me? If I remember correctly, when they got the blood work results back from my first pregnancy, I didn't feel like I learned anything of any real value. So I feel like this time, what are they going to need to check for that will be different from last time? My blood type, for example, certainly hasn't changed.

The struggle always seems to be going against the mainstream and questioning what the mw's consider to be the "norm" by asking them why they need to do this.

Having blood drawn *is* invasive for me, and that is a big motivation for me in getting my questions answered, but other than that I guess it's sort of beside the point.

Reactions: 1

chemE_momE

Discussion Starter · #13 · Aug 10, 2006

Quote:

Originally Posted by ccohenou
I'd like to know if I have Rh antibodies (lots of placental hemorrhaging at my last birth, hopefully the rhogam kept it in check)...quite sure I don't have syphilis or HIV, but if somehow I did I'd want to know. Blood count and rubella titer are harmless and all told, the information is worth a minute or so of pain to me.

Isn't there something about the baby possibly being Rh- and the mom being Rh+ (and vice versa) that could be an issue? Do you know if that is something they test for?

tika

· #14 · Aug 10, 2006

Perhaps you and your midwife can go through each of the tests that are routinely run and their purpose then you can weed out the ones that you feel are not necessary. If you don't agree to any of them then you have the right to do that. If you only agree to some of them, that may be the difference between one vial of blood being drawn and three or four vials.

tika

· #15 · Aug 10, 2006

Quote:

Originally Posted by chemE_momE
Isn't there something about the baby possibly being Rh- and the mom being Rh+ (and vice versa) that could be an issue? Do you know if that is something they test for?

You should have been tested in your first pregnancy and this never changes. If you were Rh- last pregnancy, you are this pregnancy. If you were positive, you are still positive. Like a blood type, it does not change.

If you are Rh-, you may have been given a Rhogam shot at 28wks (questionable) and one after the birth unless you had baby tested and baby was negative before getting the shot.

chemE_momE

Discussion Starter · #16 · Aug 10, 2006

Quote:

Originally Posted by ccohenou
Also wanted to say that http://www.plus-size-pregnancy.org has great, comprehensive information about GD and GD testing. Highly recommend it.

Thanks so much for the link. I'm checking it out now.

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chemE_momE

Discussion Starter · #17 · Aug 10, 2006

Quote:

Originally Posted by tika
You should have been tested in your first pregnancy and this never changes. If you were Rh- last pregnancy, you are this pregnancy. If you were positive, you are still positive. Like a blood type, it does not change.

If you are Rh-, you may have been given a Rhogam shot at 28wks (questionable) and one after the birth unless you had baby tested and baby was negative before getting the shot.

This isn't ringing any bells, so I guess I am Rh+? I may have to get my files transferred from my previous midwives to the new ones. Do you know how they test if the baby is Rh+/-? Is it important to know?

colobus237

· #18 · Aug 10, 2006

Actually, it's vice-versa - the problem can arise if mom is Rh- and baby is Rh+. If fetal blood gets into the maternal bloodstream during a previous pregnancy or birth, mom's immune system may notice the foreign Rh factor and make antibodies against it, which can cause problems in a future Rh+ baby. By the way, if you are Rh-, baby can only be Rh+ if the father is Rh+. If the father is Rh+, there's a 50-100% chance that the baby will be Rh+ depending on dad's genetic configuration.
In addition to checking your blood type, Rh- women with previous pregnancies are often screened for Rh antibodies, to see if it needs to be monitored during the pregnancy.

As others have said, the usual tests are checks for certain infections that can be harmful to the baby, checking you for anemia, looks like someone above had thyroid testing (hyper- or hypothyroidism can be dangerous in pregnancy), and blood typing & antibody screening if needed.

It sounds like blood draws are difficult for you. If you do decide to have blood tests, I wonder if something like EMLA (an anesthetic cream that you apply an hour before a stick) might make it easier on you?

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chemE_momE

Discussion Starter · #19 · Aug 10, 2006

Quote:

Originally Posted by tika
Perhaps you and your midwife can go through each of the tests that are routinely run and their purpose then you can weed out the ones that you feel are not necessary. If you don't agree to any of them then you have the right to do that. If you only agree to some of them, that may be the difference between one vial of blood being drawn and three or four vials.

That's a good point.

They wanted to draw three vials and I thought that seemed like a lot.

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chemE_momE

Discussion Starter · #20 · Aug 10, 2006

Quote:

Originally Posted by ccohenou
Actually, it's vice-versa - the problem can arise if mom is Rh- and baby is Rh+. If fetal blood gets into the maternal bloodstream during a previous pregnancy or birth, mom's immune system may notice the foreign Rh factor and make antibodies against it, which can cause problems in a future Rh+ baby. By the way, if you are Rh-, baby can only be Rh+ if the father is Rh+. If the father is Rh+, there's a 50-100% chance that the baby will be Rh+ depending on dad's genetic configuration.
In addition to checking your blood type, Rh- women with previous pregnancies are often screened for Rh antibodies, to see if it needs to be monitored during the pregnancy.

As others have said, the usual tests are checks for certain infections that can be harmful to the baby, checking you for anemia, looks like someone above had thyroid testing (hyper- or hypothyroidism can be dangerous in pregnancy), and blood typing & antibody screening if needed.

It sounds like blood draws are difficult for you. If you do decide to have blood tests, I wonder if something like EMLA (an anesthetic cream that you apply an hour before a stick) might make it easier on you?

Thank you so much for this info. If I am Rh- is it something that would have been mentioned to me during my 1st pregnancy? I just looked through all my pregnancy notes and can't find that info. I'm trying to call my previous midwives to ask but the line is busy.

The EMLA is a great idea. I will def use it if I have the test done.

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