[mariekitt24]

So, my midwife says I'm required to see a doctor twice during my pregnancy, I suppose because its to determine if I'm high risk or not. During my second visit to the doctor, they did the gestational diabetes screening one hour test. I had asked them if they HAD to do it, because I was only in there to fulfill the requirements of my midwife. they told me they HAD to do it now. I assume I could have refused, but then I figured I would have to stop seeing my midwife because the doctor wouldn't write me off as low risk and they would probably have just kicked me out right there anyway like my first doctor did when I refused a 7 week ultrasound. I had no idea I was going to get stuck doing that test, otherwise I would have prepared for it. We ended up being at the clinic 5 hours that day, it was a terrible experience.
the results came out high, so I have to go take the three hour test, and I'm having an anxiety attack about it. I'm so tired of all these TESTS and midwife visits and doctors visits and I keep telling my husband NEXT TIME WE ARE UC-ING! I'm so depressed right now I want to cry. But besides venting, I guess the purpose of this post was to ask what I can do in the next few days to lessen my chances of failing this next three hour test!

What foods SHOULD I eat? Can you give me some examples because I'm not very food savvy. I plan on cutting out all the sweets and at the very least going for daily walks. On that morning of the first test I just HAPPENED to eat two brownies because I had a craving for sweets, and had been slacking on my exercise. Would that have effected the first test?

For this three hour test they are having me come in "first thing in the morning" at 8 am, and Im not supposed to have had anything to eat since the night before.

 

[ShwarmaQueen]

Quote:

Originally Posted by mariekitt24 Would that have effected the first test?

Stress wrecks havoc on blood sugar.

If I were you, I'd go for a looooong walk (1hr+) before the three hour. This should help immensly. As far as eating, avoid starches/carbs, instead having something with fiber/fat which won't raise your BS.

 

[BoringTales]

In the paperwork my midwife gave me for my GTT it advises that you don't eat anything sugary, and stick to high protein meals without too many carbs. Finish your last meal at least an hour before the test, and don't eat/drink anything else in that hour including gum/mints.

That was for the 1 hour test though. I thought the 3 hour was a fasting test? I've never taken it though, so I could be wrong.

 

[JamieCatheryn]

I was told they're all fasting tests, and they check your sugar before you drink the glucola to be sure it's low from fasting. 70% of those who fail the 1 hour pass the 3, I did when I took it with my 1st, so I would just hang in there and try not to puke or pass out while they do their thing if you are stuck doing it.

 

[Fly Girl]

I had bacon and eggs with a slice of whole wheat toast with butter and no jelly. I'm sure the brownies didn't help at all with your first test. Definitely stay away from sugar and refined carbs and have something with protein.

 

[penstamon]

While I agree that you should stay away from sugar/carbs right before the test, it would be wise to eat a normal amount of them prior to taking the test (the days before): you do not want to shock your system with glucola after days of no sugar/carbs. I second the idea of exercise after you drink the glucola- exercise helps to metabolize glucose quickly. In addition, protein loading before you fast can be beneficial too. I did not take the three hour, but I did do all these things and passed the one-hour.

It sounds like you just had a stressful time and a poor diet that day (yum, brownies!) so that could have contributed to your failing the test. When you produce adrenaline in response to stress, your body holds on to glucose.

 

[Gena 22]

I failed the 1 hr test too. Maybe I didn't give it the full hour, and I took it right after Thanksgiving. I didn't stress over it too much, but got reemed out by my OB for not scheduling the 3 hr test sooner. He said there was no controversy about the accuracy of the 1 hr test, that I had a 0% chance of being normal, that I was risking fetal death . . .

I got a thick skin real fast about the fetal death card. I heard it all the time, for no reason. I'm still burned about it, and the OGTT was the straw that broke me. I hired a HB midwife not long after.

So, I went for the 3 hr test. Nothing special before it, but between the hours I drank a lot of water and walked as long and hard as I could.

I passed.

Some people also recommend eating a low-gylcemic meal a bit before the test. Might work.

Good luck. It's such a stress and an unnecessary pain. I'm hoping not to take it ever again.

 

[GoldmanBaby09]

Is this a homebirth midwife you are seeing that is insisting on you seeing an OB? Can she not make the determination herself as to whether or not you are a good candidate for homebirth? That seems a little off to me. If she is attending your birth, she is taking on the risk of being your birth attendant and should be able to make that call without sending you to someone else. If you wanted to see an OB, you would have in the first place. Secondly, I would ask your midwife if you have the option of doing a one or two hour postpradial with her instead and retest before jumping into the 3 hour glucose test. I just did a simple finger stick glucometer read with my MW today, and it came back just fine. It was also a measure of what I actually eat, not some chemical grossness you will never consume again. Between the brownies and the surge from the glucola, no wonder you failed. I honestly don't think it is right to force your baby to metabolize all that glucose and I don't think that they should make pregnant women fast. Explore your options a little bit more. You absolutely have the right to refuse anything they want you to do and cannot force you to test for any of this. If this causes some issue with your MW, I might look for another who has more lenient and respectful practices.

 

[GoldmanBaby09]

Quote:

Originally Posted by Gena 22 I didn't stress over it too much, but got reemed out by my OB for not scheduling the 3 hr test sooner. He said there was no controversy about the accuracy of the 1 hr test, that I had a 0% chance of being normal, that I was risking fetal death . . .

WOW, BTW. He does realize that the one hour is a SCREENING and not DIAGNOSTIC test, right? People like that are the reason I am having my baby at home!!

 

[mariekitt24]

Quote:

Originally Posted by GoldmanBaby09 Is this a homebirth midwife you are seeing that is insisting on you seeing an OB? Can she not make the determination herself as to whether or not you are a good candidate for homebirth? That seems a little off to me. If she is attending your birth, she is taking on the risk of being your birth attendant and should be able to make that call without sending you to someone else. If you wanted to see an OB, you would have in the first place. Secondly, I would ask your midwife if you have the option of doing a one or two hour postpradial with her instead and retest before jumping into the 3 hour glucose test. I just did a simple finger stick glucometer read with my MW today, and it came back just fine. It was also a measure of what I actually eat, not some chemical grossness you will never consume again. Between the brownies and the surge from the glucola, no wonder you failed. I honestly don't think it is right to force your baby to metabolize all that glucose and I don't think that they should make pregnant women fast. Explore your options a little bit more. You absolutely have the right to refuse anything they want you to do and cannot force you to test for any of this. If this causes some issue with your MW, I might look for another who has more lenient and respectful practices.

I agree it isnt right to make a baby have all that glucose and to make a pregnant woman fast. The whole thing just feels wrong to me. I didnt take into consideration that it was just my particular midwife that would have me see an OB. I guess I just assumed she was telling me what she needed me to do because she's a professional midwife and is just acting under the laws of the state? I guess I should talk to her more about it I just dont feel it will do much good.

 

[GoldmanBaby09]

Yeah, I am not familiar with any midwife who forces her clients to see an OB. I think a lot would prefer that you didn't. What state are you in? Is she a CPM or a CNM? And if you feel like you can't be talk to her about your feelings about anything pregnancy or birth related, and she isn't going to repect them, you need to find some one who will! If she can't hear you out about this, how do you know she will be respectful of the things you want in labor? She is there to work for you! It looks like it is far into your pregnancy, but there are midwives out there who will take you late in the game.

 

[mariekitt24]

She is a CPM and we are in Arkansas,

 

[GoldmanBaby09]

Nothing that I could find in a google search said anything about Arkansas midwives having to send their clients to OB's. Lay midwifery is legal there and direct entry midwives deliver a good percentage of the babies born with midwives. I would question you MW about whether or not that is her personal or professional requirement.

 

[mariekitt24]

well I asked her about it and she said I have to or see someone else, because its written in her liscensure protocol, and that its her regulations that state if I failed the one hour I have to take the three hour. She told me to avoid all carbs beforehand and I could take chromium picollinate if I wanted to, and not to worry because everyone passes.

 

[GoldmanBaby09]

Wow, well good luck with the 3 hour then. I still don't quite understand if that is a state licensure mandate or state regulations or her own, trying to cover her butt. If it is not written into state midwifery license requirements, and not all Arkansas midwives have to do that, I would personally not stand for a midwife who forced me to do anything.

 

[mariekitt24]

For a while now this forum has suggested I switch midwifes, and Im really starting to think I should look into it. I'm so angry I have to take this test, I dont feel comfortable at all with them taking so much blood from me. I feel like I have no rights. If I say no, I feel like I will just have to give birth alone, since I dont know about finding other midwifes right now. Sure its my "choice" to take the test, but I don't feel like Im given much of one. Maybe I'm overreacting but this just doesn't sit well with me at all. If it turns out I fail the test and they somehow want me to take yet another test, I'm putting my foot down.
Im almost 37 weeks pregnant... does that affect the results of the test?

 

[GoldmanBaby09]

Usually the test is done closer to 28 weeks, and it seems odd that they would wait so long to test you since you are so far into your pregnancy. Really GD can only be regulated with a diet change, and if you had other factors, like spilling sugar in your urine, they would have tested you long before this point. And since technically, you could have your baby and be term from 37 weeks, I seriously wouldn't worry about it. I don't blame you for feeling angry about having to do it in the first place. I am currently getting con-current care from both a CNM at an OB's office and my hb midwife, and I adamently declined the test with the CNM. She doesn't know that I am having a hb and also don't know that I did a postpradial instead of the glucola test. This article from Henci Goer, who wrote A Thinking Woman's Guide to a Better Birth http://http://www.gentlebirth.org/archives/gdhgoer.html pretty much sums up how ridiculous that test is to begin with. And if you have any doubts about the care you are recieving, I would still look into switching midwives. There are those who will work with you this late, especially if you feel your current midwife is pushing you to do things you don't want to do. That is why most of us here are choosing homebirth: we don't want to be told by the medical establishment what we do and do not have to do.

 

[DahliaRW]

I would have concerns about your mw too. Did yoiu ask her about skipping the GTT test? My mws (I've had different ones) have no issue with that from the getgo. The 1 hour is HIGHLY innaccurate. In fact, I failed miserably with my first ds (only OB birth), and then was on the very low end of normal for the 3 hour which was a whole other concern. That's how innaccurate it is! I have never done it again, since I have very few risk factors and no signs of GD and I figure I'd have to just go do the 3. I think that if you don't eat a sugary high carb diet to begin with, it makes the 1 hour that much less accurate since you're body isn't used to sugar overload.

 

[jecombs]

Quote:

Originally Posted by mariekitt24 For a while now this forum has suggested I switch midwifes, and Im really starting to think I should look into it. I'm so angry I have to take this test, I dont feel comfortable at all with them taking so much blood from me. I feel like I have no rights. If I say no, I feel like I will just have to give birth alone, since I dont know about finding other midwifes right now. Sure its my "choice" to take the test, but I don't feel like Im given much of one. Maybe I'm overreacting but this just doesn't sit well with me at all. If it turns out I fail the test and they somehow want me to take yet another test, I'm putting my foot down. Im almost 37 weeks pregnant... does that affect the results of the test?

Wow, that is really late to take the 1 hr. test. It's my understanding that the 1 hr. test is supposed to be given between 24 and 28 weeks and it's supposed to simulate how your body will react to normal amouts of sugar when you are in your last trimester of pregnancy. I could be wrong, but this is what I thought... Your MW sending you for this test this late in the game is wrong and possibly negligent. If possible, I would find a new MW. If it's not possible to get a new HCP, you might want to try to negotiate with your MW and tell her you will start to check your blood sugar with a glucometer before and after every meal. That will give you a more accurate picture of how your body is processing sugar than the 1 hr. or 3 hr. GTT at this late stage of pregnancy.

If you do decide to do the 3 hr. test, do not eat before-hand. The tech will draw a fasting blood sugar, which should be lower than 95, and you don't want to effect that result. The fasting is usually only 8-10 hrs, so just don't eat breakfast before you go. I took the 3 hr. test and I walked during the entire test. I just came back to the office for my blood draws. The walking will help your body process all the sugar.

I also don't know how legal it would be for your MW to "drop" you from care since you are 37 weeks, even if you do refuse the GTT. Maybe someone else can advise you about medical abandonment better than I can...

You might want to x-post this in the birth professionals forum. They have a wealth of insight on this kind of stuff.

Good luck with whatever you decide to do!

 

[mariekitt24]

thanks for the replies guys! I ended up just taking the stupid test. I did fast, and I woke up early to go walking before the test, and walked in between blood drawings as well. Since I didnt receive a call I assume I passed. But in the future we at least know to find a different midwife from get go. I certainly didn't appreciate getting my blood drawn four times in one morning, but I survived. *phew*

What happened was the nurse midwife at the hospital whom I was seeing as an OB for my required appointments was not updated on my new due date, so the hospital didn't know how far along I was anyway. When I first saw her we hadn't had an ultrasound and I ended up being 2 months farther along than we originally guessed. My midwife asked ME why they were testing me for it in the first place, and I was confused by that. But whatever, it's done now. I dont have to go to the hospital any more and just one month to go!