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I am just looking for a little feedback to make sure I am not nuts.<br><br>
The problem: I am about 20 weeks. At my OB appointment Monday (11/29), I was informed that I had a “little bit” of sugar in the urine sample that I had given when I had my blood drawn 11/18. There has not been any sugar in any of my previous urine samples (3 or 4 previous appointments) including the one on Monday. However, my doc now wants to do my GD screen ASAP because of the “little bit of sugar,” the fact that my dd was 9 lbs 15 oz at birth (40 weeks) and according to them I am overweight.<br><br>
My problems with this are:<br>
I am 5’9”, pre-preggo was at about 175 lbs, currently between 190-195 lbs. Sure I started with a couple lbs to lose and have probably gained more than “normal” but I don’t get morning sickness, so I can actually eat through the first trimester. But I am healthy, I don’t eat crap all day, and my blood pressure is normal. I hardly think that I qualify as overweight. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shrug.gif" style="border:0px solid;" title="shrug"><br><br>
Second: Like I said I am 5’9”, dh is 6’1”. I am not small framed. We were both around 9 lbs when we were born. I am not going to have a 6 lb full-term baby. The hospital checked dd blood sugars at birth because she was over 9 lbs. She had absolutely no problems at all. I can obviously birth a large baby vaginally, so I don’t see this as a reason to get all freaked out.<br><br>
Third: I am concerned that even if my GD test comes out normal, I will have this red flag on my chart and will be seen as unofficially and unnecessarily high risk regardless of the outcome. That is not something I want.<br><br>
Questions to all of you: I am not crazy for not wanting to deal with all of this and find a midwife, am I?<br><br>
Thanks,<br>
Karla
 

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I don't think you're crazy at all. I think you should do what makes you feel comfortable. How has your relationship with your doctor been before this point? Maybe if it has not been so good, this is a good time to explore other options.<br><br>
On the other hand, as an AMA patient (advanced maternal age) they gave me the glucose test automatically, even though my weight was considered within normal limits. It came out fine and although I was probably "red flagged" as an AMA, I don't think I really got treated any differently. I carried full-term and had a vaginal delivery without complications, save a 4th degree tear (a complication for me but not my baby LOL). I had all the same options during my labor as any other mom. You didn't say how old you are; is your age a factor here?<br><br>
My personal feeling is to err on the side of safety, but that is me. It's a balance how we choose these medical advances that our foremothers may have only dreamt about--but which we sometimes feel are imposed upon us. And I also have an OB who I LOVE LOVE LOVE so that really helps.<br><br>
As for your weight, I don't know if you're really overweight or not. I guess that depends on your overall health, which sounds good, and physical fitness level. If you are heavily muscled, you could weigh more and still be more healthy than someone who weighs less but has less muscle and more fat.<br><br>
Good luck with whatever you decide.
 

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Nope! Not crazy! Time to go midwife shopping! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> Good luck!
 

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If you don't feel the test is necessary then just say no - you totally have that right. Most doctors like to err on the side of caution which I generally don't think is a bad thing - if you do have a problem then it would be good to know ASAP. If the test comes back fine I don't think you would be red flagged but if the test shows something is wrong then it would be good to find out early. KWIM?<br><br>
I had a 9 pound 6 ouncer last time and my doctor has also expressed concern that I could have a problem with GD - but I was on South Beach before I got pregnant so I was already use to not eating a lot of sugar and staying away from "bad" carbs so we both just agreed that I would continue doing that and he wouldn't make me do the yucky glocuse test :LOL Remember that subsequent births often produce bigger babies (my first two were 7.3 and 8.7 respectively) so he may not be concerned about you having a 9 pounder - but an 11 pounder could be dangerous (and awfully painful!) I know that's my doctor's main concern.<br><br>
Kitty
 

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I would just request that they give you a few dip stick tests to take home or allow you to come in again at a later date for another pee test. My understanding is that things like urine concentration and time of day can alter pee test results.<br><br>
I think most OBs like for you to have a gd test at some point in your pg, so if you are planning on taking it eventually perhaps you might as well take it now? IF you aren't planning on taking it at all you might as well get that discussion with you OB over with ASAP, so that you can shop for a MW if nescessary.
 

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I had a bad experience with an OB over the GD test this pregnancy too. I told the nurse beforehand that I would be declining it and her reaction was "Oh, that's not good at all...." and then I heard them discussing it outside the door. When the dr came in, she tried to bully me. She was worried because of my previous baby being 9lbs ( <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"> borderline) and because I was measuring 2-3weeks ahead. She pulled all the stops including "well I won't see you anymore then." Which of course didn't bother me in the least seeing as I'd never seen her before :LOL And when she realized the threat wasn't working, took it back. She accused me of everything from not caring about my baby and being selfish, to being afraid of needles. Then she wanted to test me for cyphillis (sp!) which had never been mentioned by anyone else in a previous visit. She also said that I wouldn't be labeled as high risk if I tested positive, which I know was a load of bull.<br><br>
I told her about the research I'd done and her only reaction was "That's absolutely untrue, I've never heard of that before" I asked her to share her resources and if she could produce something that convinced me it was a good option I would certainly reconsider. She asked if I'd gotten the standard packet handout. I said yes, but all that said was 'you'll be getting this test between weeks 24-28' and no real info. I told her it wasn't informative or convincing and she left to go look for something else (I don't really think she had anything, but she left-yay!) and then a week or two later, I got a call with a reminder for an u/s appt that I'd never made! Apparently, she scheduled one to check the baby's size without even telling me!!! I canceled and ran from that practice.<br><br>
I'm now seeing a MW and LOVE LOVE LOVE it. It's so much better, and they didn't blink an eye at the long note about c-sections and needles the stupid dr left in my chart. She just asked if I'd ended up taking the test and I said no and that was it. It's so nice to have somebody that respects the fact that you choose to educate yourself and doesn't treat you like an idiot because you don't just blindly follow them.<br><br>
The bottom line here is, I think that if I'd stayed with the first practice, I'd definately be flagged (especially after seeing the note she put in my chart) and even if I had taken the test and passed, they were looking for a big baby, which I'm not afraid of, but just the fact that they expect one would increase the chances of an unneccessary c-section. Also, I definately didn't want to have to fight like that over interventions they'd try to push during labor. I know that I go inside myself and can't speak well when I'm in pain/nausea and of course didn't want to deal with that kind of stress.<br><br>
You are not crazy AT ALL and should definately check out some MWs. I can't even tell you how much better I feel now.<br><br>
If you're worried about your sugar levels (which it doesn't sound like you are) you could always get a monitor and check yourself. If you do end up deciding to get the test, do it early because your blood sugar levels rise as the pregnancy progresses and therefore you could pass at 24 weeks but fail at 28 weeks.<br><br>
It's such a no win situation in that the test isn't particularly that accurate (unreproducible up to 22-24%) or natural, but if you decline, they still flag you <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">: Sorry this was so long, it's just that it really stressed me out how much hassle they gave me over declining it.
 

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Why would it ever be crazy to want to find a midwife? :)<br><br>
Seriously, do you have any reason to stay in a game you have to play defensively? Do you have health concerns you think require OB care? If not, why not skip the stress and unnecessary risk?
 

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Its never too late to fire the OB. We dropped ours for just about the same reasons. I am 5'9", large framed. I weighed 235 LB at conception and 282 LB at delivery. My OB went through every scare tatic possible .... she said that because of my size that GD was a potential late term problem. She also said that Hyper tension was a problem.<br><br>
We took control of my prenatal care. We purchased a Blood Pressure monitor. We bought urine test strips. I used my dh's glucometer to test my blood sugar daily. Basically every time I had a visit their was a grave concern about some problem or another. One visit it was too much amniotic fluid. The nurse practioner jggled my belly claiming hysterically that there was too much fluid. She was wrong. Another visit ther was a concern that the baby was too large. and the last time I went to that OB she wanted a pre stress test because she was concerned about toxemia. That was the last time I saw the OB.<br><br>
A lot of people have concerns that they are losing control of the pregnancy. That is is becoming the OB;s not theirs.<br><br>
A Midwife did not work for us. In CT most are CNM's and still traditionally trained and we were still concerned that it wouldn't be our birth.<br><br>
If you choose to go with a midwife make sure that they are there to support you, not control you. You are not a patient. Interview as many as you can.<br><br>
Read as much as possible. Become you own prenatal expert. Be on the offensive not the defensive.<br><br>
You have begun to open a door by questioning your OB's assessment. In a few instances they have legitimate concerns, however, the fact you have birthed and that you know your self and your body better than the OB's should bring you confidence and trust in yourself.<br><br>
sorry if I am on my soapbox but I really have an issue with OB's.<br><br>
All my best.<br><br>
Below is a link to my UC birth.
 

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Jessviola<br><br>
just curious your OB wasn't in vernon CT by chance?<br><br>
Your OB sounds too much like my OB!!!! Scary!
 

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No, she was at UCONN <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/scared.gif" style="border:0px solid;" title="scared"> Definately scary!!!
 

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Go find a midwife <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> and search for info on GD by Henci Goer. I got fired by a midwife at ~30 weeks because I wouldn't do GD testing (and I had NO risk factors...) <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
-Angela
 

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I'm just going through a GD diagnosis and if my last son had only been 9 lbs (he was 10 1/2) I would have declined the test again too. You need to find someone that's on your team, midwives are just different, feelings are factored in with the tests and they offer more support of personal choices *in MY experience* <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/thumb.gif" style="border:0px solid;" title="thumbs up"> Good Luck!
 

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Just wanted to add that it really depends on the OB - mine is very supportive of my opinions and has always been great. I declined the GTT and was not flagged as "high risk", yes he would have been happier if I took the test and told me so but he didn't try to pressure me to take it in any way. Your OB or your midwife - whichever you choose - should be supportive of your decisions. If you feel he or she is not being supportive then totally find a new one.
 

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No real opinion/info on the test - just an FYI that a dear friend of mine was diagnosed with GD while pg and she was maybe 5'7" and not more than 130 (size 6) prepreg, when my other DF was 5/5" and wore at least a size 26 prepreg and never had GD with any of her 3. I don't think being "overweight" is really an accurate predictor of GD so don't let them bully you on that count! After all, look at how many skinny/healthy people have type 2 diabetes - Halle Berry for one!
 

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Here are some links for you:<br><a href="http://gentlebirth.org/archives/gdhgoer.html" target="_blank">http://gentlebirth.org/archives/gdhgoer.html</a><br><a href="http://bmj.bmjjournals.com/cgi/content/full/316/7134/861" target="_blank">http://bmj.bmjjournals.com/cgi/conte...l/316/7134/861</a><br><a href="http://www.parentsplace.com/expert/birthguru/articles/0,,243381_269209-2,00.html?arrivalSA=1&cobrandRef=0&arrival_freqCap=2" target="_blank">http://www.parentsplace.com/expert/b...ival_freqCap=2</a><br><a href="http://www.parentsplace.com/expert/birthguru/articles/0,10335,243381_253331,00.html" target="_blank">http://www.parentsplace.com/expert/b...253331,00.html</a>
 
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