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In a Dilemma...

866 Views 26 Replies 8 Participants Last post by  onlyboys
..about the whole Glucose Screen coming up in two weeks.

Last pregnancy, I didn't really even think of refusing the glucose test. I ended up being called "borderline". So I didn't actually get labelled "Gestational Diabetic". As a precaution they had me see an OB once or twice, and a Diabetic consultant had me follow the Diabetic Diet. By the way, that diet was way high in carbs for something that is supposed to help with blood sugar issues. I followed a lower carb version of it. They gave me two ultrasounds way after 22 weeks to check the size of the baby...which is totally inaccurate after 22 weeks. I was told at a 34 week ultrasound, "Your baby is anywhere from 7 to 11 pounds. This baby could be big!". He was 7lb 6oz at birth. So anyhow...

The 1-hour glucose screen is coming up in 2 weeks, and after a lot research I'm not sure I'm feeling that comfortable taking this test. I'm just getting the idea that it's an uneccessary and inaccurate test. My only "risk factor" is that I am overweight. But I'm eating healthy, I'm exercising 5 times a week for at least an hour a day. I've asked the birthing center if they'd allow me to eat regular foods instead of the sugary drink and they said no. They said they don't do this any other way, etc. I just feel like I'm not getting any choice on the matter and I don't like that.
So I'm thinking of refusing the test this time. My DH thinks I should take the test and go from there. I do like my midwife, she is very nice and hands-off, etc. But they did tell me once labelled GD then that is high risk and delivery must take place in the hospital, etc. I feel that would be completely uneccessary and not the choice for me at all.
So maybe I am worrying needlessly. I was only borderline last time and had a healthy outcome, but I started this pregnancy a little more overweight. So I am stressing slightly and not sure what to do.
I guess this is mostly a vent, but if anyone has any similar experiences I 'd like to hear what you have to say. I may just see what they say if I tell them I'd like to refuse the test this time....
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I can't decide, either. With this lovely new passing out phase I'm in, I can't possibly fast beforehand. My dad has Type 2 diabetes, but I'm not sure how much that increases my risk. Hmm, maybe I'll post...
Personally I wouldn't do it. I am also overweight. If I were concerned like you
(BC vs hospital), I would just not do it and follow the diet that you did last time. It would keep you out of the woods, I think. Can they watch it any other way?? Instead of doing the test...can they detect anything w/your urine specimen? Just a thought to keep you at the birth center

my 2 cents
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I am not having the test. I do not believe that the test is totally indicative of GD, and I suspect that if I did truly have it, my body would tell me and my midwife. The test is something that they use to screen women which seems to take the place of careful observation on the part of the caregiver.

If you do develop GD, you will know, I think. If the test will risk you out, there's no way in the world I'd take it.

Good luck to you!

By the way, where in FL are you? Are you using CPMs or CNMs?
The main midwife at the Dunedin Labor of Love birthing center I'm seeing is an RN and an LM. The midwife who is on call in case Marianne couldn't attend is and LM and a CPM. There is a CNM that oversees the birthing center but does not attend births.

I am strongly considering what you all are suggesting, just not taking the test. I think I will call on Monday and try talking to a midwife instead of an assistant. I want to try and talk to my actual midwife first and not the CNM who oversees. I'm hoping they will just let me stay on my healthy diet and maybe just have me monitor my blood sugar at home or when I visit them. If they want to drop me for practicing my constitutional right to refuse a medical test/care, then that would be there choice and I will happily look for an independent midwife in the area. I've heard of a few good ones from some of my mommy aquaintances in the area. DH thinks I should just do the screening and go from there, but he also said he will support me in whatever I decide.
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Have you met Daniela?

She went to the school I am going to. Tell her Amanda says hello!

They will be totally cool with you choosing not to do the test. I'm using Labor of Love in Lakeland. What a small, small world.
Onlyboys, yes, I have met Daniela! For the appointment before the last one I saw her since Marianne was at a birth. She is so nice. Okay, so I guess I am just getting worked up over nothing then. They are such a nice group so I don't know why I'm fearing the worst. I guess I tend to worry too much sometimes. Yes, it is a small world! Didn't realize you were so close!
I will say Hello to Daniela for you.
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If you have already had one healthy pregnancy where you didn't have gestational diabetes (borderline or not!), I cannot think of one single logical reason for you to have the test this time around. Of course, I've never had the test, since IMO the way it is generally done has no real-world counterpart.
Daniela is great!!!! I can't tell you enough how competent and great she is. You have nothing at all to worry about. My midwife at LOL in Lakeland said frankly to me, "Refuse it all, we don't care." So, yeah, I suspect that they are cool.
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I'm refusing it. Fat does not mean unhealthy!

I did buy a cheap glucometer and have been doing some blood sugar analysis at different times. I know my blood sugar is excellent so I'm not worried about GD. If, for some reason, by blood sugars go bad I'll focus on diet -- just as you would if you got diagnosed with GD.

Good luck to you!
Thanks everyone for your replies. I'm not feeling stressed out like I was and I am not afraid to just refuse the test now
. It's good to have support from other mamas.

Shorin_Mama, you are so right. Fat does not neccessarily mean unhealthy. And in March I actually had a physical and everything came back extremely good...cholesterol was great, stress hormones normal, all the bloodwork came out really good including my blood sugar!

Onlyboys, you've been especially helpful in easing my mind since you are going to the same group. I like that attitude, "Refuse it all, we don't care".
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btw there is a GD post in the I'm Pregnant section too...maybe you'd want to read it through?

I'm sure you'll make the right decision for you! And that's what counts!!!

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This is my 5th pregnancy and third time with GD. I was diagnosed at 18 weeks this time. I have read all the research for and against GD intervention and have decided to follow the treatment my OB suggests. Though there have been studies that suggest that the higher glucose levels in your blood may or may not directly affect my baby the thing that sways my opinion is the spilling ketones problem. There have been studies suggesting that ketones can cause brain damage and or lower babies IQ. Other than causing mothers to be more closely watched and a higher rate of inductions I haven't heard any drawbacks to being under care for GD.

Also my last pregnancy in which I was monitored more closely had some non-GD complications that were picked up because of the extra tests.

I did have a perfectly normal first pregnancy and third pregnancy. This time and last time diet was not enough to control my glucose levels and I needed insulin.
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GenMomof4+1, thanks for your reply. I guess for me it's just that I have no issues arrising whatsoever indicative of GD. We test my urine for ketones and sugar each visit and it is always negative for both. And since the research I've done indicates that the glucose screen is not always consistant or accurate, that is more my concern than anything, as I've read it can give both false positives and false negatives. Since I was borderline last time, I am following the diet they put me on already all of my own accord. I'm also exercising an hour a day either on the treadmill, swimming, or yoga. I am probably 10 times healthier than I was last time I was pregnant, so I just hate the idea of taking a test, possibly getting a false positive results and having unneccessary interventions.
So I called the birthing center today, and talked to Janet the Nurse Practitioner, and had a really good conversation with her. I asked her if I could decline the glucose screen this time, and she said since I had an abnormal reading last time I have to do some type of screening ... basically because of insurance liability issues. She was very sweet about it though, and totally agrees that it's a very inaccurate test. She said she would look over my file from DS's birth and go over it with my midwife Marianne tomorrow and then give me a call back. I may be able do the post-prandial test where I can eat foods instead of the sugary drink. I had called last week and asked an assistant who told me I couldn't do that, so it was nice to hear I may at least have some kind of option. So now I'm just waiting to hear back, hopefully it will be okay for me to test this way. I mean, I'm exercising more this time, I told Janet I'm already following the diet they put me on last time as a precaution, I'm exercising 5-6 times a week, Jakob was only 7lb 6oz when he was born...these things should all work in my favor. Cross your fingers for me that I can do it this way. From what I understand it is much more accurate to test this way.
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I have a feeling this is a CYA kind of thing. So, even if the test comes back a little wonky, I'll bet they will work with you.

Good luck with it. And, I agree, I've heard it's way more accurate this way. How normal is it to drink all that liquid sugar?!
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Gosh, I am so aggravated! I called in to check if they'd decided on whether I could do the post-prandial test instead. I guess Janet and the midwives had a conference about me, went over my file and have decided they will not let me do the post-prandial test. I just don't understand why they aren't going to let me do a more accurate version. I was going to make a payment today over the phone but couldn't because I started crying....
What, are they going to drop you if you don't do the test? I've annoyed the heck out of a couple of OBs by correcting them forcefully when they told me I "had" to do a test. :LOL I'm getting the impression you really like these people, eh? You can always come join us on the UC board.
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I was delighted when I came across this article on GD:
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