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Discussion Starter · #1 ·
I had my latest m/w appt this week and the subject of the GTT came up for my appt in 2 mos. Is this test absolutely necessary if I have none of the warning signs (only 4% of PG women test positive)? If it is, I'll definitely do it, but I wanted some other opinions too.
 

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I'm wondering the same.......<br>
I'm set to do mine on March 31st and I'm dreading it.
 

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Do you mean an appt in 2 weeks as opposed to 2 months? In standard OB care, I think the test is usually given around 24 weeks? In two months won't you already be about 30 weeks? (We have a similar due date). I asked my mw at the last appt and she said that unless I show the warning signs (I wish I could remember what she listed) she wouldn't do anything. And if I did, it would only be a finger prick. I did a little sleuthing online and it said most women don't even show symptoms - so I'm a little confused. I'm probably pretty high risk: over 30 and overweight but I've been eating a fairly good diet all along (especially trying to limit refined sugars and "bad carbs" but I'm by no means perfect) so I'm hoping it won't be an issue. I'm curious what other homebirthers are doing!
 

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Discussion Starter · #4 ·
soapdiva - you're right, I should have it at my next appt, not in 2 mos, but I swear that my m/w said 2 appts away. I'll have to call and check up on that. The test my m/ws do is the standard one hour test with the nasty sugar drink.
 

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There was a really big thread on this recently here:<br><br><a href="http://www.mothering.com/discussions/showthread.php?t=387863" target="_blank">http://www.mothering.com/discussions...d.php?t=387863</a><br><br><br>
Personally, after reading what Henci Goer had to say on the topic I'm not convinced that true GD exists. My midwife doesn't test for it - I had my GTT scheduled for this month with the OB and when I switched over I mentioned that I had the appt and asked if I should keep it and let her know the results. She was like <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/rolleyes.gif" style="border:0px solid;" title="rolleyes"> "seems like everyone and their sister have GD these days!" So I cancelled the appt <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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I had an extensive discussion with my midwife and will not be doing this test. I read the above-noted thread in its entirety and also all the Henci Goer stuff. I personally do not ever eat/drink refined sugars/carbs like that stupid drink, so why would I test a blood sugar response to a huge sugar challenge like that. I had the testing with last pregnancy and still had a larger sized baby. I am following my gut on this one.
 

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I'm a little torn on this one - not because I think it's necessary or even accurate or worth doing. I took it the first time, and scored 141 (one point out of normal range) so I had to take the 3 hour. YUUUUUUCK. Of course no GD, and the baby was 7.12. The second time I took it and passed fine, and when the baby was born she was 9.2, so they wanted to to heel pricks every hour to check her blood sugar. I absolutely did not let them do this. I really want to refuse the test this time, but I worry that if I have another larger baby, they'll give me a harder time about the heel pricks if I don't have a GD test on record.<br><br>
Of course, writing this down makes me feel so silly - I don't have to take the test, and I can still refuse to let them stick my baby. It's just a lot more difficult to see things objectively when you're there in the moment. I guess I'll just talk to my midwife about it - I know she'll recommend the testing (it's "hospital policy" you know, and while she is very naturally-oriented, her backup docs give her a hard time when all the t's aren't crossed).
 

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In the UK they stopped doing the GTT a couple of years ago, so i guess the doctors / midwives don't think its worth it.
 

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Discussion Starter · #10 ·
I'm still torn whether or not I'll get the GTT. I don't have a problem with necessary tests, but I haven't been convinced that this one is necessary. Anyone know the consequences of not getting it done? Are m/ws usually ok with doing a normal meal and then testing rather than having to have the high packed sugar drink (which has more sugar than I'd ever have in an entire day!). This decision has been weighing quite heavily on me.
 

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In the thread posted above, it sounded like the outcomes were the same regardless of "treatment", except that women diagnosed with GD had a higher risk of a c/s once labeled as having GD. It was highly recommended to do a google search on Henci Goer and GD.
 

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I wouldn't call the GTT "necessary". I can think of many reasons not to do it and not many reasons TO do it.<br><br>
After reading this thread and rereading my earlier post, I realize that the only reason I'm even considering it is so that I could have it on record that the test was negative, if my baby ends up being large. I certainly don't expect to gain any information or insight from the test. Which makes the test pretty worthless for me, when it comes down to it.
 

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I'll have mine done at the local birth center. What they do is have you come in 2 hours after a normal meal. It is a more accurate measurement of your glucose levels.<br>
I didn't have it done with Seth at all, and I did with Emma. I didn't have GD with either of them and doubt that I will have it this time.
 

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I don't know if this was mentioned in that other thread or in Henci's work as it's been a little while since I've read it, but one of the major issues with the test itself is that the protocols are inconsistently administered leading to skewed results being evaluated against the same scale.<br><br>
for example- three women go in to take the test at 7am. one is told not to eat anything after 8pm the night before (which is majorly stupid for someone to tell a pregnant woman anyway). one is told she can have a light "tea and toast" breakfast before she comes in. and one is told to eat normally. yet their test results are all compared against the same ranges.<br><br>
the issue for me isn't so much even the diagnosis of GD-- it's the treatment approaches taken by most OBs which are sometimes highly interventive and unnecessary. i had a mom as a doula client who was told she had GD by her first OB after "failing" the 1 and 3 hour tests. she didn't buy it because she never sat down and ingested that much sugar on her own at one time. so she ate her usual healthy diet, tested her own blood sugar after meals with a home test kit for two months and never had a test out of the normal range. she ended up switching to a homebirth midwife who didn't believe in GD and had her beautiful healthy 7lb. 2oz. baby at 43 weeks.<br><br>
it all goes back to good quality nutrition.
 

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I won't be taking the GTT. I just don't feel that fasting for 8-10 hours and then slugging down a big ol' container of glucola would be an accurate indication of how my body handles glucose. At the place I get my bloodwork done (military hospital) the post-prandial test is not an option.
 

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Discussion Starter · #16 ·
I called my m/w office today to make sure I understood that this test should be done at my appt in 2 mos. I was assured that it was routine at that office to do it b/t 28-30 wks. (that appt. would be at 30 wks). Luckily this means I have a little more time to talk with the m/ws and do some more research.<br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">one of the major issues with the test itself is that the protocols are inconsistently administered leading to skewed results being evaluated against the same scale</td>
</tr></table></div>
This is very interesting! Do you have any idea what the true "standard protocol" is ... or isn't there one?
 

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Whole article by Henci Goer is here: <a href="http://www.gentlebirth.org/Midwife/gdhgoer.html" target="_blank">http://www.gentlebirth.org/Midwife/gdhgoer.html</a><br><br><br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Good medicine demands that diagnosis and treatment of any disease fulfill four criteria:<br><br>
* The condition has to pose a health risk;<br>
* Diagnosis must accurately distinguish between those who have the disease and those who don't;<br>
* Treatment should be effective; and<br>
* The benefits of diagnosis and treatment should outweigh the risks.<br><br>
An entire medical industry has grown up around diagnosing and treating gestational diabetes (GD) in the belief that doing so prevents perinatal deaths, congenital anomalies, neonatal complications, macrosomic babies, and because of fetal macrosomia, birth injuries and excessive cesarean rates. However, diagnosis and treatment of gestational diabetes don't fulfill any of the above criteria.</td>
</tr></table></div>
I have to say that I've done a 180 on my attitude toward prenatal care and birth since finding MDC and doing a lot of the reading that others here have done. I used to be right on board with anything my doctor suggested. Now... not so much. I am really not the kind of person to refuse a test just to refuse it and stir up trouble, but I have to say that I will never be taking the GTT again. It's just common sense. Every woman can benefit from having a healthy diet that is high in nutrients and low in useless junk calories, no? As long as you eat right and keep active you'll be just fine, and as the article and other posters mentioned, very few women who are diagnosed actually have large babies or any other supposed GD related problems.<br><br>
The article is good. Food for thought.
 

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I had it with my first 6 children out of ignorance, but not with the last 2 and not with this one either. I do have huge babies, my last 2 were 10lbs 1 ozs and 11lbs 13 ozs. my other were all 10 pounds and upper 9 so I just have big babies. I've never had any symptoms of GD.
 

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I had the test done with #1, but told my dr I did not want to take it this time around. She seemed fine with that. My reasons for not wanting to take it is partly because it made me feel SO HORRIBLE. About 15 minutes after I left the lab as I was driving, I felt like I was going to pass out, was sweating, had heart palpitations, and felt so so weak. My blood sugar just crashed. I had to stop at a convienience store and buy something to eat! And partly because I can not sit still in a lab for an hour with my 2 year old ds. I'd be running around after him, and that is a no-no, since moving around - even a nice light stroll - affects the test results. It would be impossible for me to take the test the way they say it has to be taken.
 

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Discussion Starter · #20 ·
Quagmire - Thanks for posting the link to the Henci Goer article. I tried to do a search for it, but I have bad luck when trying to search the internet! Something that I found really interesting was:<br><div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Because glucose levels rise linearly throughout pregnancy, a woman could "pass" a test in gestational week 24 and "fail" it in week 28.</td>
</tr></table></div>
I'd be scheduled to take it later on the time line, meaning I would be more apt to "fail" it. I think I'm going to opt out of taking it if I'm at all able. I'm leery of anything that is required by the medical community, especially while PG.
 
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