Questions about testing at 41 weeks...

699 Views 10 Replies 9 Participants Last post by doula and mom, Apr 14, 2006

clynnr

Discussion Starter · Apr 14, 2006

So at my last appointment, my MW (CNM, hospital birth) wanted me to schedule a u/s to check fluid levels at 41 weeks, then come to her office to do an NST. It all seemed perfectly normal while she was telling me about it, but then she said that we should schedule our appointment on Wednseday (the day I turn 41 weeks) because if we needed to induce, that would be a good day to do it. Then she kind of bactracked by saying that the only reason she would induce is low fluid levels.

Now when I interviewed her, she said she wouldn't do anything if I went overdue as long as we were both healthy. She also said she had just seen a 42+5 week preganant woman who was doing fine that day. I also am almost 99% positive that I ovulated a week later than she thinks I did due to nursing, but I didn't do the early u/s for dating because I specifically asked her, "Since you don't care if I go over, there's no reason for it, right?" And she agreed.

Then when I called the clinic to schedule the u/s, they said it would take an hour because they would need to do extra measurements, etc. An hour??? To check fluid levels???

So after thinking about all of this, I'm going to call my mw and ask her to explain the purpose of these tests and what their supposed benefits are for me at this time. Hopefully I will go into labor before then and it won't be an issue, but I would like to go into it fully informed, KWIM?

Does anyone have any more info on this? Thoughts? Opinions? I know I have the option to refuse anything (and she is really good about that), but I'd like to know both sides before I choose. Thanks!!

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Tori Gollihugh

· #2 · Apr 14, 2006

I hope this isn't the case, but it rather sounds a lot like my midwife with hospital birth situation... she induced me (swiped cervix) on a Wed afternoon and I totally believe it was to avoid a weekend baby.

I think it's rediculous to think the u/s would take an hour to check on fluids! I wouldn't allow that, personally... but then, I wouldn't let them do the u/s in the first place.

I 'had' to have the NST with DD as well because I was "overdue". It was annoying, but not horrible. However, this time around I would refuse it because I've read so much (and heard so much) about so many women being induced because that test showed signs of distress or something that didn't seem to jive with the situation. Anyway... JMO, of course.

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eirual

· #3 · Apr 14, 2006

Yes, it takes that long. I went in at 41 weeks for that same ultrasound and it took forever! they look for a lot more than just fluid levels from what i could make of it. They also check your cervix (lol, they go below the equator for that and i remember asking- "my god are you gonna put that in there?!"- they dont') But anywhoo. They just want to be sure that there's enough fluid in there to keep your baby safe and happy- babies can get into trouble and even die if they're in there too long (dont' know what keeps them in there, but it can happen)

A friend of mine who was planning a home birth did this ultrasound and they learnt that there was low fluid, and that the cord was wrapped tightly around baby's neck which is why baby never dropped and hece she didn't labour. The doc recomended an emergency C-section, but she asked if it was safe enough to do it the next morning so that she could prepare herself mentally for such an extreme change of plans- so they did that the next morning.

And onther other hand, I went in, was given the okay, and both my MW and I felt comfortable with going overdue knowing that everything was safe (he went 10days in total).

So i see no harm unless you're worried about unltrasound waves and your baby, in which case you could ask them to keep it as short as possible and check only the fluid levels and other signs that baby's safe and happy (i think they also look at the spine and formation of things, but i could be wrong)

As for your midwive's seemingly changing viewpoints on going overdue- i think by the sounds of things she's happy letting it go on, but only if she *knows* it's safe (i.e. she has ultrasound confirmation). Without this assurance I think she'd be skeptical (and PERSONALLY I would be too- for me thebenefits outwheighed the risks for that ultrasound)
Edited to add:

As for the NST....ugh! My midwive's reasoning for that was to be sure things were fine (which I was positive they were since i had been getting contractions pretty regularly when i went in- not so fun) but also to meet the hopsital staff- just incase.....I went along with it, but wish i had refused that one. (although i got to see what it would be like to labour in the hospital, and I was that much more relieved that I had decided to do it at home- hopsitals weird me out!- i was thinking the whole time i was in there- my god I'm glad I'm not you! - about the women comming in in labour--without midwife support i should add)

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nonconformnmom

· #4 · Apr 14, 2006

I went past due with all my babies and so I'm very familiar with the 41 week ultrasound to check fluid levels and the NST. Personally, I think it's important to get these checked, and I always felt reassured after the NST - which is about as non-invasive as a test can be.

Your midwife mentioning inducing was probably just out of habit because so many pregnant women these days are begging to be induced. The fact is, nobody can MAKE you get induced. If you go into it feeling strong about what YOU want and the way YOU want it to go, it won't matter if someone says 'let's induce today'. You can just say no.

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nichole

· #5 · Apr 14, 2006

drink lots of water. sometimes being slightly dehydrated makes your fluid levels low.

the patient that went past 42 weeks probably was going in for non stress tests and such. and the midwife could have recommended inducing at 42 weeks but the patient refused. you never know. there is what she will recommend, and what she will be cool with, kwim? so just b/c she had one patient go past dates, that doesn't mean none of her patients are induced and that they are not being monitored closely. CNMs are extra careful about these things b/c they are under the watch of an OB and have to maintain that their patients are low risk. i had a FP with my son and she would recommend all kinds of stuff as a dr, but she made it very clear i could refuse ANYTHING and she wasn't going to bully me about it. she would say that certain things would make her nervous, but it was my decision. i hope i am making sense.

i would go personally. maybe call her and have her explain why the u/s takes an hour if they are only checking for fluid levels. the u/s tech might be looking for all kinds of things but your midwife is mainly concerned with what the fluid levels say. is someone going with you to the appointment?

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clynnr

Discussion Starter · #6 · Apr 14, 2006

Thanks for the replies!

I'm not too concerned about the NST, as I voluntarily went to the hospital to do one a couple weeks ago when the baby wasn't moving all day. For a test, it really isn't invasive at all, and I did feel better after doing it.

The u/s is bothering me a little though... I just want her to tell me what the heck they do for a whole hour. I don't mind checking fluid levels, but I just don't want them to decide my baby is too big and that we have to induce/csec. Her office is closed today, but I know she checks her messages, so I'm going to call and ask about it.

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clynnr

Discussion Starter · #7 · Apr 14, 2006

Quote:

Originally Posted by nichole
drink lots of water. sometimes being slightly dehydrated makes your fluid levels low.

I had heard that, and was planning on overloading the night before and that morning--though it really sucks to have a full bladder during a u/s! When I did the one at 21 weeks, the tech actually showed me my bladder and said, "Your bladder is really full." Duh! Can't you tell by the way I'm crossing my legs, LOL!

Quote:

Originally Posted by nichole
the patient that went past 42 weeks probably was going in for non stress tests and such. and the midwife could have recommended inducing at 42 weeks but the patient refused. you never know. there is what she will recommend, and what she will be cool with, kwim? so just b/c she had one patient go past dates, that doesn't mean none of her patients are induced and that they are not being monitored closely. CNMs are extra careful about these things b/c they are under the watch of an OB and have to maintain that their patients are low risk. i had a FP with my son and she would recommend all kinds of stuff as a dr, but she made it very clear i could refuse ANYTHING and she wasn't going to bully me about it. she would say that certain things would make her nervous, but it was my decision. i hope i am making sense.

i would go personally. maybe call her and have her explain why the u/s takes an hour if they are only checking for fluid levels. the u/s tech might be looking for all kinds of things but your midwife is mainly concerned with what the fluid levels say. is someone going with you to the appointment?

These are good points. My DH goes with me to all my appointments (and he was REALLY skeptical about both tests). Here's hoping I won't make it that long!

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bri276

· #8 · Apr 14, 2006

I had a 41w u/s that only took about 2 minutes. I wouldn't want it to go much longer than that. there is no reason for it to. after a max of 5 minutes if I were you I'd just say, I don't feel comfortable with long u/s, could we end now please.

THEY can't decide you have to be induced. they have absolutely no leg to stand on. (I am testy right now, just got thru watching an episode of Runway Moms where they freaked the mom out about a small baby "below 50th percentile- so?? and turned out to be an 8.8 lbs baby

)

anyways, if they have a woman over 42 wks, I bet you will be fine. but you're right, there is no need for an u/s to be that long, ever.

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boscopup

· #9 · Apr 14, 2006

Checking fluid levels alone does not take an hour, but it sounds like they'd probably be checking lots of stuff to see how the baby is doing - not just fluid levels. I had two u/s's 4 days before my DS was born (had PPROM at 29 weeks), and they checked fluid levels and other stuff, and I think each one took 15-20 minutes total. Those were the first u/s's I'd ever had, but they were important given the situation I was in.

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Hayes

· #10 · Apr 14, 2006

I'll be honest. I wouldn't do it unless I was concerned. I went 12 days past due with #2. Baby was active. I felt well, no blood pressure issues. She came when she was ready. I went for one NST which seemed silly since I could ALREADY count her movments without being on the monitor.

You might want to cross post this in Birth and Beyond.

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doula and mom

· #11 · Apr 14, 2006

wow your mw sounds great. but for those who have mw's that would induce an overdue preggo haveing the test is a great way to appease everyone. they wanted to induce me and i told them no. once they checked my levels and saw everything was fine they got off my back. it was worth it.

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