GD test?

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lexirunner's picture
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GD test?

I know this is a little last minute, as my Dr. appointment is in a few hours... But how necessary IS the GD test? I did it with my other two pregnancies and the results were normal. This time, I really don't want to... I don't know why. It tastes gross, and feels unnecessary unless I'm showing other signs/symptoms of GD. I'm not really prepared to fight my way out of it, but would be happy to sign a waiver... I have a feeling they won't let it go that easily though.

In class when we were practicing taking blood sugars, mine was 64 (fasting), which is low/normal. Maybe I can use that to argue in my favor?? If they make a big deal about it, I'll probably just "forget" to get it done, unless they have a good reason that they want me to do it. I don't know! Do you guys think it's a big deal?

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I dont know....I just do it. It is used to find the people with problems...a screening tool. you would probably be fine to not take it...but doctors dont just do things for the heck of it....what do they care? they do it to find moms that need intervention with diet or meds...babies born to moms with gd are big and can be very sick...so if there is an easy test to find these moms that need intervention... then great. My doctor said he was pretty sure my test would be fine. So...I guess I could have skipped it...but its not that big of a deal to me. if you were good in the past and your sugars are usually low...I bet your doc will be fine with you skipping it.

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I declined this test. Audra has the best links on this...she posted them already somewhere.... but the point is there ARE other things your OB does already that would catch GD better than this test. Unfortunately, there are a lot of things that doctors do for everyone, because it is easier than not doing it for everyone...but it's not necessary. Seems to me that this test falls into that category. When I told my doc I didn't want to do it, she actually didn't really fight me on it- just said to keep being mindful about what i'm eating and how I'm feeling. Let me see if I can find the info that Audra posted for me before...

Here's some stuff Audra posted before:

Here are some articles about GD testing. Henci Goer is well known in the birth world.

She encourages all women to make informed decisions about their care based on EVIDENCE based medicine.

http://www.gentlebirth.org/archives/gdhgoer.html

The American College of Obstetrics and Gynecologists (ACOG) said in a recent statement to the media that there is not one certain method to be used to effectively screen the pregnant population for gestational diabetes. They do not, however, know what screening is best or agree on when the screening should take place.

Taken from: http://pregnancy.about.com/cs/glucos...e/a/gttest.htm

And another Henci Goer article: http://www.gentlebirth.org/archives/gdmodent.html

What I like about this article is this emphasis-- that rather than screening/scaring women about GD, we should be offering practical nutrition advice to ALL women, regardless of their "diagnosis" of GD....Essentially that all pregnant women should eat complex carbs, high protein diets and that they should exercise regularly-- but almost no OB's offer any nutrition advice or even ask about levels of physical activity.

Mara-- there are other signs/symptoms of GD. You would spill glucose in your urine and could diagnose with finger prick blood tests at regular intervals over time if you exhibited signs/symptoms (excessive thirst, fatigue, etc.)

Good luck!

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I've declined it with my last three pgs. It is as simple as signing a waiver. If you want, you can ask for a finger prick in addition to your urine glucose screen (my MW did that and I got a clear picture of what my blood sugar level was without any weird sugar load.)

First things first, you absolutely do NOT have to submit to any test "just because". I don't totally trust the medical establishment and what they deem as routine for most patients, bc they operate from a worst case scenario perspective most of the time. I prefer an individualized, personalized approach, which frankly, most OB's and hospitals do not function from.

Just think about the other things in newborn care that have been "routine" that we found out later were NOT in the best interest of mom or baby-- docs not washing hands between births, docs administering ether for births, newborns being separated from mom immediately after birth, formula feeding ALL babies, bc nursing was seen as sub-par, routine episiotomies, etc. My point is that while I think maternal care is improving, it is still far from perfect. And there is a lot of gray area. I also think about the number of doctors who have started inducing women without evidence that it is improving outcomes (and ACOG just had to come out with a statement about how inductions for no medical reason ARE a bad idea....and encouraging OB's not to do it.)

Mara shared the posts from previous convos about this. Good luck with your decision.

Eat well. Exercise. Your doc is not responsible for a healthy baby, you are.

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I do think this test is used overly...because giving it to some who do not need it is a better option than missing those that did need it. Like I said before, I have seen a baby sick because mom did not get care for GD. Its sad that it happens and it can totally be prevented...these screening tools are to find THOSE patients...unfortunately....most doctors just follow the recommends and do not use common sense and patient specific circumstances to figure out who should and should not get the tests. If you have been good in the past and you are healthy with diet etc...Im sure your doc will not mind you skipping it. I just get a little annoyed when people look at their own circumstances and say a screening tool is totally not necessary...when there is a HUGE population of people out there having babies....this screening tool may be very valuable for some...and should not just be skipped by everyone!! This is just my own opinion. I totally know doctors are humans they are not perfect and they are not responsible for the health of our babies....but I personally have medical conditions that require medical intervention. Without it...I wouldnt be able to have children...so to act as though the doctors are the bad guys is a little annoying to me. I also believe that just because people choose to have medical intervention does not make them "uneducated" on the topic. I am very educated on it...and I still choose to let them do many things. Not to start a huge debate...but sometimes I dont like the anti medicine tone some of these discussions take on. To each there own.

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It really sounds like you have a low-risk factor, if you feel comfortable turning it down - then do it. I really wish I would have followed Audra's advice and declined mine a couple weeks ago. It was unneccessary as my risk factors are extremely low, I had no symptoms, and frankly it made me feel like crap for hours afterwards.

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I will be having it done next thursday. I feel like i will not hurt me at all to have it, but it could only help to know the results. I had a 10 pound baby without having gd so I cant even imagine how big a baby I would grow if I did have gd and wasnt screened and didnt regulate my diet.

lexirunner's picture
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Thank you for the responses! I wasn't meaning to stir up any issues with anyone. I just feel that for me, I don't think it is necessary at this time, but that's not to say that someone else shouldn't do it. The best thing anyone can do is inform themselves, and hopefully work with a doctor/midwife to choose the path that is best for their individual situation.

boilermaker's picture
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"mamato6" wrote:

I do think this test is used overly...because giving it to some who do not need it is a better option than missing those that did need it. Like I said before, I have seen a baby sick because mom did not get care for GD. Its sad that it happens and it can totally be prevented...these screening tools are to find THOSE patients...unfortunately....most doctors just follow the recommends and do not use common sense and patient specific circumstances to figure out who should and should not get the tests. If you have been good in the past and you are healthy with diet etc...Im sure your doc will not mind you skipping it. I just get a little annoyed when people look at their own circumstances and say a screening tool is totally not necessary...when there is a HUGE population of people out there having babies....this screening tool may be very valuable for some...and should not just be skipped by everyone!! This is just my own opinion. I totally know doctors are humans they are not perfect and they are not responsible for the health of our babies....but I personally have medical conditions that require medical intervention. Without it...I wouldnt be able to have children...so to act as though the doctors are the bad guys is a little annoying to me. I also believe that just because people choose to have medical intervention does not make them "uneducated" on the topic. I am very educated on it...and I still choose to let them do many things. Not to start a huge debate...but sometimes I dont like the anti medicine tone some of these discussions take on. To each there own.

I'm sorry. I in no way mean to suggest that those who opt in for these tests and others are "uneducated". Not at all. I'm not anti-doctor or even anti-OB, but I do think we as mothers and women and individuals owe it to ourselves to learn about this stuff and not go blindly into pregnancy and childbirth.

The US has some of the WORST perinatal outcomes in the world. Seriously. Moms and babies are dying, and yet we spend more than just about every other country on healthcare for moms and babies. We must be doing something, many things, wrong, or we wouldn't have these outcomes. Our birth outcomes are worse that Latvia.
http://whqlibdoc.who.int/publications/2007/9789241596145_eng.pdf

I also never suggested that people NOT be screened for GD-- just that most OB's are already screening for GD at every.single. appointment-- they test for glucose in your urine. They can prick your finger. The finger prick is MORE reliable than guzzling that sugar drink and drawing blood later. The screening test is inaccurate. Not only does it flag people who don't have GD but it misses people who DO have it-- *that* is my point. I want better health for moms and babies.

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I am always glad to read both sides of this issue. I think there are good reasons to stand on both sides of this question - to test or not to test. I fall on the side of testing for GD - my doctor recommends it, and I trust his opinion since I have some other risk factors as well. My OB must not be most OBs, because I do not take a urine test at every appointment. Is that pretty common?

I think this falls similarly into the idea of prenatal vitamins. If you cast a wide net and recommend that EVERYONE take the prenatal vitamins, or do the glucose testing, then you have a higher chance of catching the women who do need further nutritional coaching and intervention. We all probably don't need it, and I don't see any issue with refusing it if you feel comfortable. However, I also feel comfortable that the 1 hour screening has been scientifically validated and is still recommended by ACOG, according to the documentation I found.

Nice discussion, ladies!