Posted by My OB said WHAT?!?.
Posted by My OB said WHAT?!?.
“Since Your First Was So Large, We Are Going To Need To Test You For Gestational Diabetes Twice…”
“Since your first was so large, we are going to need to test you for Gestational Diabetes twice – once as soon as the first-trimester nausea passes, and again at the usual time.” – OB to a mother with no history of Gestational Diabetes.
I was NOT amused. However, I otherwise very much like this practice, this doctor, and the hospital they can deliver at…so I stuck out the stupid tests.
My first was 11 pounds 9 ounces. I passed the GD one-hour with flying colors that pregnancy. She insisted on testing my blood sugars after delivery also, and that test also came back normal.
Meanwhile, I learned and told her that we have family history of large babies on both sides (10+ pounds on my husband’s side, my father’s brother was *12* pounds).
So for the next pregnancy I got to do the GD test twice. To add insult to injury, I missed the 1-hour cutoff by like 4 points on the first go and had to do the 3-hour – and then she just had me do the 3-hour again at the end. Ugh. Passed both of them.
Second son arrived 40 weeks 6 days at 10 pounds 8 ounces.
Obviously, the GD test was very useful. Also, after I passed BOTH GD tests I was STILL advised (both times) to cut back not just on sugar but on carbs…without asking how I was already eating. Ummmm….
I’m not as thrilled with this practice as I was before this crap. And yet, they helped me deliver a large baby, completely natural, no interventions, and the particular doctor I work with was as frank as she could be about when she was following a legal (rather than medical) obligation in a recommendation. There’s a lot that I like about them. This GD crap is NOT one of those things.
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Laura Reply:
December 13th, 2011 at 2:37 pm (Quote)
Darnit. Missed the pink ticky-box. This is the OP.
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Knitted in the Womb Reply:
December 13th, 2011 at 2:49 pm (Quote)
I think your post got lost somewhere?
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Knitted in the Womb Reply:
December 13th, 2011 at 3:16 pm (Quote)
Oh…its there now…weird! And now your post that used to be pink isn’t pink anymore. Good to read the back story though!
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Laura Reply:
December 13th, 2011 at 7:03 pm (Quote)
That was REALLY weird. When I posted the original one, I didn’t get the pink-this check box. So I saw it and replied and pinked that, but my computer showed both and neither was pink. On my cell phone in the mobile view, my original post didn’t show. Weird….
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Veronica Reply:
December 13th, 2011 at 5:52 pm (Quote)
I like that the doctor admitted it was a legal obligation to recomend the 2 times testing.
At least it was not out of their own stupidity!
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Laura Reply:
December 13th, 2011 at 7:02 pm (Quote)
Oh, she didn’t on that one – that one was more to appease her colleagues in the practice. Sigh. The legal obligation thing was advising me to induce with a completely healthy, suspected large baby, as soon as he went 40 weeks 1 day. He was, in fact, large. He also was just fine where he was and I figured he’d come out on his own – as he did – and there’s no indication that induction improves outcome for big babies in any case, that I could find.
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Common Sense says: So……what does her chart from the previous pregnancy say about gestational diabetes? Maybe that could be a clue as to wether or not she’ll have GD this time….
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Laura Reply:
December 13th, 2011 at 7:04 pm (Quote)
Oh, even better than my chart from the first pregnancy (which showed I passed the 1-hour GD screen with flying colors, AND the blood-sugar test after delivery as well)….
…I saw the same OB for both pregnancies and she *remembered* me, my baby, and my test results, and STILL said this gem while acknowledging that!
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Melissa Reply:
December 14th, 2011 at 4:26 pm (Quote)
I do have to say that I did not have GD with my first… passed with flying colors. I am now in my 2nd. Same weight at previous, and have actually stayed under my pre-prego weight. (i’m overweight so it’s okay, baby is growing well) I just found out I have GD…and it’s bad enough I have to be on Insulin shots. So just because your first pregnancy was fine doesn’t mean you 2nd will be.
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Why oh why can’t babies just be big? X/
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I wonder what she would say to someone like me whose first trimester nausea never went away. I’d be just fine with never testing
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jenni Reply:
December 15th, 2011 at 4:16 pm (Quote)
mine usually goes away just in time to take the one test, and if i didnt have lovely veins that make the test easy for me, i’d probably be ticked to do the damn thing. oh, and i like the hour i get to read my romance novel…. and as much as i do try to assert myself, they are taught really well how to con you into their tests… more time is spent teaching them how to con you into the test than is spent on the bad effects of interventions i’m sure.
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Probably will be an unpopular response here but I’m in a similar situation. My first was almost 10 lb and I have pretty much every other risk factor for GD other than not having it with my first pregnancy (to put it succinctly – large first baby, old, fat and strong family history of Type II diabetes). Just took my first test at 14 weeks and passed. Will take it again at 24-28 weeks. I have no problem with it. Honestly, I’d rather be safe than sorry. That said, my OB is supportive of moms with GD birthing the way they want, even if that means going past 40 weeks, going med-free, etc. If that were not the case, maybe I’d feel differently.
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WellBegun Reply:
December 13th, 2011 at 10:10 pm (Quote)
Similar indications here, except that I also have PCOS. I declined the early screen. My midwife was fine with that. Unfortunately, due to silly state regulations, I do have to do one screen if I want to stay at the birth center. So I’ll do ONE. Grudgingly. In the third tri. I haven’t done one since my first baby, and the whole experience surrounding that situation was quite awful. My subsequent babies were homebirths.
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Rebecca Reply:
December 14th, 2011 at 10:36 am (Quote)
I actually don’t think the initial request is unreasonable. I lost my first son to birth defects caused by undiagnosed type 2 diabetes. The diabetes started just prior to the pregnancy, a test would have been the only way to catch it in time, but that’s not a standard test, unless you are significantly overweight, which I am, but even then, testing that early isn’t common.
Anyway, I fall into the better safe than sorry crowd. However, I think that requiring the repeat testing was ridiculous. Four points? Come on. I get that there are standards, but doctors make judgement calls all of the time. Like I said, I’m a diabetic. I check my blood glucose levels every morning when I get up. My goal is 90, but you aren’t going to see me calling my doctor if I get a 94. That’s totally ridiculous.
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they did the same thing to me too! My first child was 10 lbs 3 oz. i did not have GD. The second time around they made me do that stupid test twice for the same reason! guess what? I didnt have GD the 2nd time either! i just have big babies. (#2 was 8 lbs 13 oz)
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I hated the GD test. I had hyperemesis gravidarum so I was terrified of the test, and failing it. I offered to show them the record of my blood sugar from the whole pregnancy instead, and they told me it was inaccurate. Just to be clear, I kept track of it because I have fainting spells randomly and I am trying to find a connection between sugar levels and fainting. I had no risk factors, and they made me do a draw before the test, at 1 hour, at 2 hours, at 3 hours, and at 4 hours, and I puked every time. Totally unreliable, but I passed every one!
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Lisa Reply:
December 13th, 2011 at 10:18 pm (Quote)
If blood sugar records are inaccurate, then Type 1 & 2 diabetics are in big trouble.
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Aron Reply:
December 14th, 2011 at 6:22 am (Quote)
Blood tests (finger sticks) are inaccurate? Tell that to all the patients I’ve had to stick before each meal in the hospital. And how were they, therefore, planning to determine your blood sugar? By using a tricorder? Sonic screwdriver? Magic wand?
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Kit Reply:
December 15th, 2011 at 5:22 pm (Quote)
Did you ever figure out why you were fainting? I’m curious because I have had fainting spells with both pregnancies so far, mostly in late second and third trimester. Turns out mine is because my vena cava is in a weird position, so baby can cut off blood supply pretty easily. Maked things interesting! I have never heard of or met anyone else with the same issues, so I am being nosy.
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Lindsay Reply:
December 15th, 2011 at 7:40 pm (Quote)
I have fainting spells whether or not I’m pregnant, but it has just been discovered that I have a heart arrhythmia that occasionally interferes with blood flow, so I faint. I don’t need medicine or anything, just management skills like lying down when I feel it start and keeping myself in a safe place. Its induced by stress, and with a previous late term miscarriage, I was full of stress this last pregnancy! Its no problem “being nosy”- I’m the same way! Good luck on your future pregnancies!
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I had no other risk factors whatsoever, no family history of diabetes, no history of high blood sugars, I’m overweight so my GP had checked this previously. This is my first child so that was not a factor either. I was told by the OB that they automatically send anyone over 200 lbs, regardless of height or build to the 1 hour screen after your first appointment, you are then required to take the 3 hour automatically at 28 weeks. They are surprised every time I come that I passed both with flying colors and have not had any issues with blood pressure either… they like to make assumptions that are based on nothing.
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In Canada at least, this is the standard of care and is what is explicitly instructed in clinical practice guidelines. Inconvenient… sure. But if practitioners didn’t do this they would be committing malpractice.
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amanda Reply:
December 14th, 2011 at 12:17 pm (Quote)
do you mean it is standard to test at two different times in the pregnancy, or to do both the one and the three hour test? i have been pregnant 4 times and have never had more than the test at 28 weeks, though in my first pregnancy i had to do both the one hour and three hour.
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Ummm... Reply:
December 14th, 2011 at 4:58 pm (Quote)
According to the Canadian Diabetes Association guidelines (available for free online): All women are supposed to be tested with the 1 hr test between 24-28 weeks. If you have risk factors (like having a previous big baby), you’re also supposed to be tested in your first trimester. The 3 hour test is only used if the 1 hour comes back in the “in between” zone. These guidelines are the result of many many studies and are very evidence based.
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That same thing happened to my sister in law. Her first was over 8 pounds, and her second was well over 9. No history of GD with either one. Her mom always had big babies…my SIL was almost 11 when she was born, and her husband has big babies in his family too…he was one of a set of twins that were both over 7 pounds each. She’s 21 weeks with #3 right now, and they made her do the GD test at 14 weeks, plus she’ll still have to do the one at the regular time too. And her dr says that he won’t let her go to her due date since her babies are so big…even though her labor with the 9+ pound sunny-side up baby was 6 hours start to finish with a 13 minute pushing stage…
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Mandie Reply:
December 13th, 2011 at 7:33 pm Mandie(Quote)
Maybe your sister-in-law needs to read this site much more and “Just say no” to connivence oriented OBs with scare tactics that are just…. stupid!!
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Lora Reply:
December 13th, 2011 at 9:03 pm Lora(Quote)
Agreed! My providers didn’t get to “let me” do anything.
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Lisa Reply:
December 14th, 2011 at 8:06 am Lisa(Quote)
Oh believe me, I’ve tried talking to her, but she is convinced that her dr is always right…
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