Would you opt for increased monitoring due to age?

SeaSoul · August 2011

At my 23-wk appt my midwife told me that MFM (who did my anatomy scan) advised due to my maternal age that I have monthly growth scans from 26 weeks on, and weekly NSTs from 32 (36?) weeks on.

The midwife left it up to me...said that while there is an increased risk of fetal demise with age she didn't really think it was necessary to monitor that closely, as all seems fine and in most cases when things do go wrong there no warning signs, so the monitoring wouldn't help prevent.

I am inclined to avoid the multiple appts - if I had a medical condition then I'd do it without hesitation, but for age alone it seems excessive. However, this situation reminds me of the amnio that was offered us in this pregnancy and my first...we declined it because of the risk of miscarriage - even though we know the risk is very, very small, we would not have been able to live with ourselves if anything had happened. Similarly, if all this monitoring might possibly help prevent a tragic outcome to this pregnancy, why would we turn it down? I guess because it can also cause more stress, and that's not great for anyone either.

What do you think you'd do?

Dragonfly1226 · August 2011

I would go for the extra monitoring if it was me. But I am that person who always has freak medical issues. Like when they go over the risks if a procedure but then say, "but that almost never happens." Those things tend to happen to me.

emmyloustu · August 2011

Hmmm...I will probably be in the minority here, but I think I would decline it. I have always said that I trust my MW 100% and I know without a doubt that her goal is the same as mine- to guide me & this baby to a healthy & safe delivery with as few interventions as possible unless medically necessary. If my MW told me she did not think the additional monitoring was medically necessary & the MFM couldn't give me a conclusive reason other than AMA, I would be inclined to refuse it. Just my 2cents!

AlissaCell701 · August 2011

Yes I would go for the extra monitoring. I am scared to death of having another child with IUGR..I didn't know that Jake was IUGR until I gave birth to him and my OB is sort of the opposite of yours. He is super conservative (doesn't do lots of u/s) only does doppler checks at apts..ect..

At the end with J..I would tell him that I had some decreased movement, headaches, some blood pressure issues and he kind of blew it off. And if I had pushed harder, we might have been able to know sooner that J was IUGR and only 3lbs!. Yes, in my case things ended up ok..he was totally healthy and only spent limited time in the NICU. But in most of these cases things don't turn out so great.

So, yes I would do the u/s! It shouldn't really cause any more stress, maybe if they aren't covered by your insurance and there is a money issue..but I would still pay for them OOP just to have the piece of mind..

At my 20 wk apt next week I have to talk to my OB about allowing me to get more u/s during this 30-36wk time!

armywife76 · August 2011

I would go for the extra monitoring, but I tend to be a nervous Nellie like that.

DavezWife · August 2011

yes I would. Your ute is old(er) and your placenta is more likely to weaken and/or slow down on delivering nutrients to the baby in the final week(s). The baby's growth should be monitored.

gringa78 · August 2011

armywife76:
I would go for the extra monitoring, but I tend to be a nervous Nellie like that.

This. I went for monthly growth scans because I was on Lovenox (suggested by the MFM)...even if it was excessive (which my OB thought it was), it put my mind at ease when I saw her every month.

schmoodle · August 2011

DavezWife:
yes I would. Your ute is old(er) and your placenta is more likely to weaken and/or slow down on delivering nutrients to the baby in the final week(s). The baby's growth should be monitored.

Ditto. And if they're monitoring they may catch decreased movement/failed NST/BPP that could call for delivery and potentially save baby's life. The monitoring in and of itself isn't an intervention, and it only leads to them if there's something actually wrong. But I am very paranoid. I actually requested weekly NSTs when pregnant with Boodle and my doc said they weren't necessary...

krissyh21 · August 2011

I had the extra monitoring and would do it again. Even though most of the extra monitoring was needed because I was pre-e on bedrest, it also gave me peace of mind that everything was going good.

Plus a bonus is you get to see your LO once a month!

Of course I went and delivered at 34 weeks anyway but..

mrsolsenk12 · August 2011

I would do the monitoring but I am high risk so my perception might be schewed. Age is a factor in pregnancy.

Christakim · August 2011

Yes, I def. would go for the increased monitoring.

GuitaristsGirl · August 2011

I honestly don't see any downside to increased monitoring. While I'm sure it would be an inconvenience (I was going twice a week - I understand!) it's not an "intervention" and, for me at least, wasn't stressful. I always take whatever monitoring I can get them to offer

IMO, there's a chance good could result and no chance of bad. GL!

RoxBride · August 2011

The extra monitoring I received likely saved my life and my DDs, so I'm all for it. Of course, I'm biased since it worked out for us.

laura1 · August 2011

I would do it too. I measured small with DD and at 32 weeks they sent me for u/s. I had borderline low amniotic fluid, and my OB did weekly BPPs and NSTs from there on out (a few times the fluid measured better, but we still kept doing them). It was a bit of a pain, trying to get people to watch DS or having to bring him with me, but it was worth it to me to make sure all was ok.

But like most, I am a nervous nellie - it made me feel better to get all the monitoring. I would have been more stressed/nervous if I didn't get any monitoring.

Good luck deciding!

dundasgirl · August 2011

Absolutely get the extra monitoring. I know of too many bad stories...I take any extra reassurance I can get.

SeaSoul · August 2011

emmyloustu:
Hmmm...I will probably be in the minority here, but I think I would decline it. I have always said that I trust my MW 100% and I know without a doubt that her goal is the same as mine- to guide me & this baby to a healthy & safe delivery with as few interventions as possible unless medically necessary. If my MW told me she did not think the additional monitoring was medically necessary & the MFM couldn't give me a conclusive reason other than AMA, I would be inclined to refuse it. Just my 2cents!

This is my natural inclination...maybe I will ask the midwife I'm going to see next week (there are 4 in the practice) what her opinion is, rather than basing my decision on what 1 of them said.

SeaSoul · August 2011

GuitaristsGirl:
I honestly don't see any downside to increased monitoring. While I'm sure it would be an inconvenience (I was going twice a week - I understand!) it's not an "intervention" and, for me at least, wasn't stressful. I always take whatever monitoring I can get them to offer IMO, there's a chance good could result and no chance of bad. GL!

This makes a lot of sense to me...thanks for putting it that way!

SeaSoul · August 2011

dundasgirl:
Absolutely get the extra monitoring. I know of too many bad stories...I take any extra reassurance I can get.

Bad stories specifically related to advanced maternal age??

dundasgirl · August 2011

SeaSoul:

dundasgirl:
Absolutely get the extra monitoring. I know of too many bad stories...I take any extra reassurance I can get.

Bad stories specifically related to advanced maternal age??

Yup...I won't tell you the stories, but they didn't see it coming and it was very tragic. Three stories:(

amberleeb · August 2011

I would it's not an intervention it is just a precaution they are just looking and watching you and the baby, not doing anything that would effect the baby.

emmyloustu · August 2011

I guess the other piece of it for me is that I feel like my MWs are SO much more hands on with my care than my OB ever was. They spend an hour with me every single appt & we talk about the entire picture of my health - nutrition, stress level, activity, etc... They don't do growth scans unless needed, but they are very on top of babys growth & position - I get a weight estimate weekly based on manipulation - with Eliza they were within an oz of her birth weight. Like I said, I knew I'd be in the minority, but I feel like I am more apt to subscribe to a midwifery based model of care. I am anxious to hear if the opinions of the other MW in your practice differ...

LVBlvd · August 2011

I absolutely would do the monitoring suggested.

lrrb · August 2011

I would go for SURE. It doesn't make sense to not do what the dr suggests, its not like they are asking you to stand on your head just go to a few more dr. apt to check on your baby. If they ask you do something at the dr that makes you uneasy then thats different but I would be safe than sorry, thats my opinion. I've seen 3 friends lose full turn babies in their late 30's and it scared the crap out of me....

LucyPevensie · August 2011

NST's and growth scans are very non-invasive - based on that - I'd go. I think at 41 you are perfectly safe. BUT - I'd still go for the extra monitoring for peace of mind.