Natural Birth

Prenatal care

I apologize if this is off-topic, but I figured the natural birth thread would be the best place to get advice on natural prenatal care. I was wondering if any of you have ever refused the glucose test at 28 weeks? I really don't like the idea of drinking a bunch of sugar water with artificial coloring, and I have heard that the test is not reliable. I am also under 25, at a healthy weight, and already eat a diet very low in white flour and sugar. 

Along a similar line, do any of you have experience with the Rhogam shot? I am Rh-negative and I am supposed to get that at 28 weeks too, but I am nervous about the fact that it is a blood product. Thanks! 

Re: Prenatal care

  • I didn't do the glucose test with my second because my doctor did GD screening based on risk factors instead of universal screening, and I did not have any risk factors.  

    Rhogam is a pretty safe product and personally I think you should get it.  If you become sensitized to Rh proteins in this pregnancy and get pregnant in the future with a baby that is also Rh+, your body's immune system can cross the placenta and attack the baby's blood cells, which can cause serious health issues for the baby.  Do you know if your husband/partner is Rh+?

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  • Please don't skip the Rhogam shot, it's too important!

    As far as skipping the GD, I wouldn't personally, I really do see the value in it.  And you are talking to someone whose results were a score of 69, extremely low, but when I'm pregnant next I will do it again.  There are alternatives, I know sometimes you can do a finger prick for I think 24 hours or eat a big carb heavy breakfast and then do a blood draw.  Also as far as the artificial food coloring, they do make a clear version which I had last time :)   

  • Thank you for the replies! My husband is Rh+ so there is definitely a chance that the baby is too. I will probably get the shot, I just wanted to hear from others about it. I have read things on both sides. The naysayers claim that if you don't have any stomach trauma or spotting, you don't really need the prenatal shot since the blood systems shouldn't mix, but those in favor say that the blood systems could mix without you knowing or having any signs. But I would rather do the safest thing for the baby. 

    Thanks for letting me know about the clear glucose solution. I will keep that in mind! 

  • I skipped the GD screen both times I was pregnant. My only risk factor for both was my age, and anymore I think ACOG wants all women over 25 tested (which is pretty much everyone!).

    I think it's like a lot of things with maternity care in this country - it goes overboard by insisting all women test (the rate of GD is actually under 5%, but the way the current test is run, your chance of being diagnosed is somewhere between 3-15%). Not to mention that different providers have different cut offs of what's considered GD, and that your body processes glucose differently at 24 vs 28 weeks. Until it's standardized enough that the results are consistent across the board, I don't see what the point of testing for it is (for me, personally, that is).

    Henci Goer has written about the flaws in the current method of testing for GD. This is a good article to read: https://www.ivillage.com/gestational-...ach/6-a-129188. And she writes more about it in "Obstetric Myths and Research Realities", though I can't seem to find it online right now, this is an excerpt that was in the book: https://www.gentlebirth.org/archives/gdhgoer.html

    I also find it interesting that other countries don't routinely test all women for GD the way the US does. I think things would be better if the importance of nutrition during pregnancy was taught and emphasized, rather than making every pregnant woman drink some glucola. hth

     

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • Just in my little group of friends, two women who were both under 30, very slim, athletic, no risk factors were diagnosed with GD after failing their glucose tests--one by a huge margin, one by 10 or so points.  They both followed the GD diet religiously during the third tri, but the one who failed so bad needed insulin by the end.  They both gained under 30 pounds during their pregnancies, and were very, very healthy pre-pregnancy. 

    For me, the GD test is a no brainer, considering how it really can affect anyone.  If you go on the high risk board, you will see that LOTS of women who have GD did not have any of the warning signs.  It is such a minimally-intrusive test, and it really is important.  I would wait until 28 weeks to get the maximum benefit from the screening.

  • This is too important to worry about a little dye or whatever.

    Healthy, height-weight proportional, active women can and do develop GD.

    Having a negative Rh factor and a husband with a positive Rh factor means you are putting future kids at risk if you decline this shot. We're not planning on having more after this one, but I still got the shot because plans can change. It's just too important.

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  • I would never refuse the test. My SIL is at a healthy weight, works out, eats a healthy diet, and she had GD. You just never know.

    It won't be the end of the world. Likely you will pass and that will be that.

    The ramifications of untreated GD are far worse than the junk you will have to drink.

    Wyatt 9/6/2011 
    Tessa 7/5/2013
    Baby #3- ????? (ttc soon)


  • I skipped my GD test. My midwife left it up to me and I decided not to do it.
    Mommy to Emery Vera 5.20.12  Blog
  • I am delivering with a very easy-going midwifery practice and they are very open to refusing any testing that I want.  But they REQUIRE the GD test.  If you have GD, there are just too many potential concerns, so the MWs need to know what they are dealing with and if it would ultimately be safer for you to deliver in a hospital.
  • This article is a pretty neat one looking at the pros/cons and reliability of the glucose test: https://evidencebasedbirth.com/gestational-diabetes-and-the-glucola-test/  

    Keep in mind--GD is not the same as "normal" diabetes so your health and diet might not mean you're in the clear. Your metabolism changes with pregnancy in ways you can't control.  At the same time, you're right--the test is not 100% reliable and IMO overdiagnoses and leads people to start suggesting more interventions (the most common I've seen is people who have GD or are "cuspy" being told they need to induce).  IMO, testing isn't the issue--it's taking charge of your health and knowing what to do with the results that matters most. 

    I went ahead and did it...but then again I'm a closet Fanta drinker so sugar water with fake color didn't bother me as much lol! 

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  • Thank you all again for your replies. This is my first pregnancy so I just wanted to get advice from other women before I decided anything. I am still going to talk to the doctor but I will most likely get the test. 
  • I refused the glucose test you are describing because I don't consume much sugar and I worried it would make me sick. My midwife offered another way to test, which is where you eat a full breakfast and then 2 hours later they draw your blood and test it. I am young and a healthy weight but this is my first baby so I wanted to be sure. Also the shot for RH negative is important. My mom was negative and my sister and I are positive, she did not get the shot and we both got jaundice. 
  • Please get Rhogam - it is super important if you want another child.  If you develop the antibodies to Rh+ in this pregnancy, and then you have another child that is Rh+, not only could that child be jaundiced, but he or she could become severely anemic in utero.  Some babies require in utero transfusions when this occurs.  Then after they are born, the risk for an exchange transfusion due to jaundice or anemia is much higher.  By attempting to avoid a blood product for you, you could inadvertently be putting a future child at risk of needing significantly more blood exposure.  

     https://www.webmd.com/baby/intrauterine-fetal-blood-transfusion-for-rh-disease

     https://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn#Treatment

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