How typical is weekly non-stress tests at 34w+ just for being 35+ years old?

RedLucia · July 2013

Did/does your OB/Dr want you to have weekly non-stress tests starting at 34 weeks just for being 35 years or older?

My OB wants me to have them due to age even though every aspect of my health and pregnancy looks good. On the one hand, the non-stress test could result in false positive "lack of reassurance" and even more monitoring and worry. On the other hand, there is a very extremely slight chance it could help avert harm to baby.

It makes me sort of sad to be scheduled for non-stress test monitoring. I've been enjoying using my own evaluation of my baby based on her robust movements and occasional heart monitoring.

On another note, it will take more of my time and add to the insurance bill.

SusanTeach · July 2013

I'm 40, a 1st-time mom, natural---due to my age, they are recommended. There was a recent miscommunication that I wrote about in another post (won't go into it here), but I found my docs (there is a practice w/4 female docs and patients see all of them) assumed I have been going weekly. Funny thing is, not one of them told me to do so.

Last Friday, I didn't feel the baby kick for 4 hours. I panicked and had my DH page the docs. They said to head over to the Birthing Inn for a NST. I was crying the whole way. I am 40 weeks, due on the 6th (this Sat.), so all I could think was STILLBIRTH. This happened to a younger colleague a few years ago, otherwise it wouldn't have entered my mind. ALL WAS FINE. I also scheduled one for this Friday. At this point, I could start labor any moment or be overdue. Better to safe than sorry.

RedLucia · July 2013

I started searching on other forums (not bump) and found that a lot of women are sent for weekly non-stress tests around 34 weeks. However, AJOG guidelines do not list age as a stand alone criteria for these.

Also, a lot of women have posted that there is a sound from the non-stress test monitoring belt that "upsets" their baby. I thought the heart rate monitor was outside the range of human hearing. So I am trying to figure that out.

I don't mind spending my time or money, but I wouldn't want to do a repeat procedure that is probably unnecessary AND distresses my baby.

Abeille · July 2013

I've had weekly u/s since 32 weeks mostly b/c of my age. The u/s are to check fluid levels, assess the health of the placenta, and make sure baby is moving and gaining weight. I do think my OB is taking a very conservative approach, but I am fine with it. The reality is that there are more risks just b/c we are AMA. Even though chances are everything is going to be fine and so far every u/s has come back perfect, I'd rather be on the safe side.

In the end it's about a healthy mom and baby.

RedLucia · July 2013

Abeille:
I'd rather be on the safe side.
In the end it's about a healthy mom and baby.

I agree! Just a bit of shock for me to be referred for weekly extra monitoring.

Abeille · July 2013

RedLucia:
Abeille:
I'd rather be on the safe side.
In the end it's about a healthy mom and baby.

I agree! Just a bit of shock for me to be referred for weekly extra monitoring.

I was 35 when I delivered my 1st and I didn't have this much monitoring towards the end. I do have a different OB, or maybe it's b/c I'm 39...I was a little surprised to start weekly monitoring at 32 weeks. But as I'm approaching my due date, I think those u/s looking good every week have help ease a lot of anxiety too..I know he's doing weell, and it's helping me relax a bit.

RedLucia · July 2013

I will probably enjoy the extra attention and monitoring!

kellyk17 · July 2013

I'm FTM and only 27 wks, but I feel like if my OB recommends this I'll want more info. So much medical research now proves that AMA is not enough reason to do so many of the extra tests they recommend. It depends on a lot more factors then just the moms age.

Melissa72777 · July 2013

Hi I'm new to all this can someone tell me what AMA means and what non stress testing is? Thanks!

happywifemomofone · July 2013

AMA-Advanced Maternal Age

NST-Non-stress test I think that they hook you up to a monitor and measure baby's activity and HB fro 20-30 minutes. They are watching for dips in HB with activity. Is that correct ladies?

BootsOrHearts · July 2013

If you're not comfortable with it, ask your doctor for some more information before agreeing to extra testing. Is there some data they have that shows that doing NSTs for AMA women helps prevent stillbirth or labor complications?

If there isn't any medical evidence like this, your insurance company may deny it for being not medically necessary so if you're going to pay OOP for it, you'd want to know that up front before you make your decision.

RedLucia · July 2013

I did ask for more evidence and the basic evidence is that risk of still birth is 1.9 times higher for women age 35+ vs those <35 years old without adjustment for other factors such as BMI, blood pressure, and other health issues. My OB could not tell me how many non-stress tests need to be performed to prevent a single still birth among women with no other clinical indications for the test aside from AMA. I could not find it as a specific criteria on AJOB Guidelines. However, my insurance will cover it.

I don't think there is a good public health cost-effectiveness case for performing these tests simply for AMA. In other words, doing this test repeatedly with no other indication but AMA does not save enough lives to justify the expense. If I just think about myself, I can afford the test and I would probably enjoy the information. When I think about society, I am ethnically concerned that doing these unnecessary tests simply contributies to the rising health care expense problem.

BootsOrHearts · July 2013

RedLucia:
I did ask for more evidence and the basic evidence is that risk of still birth is 1.9 times higher for women age 35+ vs those <35 years old without adjustment for other factors such as BMI, blood pressure, and other health issues. My OB could not tell me how many non-stress tests need to be performed to prevent a single still birth among women with no other clinical indications for the test aside from AMA. I could not find it as a specific criteria on AJOB Guidelines. However, my insurance will cover it.
I don't think there is a good public health cost-effectiveness case for performing these tests simply for AMA. In other words, doing this test repeatedly with no other indication but AMA does not save enough lives to justify the expense. If I just think about myself, I can afford the test and I would probably enjoy the information. When I think about society, I am ethnically concerned that doing these unnecessary tests simply contributies to the rising health care expense problem.

This. And there's plenty of other examples like that. There are some doctors who seem to believe that a pregnancy cannot possibly progress without their constant intervention and testing. Don't even get me started!

Geeps2 · July 2013

I was just a few months shy of my 38th birthday when I had my daughter. My OB practice didn't have me do non-stress tests till maybe the week before my due date if I am remembering correctly. I had no complications, no GD, Fluids were good, baby always appeared to be healthy and holding its own so I was pretty much left alone. I was surprised because I rememeber reading on here all the ladies that were having weekly stress tests and I wonderded why I wasn't, but I wasn't complaining either. If things keep progressing the same as last time I feel confident that they will be leaving me alone till around the same time period. Good Luck! The light is at the end of the tunnel

RedLucia · July 2013

BootsOrHearts:
RedLucia:
This. And there's plenty of other examples like that. There are some doctors who seem to believe that a pregnancy cannot possibly progress without their constant intervention and testing. Don't even get me started!

*sigh* All told my insurance was billed about $12,000 just related to the false positive from the Verify test back in February/March. Aside from advance maternal age, there was no reason for me to ever have the Verify test in the first place. I feel like my pregnancy is a pretty good example of the problem that is described in this NYTs article.

https://www.nytimes.com/2013/07/01/health/american-way-of-birth-costliest-in-the-world.html?partner=rss&emc=rss&src=igw&_r=1&

Now, if I do 6 NSTs before I delivery, my insurance will probably be billed about $8,000 more for that. This is assuming no false positives from the NSTs. All the while, my OB says, "I expect all the non-stress tests to be fine." So I wonder why we would do this expensive procedure.

babystoli · July 2013

I'm 39, overweight, and have hypothyroidism. And I will be 37 weeks tomorrow. Third trimester has been a breeze and everything is going great. I asked my doctor about all these tests, and his mantra is "this is a normal pregnancy until there is reason to think otherwise."

Half of their practice is 35, and he but it's been a lifesaver the past few weeks. He said if there was any indication that it was necessary for me, at any point, they would order the biophysical profile and NST. But so far everything is fine.

Jaytee501 · July 2013

Abeille:
I've had weekly u/s since 32 weeks mostly b/c of my age. nbsp;The u/s are to check fluid levels, assess the health of the placenta, and make sure baby is moving and gaining weight. I do think my OB is taking a very conservative approach, but I am fine with it. The reality is that there are more risks just b/c we are AMA. Even though chances are everything is going to be fine and so far every u/s has come back perfect, I'd rather be on the safe side.nbsp;In the end it's about a healthy mom and baby.nbsp;nbsp;

This. I'm 40 now, almost 13 weeks pregnant with my 2nd.

I was 38 with DS; I had twiceweekly NST with him from 32 weeks. I understand once a week is often protocol if there are not risks other than what come with AMA; I had blood sugar issues.

There were never any signs of distress with the baby.

Everyone has to do what they are comfortable with. I did as my doctor advised and was thankful for the careful, additional monitoring.

RedLucia · July 2013

Interesting! Your doctor is very different from mine. I am normal weight, normal on every test & she still wants to test all these things. I went ahead and scheduled the tests to start at 36 weeks, but I might cancel the first 2.

I still have not found a single published article showing the NST decreases risk of still birth.

I think that another 2nd level ultrasound to look at the quality of the placenta and the biophysical profile of the fetus at 38 weeks would make a lot more sense that doing 5 NSTs and would probably cost less.

If something is going to go wrong, it would probably happen in between the weekly NSTs.

RedLucia · July 2013

Interesting! Your doctor is very different from mine. I am normal weight, normal on every test & she still wants to test all these things. I went ahead and scheduled the tests to start at 36 weeks, but I might cancel the first 2.

I still have not found a single published article showing the NST decreases risk of still birth.

I think that another 2nd level ultrasound to look at the quality of the placenta and the biophysical profile of the fetus at 38 weeks would make a lot more sense that doing 5 NSTs and would probably cost less.

If something is going to go wrong, it would probably happen in between the weekly NSTs.

Bunnyfer · July 2013

I was told to start my NST's 2x a week at 32w! When I asked why...they said because I had 1 slightly high BP in the beginning of my pregnancy. Its been normal ever since, and they determined I am not hypertensive. So I take the test, and end up not getting what they need, cause my daughter usually is less active in the mornings...So I got sent to the hospital triage unit for a BPP and another NST...both came back excellent. Hospital determined the doc office did not hook me up properly. I talked to my U/S doc, since he is the one who put in the notes for the NST's about it, and he told me he does not see the need for them now unless there is an issue...Thank goodness. That was enough stress for me

RedLucia · July 2013

I am sorry you had to go through triage due to the NST. I'm glad they cancelled the rest of them. Undue stress from false positives (or "lack of reassurance") is not good.

miracleat47 · July 2013

I have been having NST's every week since my 34th week. Not only because of my age, but also because I have GD. Everything is fine with the baby, but yet, they also scheduled another u/s 2 days before my due date. This will be my 6th one. Granted I am almost 48, but I think they worry more than I do. I do not have insurance and pay for everything out of pocket. I am shocked at the cost the insurance has billed for services. My NST's are $124.00. I know that my hospital costs are higher as a result of insurance, regardless if you pay cash. Serious problems with our healthcare system.

Want a personalized experience?

How typical is weekly non-stress tests at 34w+ just for being 35+ years old?

Re: How typical is weekly non-stress tests at 34w+ just for being 35+ years old?

Choose Another Board

Search Boards