question about weekly NST and ultrasound after 36 weeks

fromvatobk · September 2014

My usually lowkey midwife told me today that I need to start scheduling these (I'm almost 35 weeks). I really don't want to. I am 39, have had a fantastic pregnancy (except for some serious morning sickness, but that ended at 22 weeks), feel good, and have a very active baby in there who moves often and has consistently had good reviews at all appointments. I don't feel any different then I did with my son at 34 and I don't understand why my age is the driving factor here. My midwife said I could wait until 38 weeks if I want to, and I suppose I will, but I really just feel it is unnecessary since I have no real high-risk factors save my age. Has anyone else gone through this and had similar concerns? Would love to hear from others as to what they were told about the necessity of this testing and what you decided to do. Thanks for any help.

supersarah77 · September 2014

I had weekly NSTs and amniotic fluid checks starting in 3rd tri with DD1 but only because I had another risk factor for delayed growth rate and preterm birth (high Inhibin A). I was also AMA but that's not why I had them.

banana2020 · September 2014

I don't know why you wouldn't want to at least have them. They are non-invasive and they monitor the baby in a way that you can't. Maybe I'm old school, but when it's non-invasive and not a potential detriment to the health of me or my baby, I tend to err on the side of caution and trust the recommendations of my health professionals.

ksgsmu · September 2014

sorry I guess I don't understand why you wouldn't want more monitoring?

JilliansMoma · September 2014

banana2020 said:

I don't know why you wouldn't want to at least have them. They are non-invasive and they monitor the baby in a way that you can't. Maybe I'm old school, but when it's non-invasive and not a potential detriment to the health of me or my baby, I tend to err on the side of caution and trust the recommendations of my health professionals.

I agree. I had a bump friend that lost her beautiful son at 40 weeks.

I personally wouldn't risk it. I actually didn't think I would have to have them with this PG because I wasn't GD. When my Dr started scheduling them for me once a week at 32 weeks I asked her why. She said it was because I was over 40 and the placenta breaks down much faster towards the end of AMA PG.

I will do whatever it takes to get my baby here healthy and happy. It's relaxing to listen to his/her heart beat for a half hour once and week and I get to see them on the ultrasound when they do the fluid check. Things can go from good to bad so quickly I don't see why you wouldn't want them just as a precaution.

GL on your decision.

fromvatobk · September 2014

Thank you all. I should have added that my baby doesn't seem to like the doppler in general and kicks at it when it is placed on her. Also, in my anatomy scan, it seemed to me like she reacted to the application of the u/s. Given that she is so incredibly active as it is (I have been feeling her since 11 weeks and literally feel her moving almost constantly from the time I wake up through the time I go to bed, including as I sit here typing), I am a bit hesitant to subject her to additional testing that seems unecessary given her activity, that she doesn't seem to like, and which becomes uncomfortable for me. That being said, I would be the first person at the hospital/doctor, etc. if I noticed any changed in fetal movement or any other problems. I just can't find any good research supporting using it for age only at my age in my situation and even my midwife said it is probably overkill and there is no great research on it. That is why I am asking here.

bowzndice · September 2014

Hi, just lurking as I'm no longer pregnant.
I'm 42. I had bi weekly U/S (BPP) and twice weekly NST while pregnant with LO after I hit 30 weeks primarily due to my age.

My doctor recommended the testing because women 40 and over are at higher risk for the placenta to deteriorate or detach early (before 40 weeks) and high risk for still birth at 40 weeks or over.
I had all the testing because I didn't want to continue along assuming everything was fine then possibly have an issue where baby could not be saved if something came up. My pregnancy continued just fine and baby was born healthy (and large) at 39 1/2 weeks.

As a side note. I had a friend last year that was 39. She had the additional testing. Her placenta slowly degraded and she had her baby at 38 weeks because it wasn't healthy enough to continue the pregnancy. Without that knowledge she possibly could have carried to 40 (or plus) weeks then had a stillborn baby because of the placenta.

2ndGeneration · September 2014

Hmmm, my midwife (in an ob practice) isn't starting that stuff until I am 40 weeks. Now I'm wondering if it should start sooner? I'm 43.

OP, I think the testing sounds like a good idea, after reading here I think I want that also.

jcrising · September 2014

Anyone over 35 should be going to an OB even if using a midwife. The risks of complications skyrocket for older mothers. As PPs have said, there is a chance that your baby could have problems that you can't see or feel.

Also, OP, I don't mean to be glib about your feelings, but it is highly unlikely that your baby senses the ultrasound at all. The machine senses sound and movement, but your baby is not likely reacting to it. It's possible your baby feels the coolness of the gel on your belly and moves because of that. And the NST is just a heart monitor, so your baby doesn't feel anything at all. All in all, when it could save your baby's life, isn't it worth it?

banana2020 · September 2014

fromvatobk said:

Thank you all. I should have added that my baby doesn't seem to like the doppler in general and kicks at it when it is placed on her. Also, in my anatomy scan, it seemed to me like she reacted to the application of the u/s. Given that she is so incredibly active as it is (I have been feeling her since 11 weeks and literally feel her moving almost constantly from the time I wake up through the time I go to bed, including as I sit here typing), I am a bit hesitant to subject her to additional testing that seems unecessary given her activity, that she doesn't seem to like, and which becomes uncomfortable for me. That being said, I would be the first person at the hospital/doctor, etc. if I noticed any changed in fetal movement or any other problems. I just can't find any good research supporting using it for age only at my age in my situation and even my midwife said it is probably overkill and there is no great research on it. That is why I am asking here.

I hope I don't come off like a complete jerk (not my intention and I don't want to sound insensitive) but you aren't really subjecting your baby to much testing at all. It's proven that ultrasounds don't affect the baby in a negative way. If the u/s tech is pushing and prodding with a lot of force & pressure, then sure. But otherwise, moving a little wand around your belly with some u/s waves is not going to bother your baby. Oftentimes it's pure coincidence that our LOs inside get moving a lot during an u/s or NST (and it's good during an NST! that's what they want!) because you are at rest at that very moment. They aren't often rocked/cradled to sleep by your movements/voice/etc like they often are when you are up and about. But there ism't much of an "application" with an ultrasound so I can't really see why this is an issue for you.

Ultimately these are your decisions, of course. But I would never turn down non-invasive testing that my doctor/nurse/midwife/etc recommended to me considering they are the professionals. There are risks involved in being AMA that go beyond anything that we can see/feel ourselves.

fromvatobk · September 2014

Thank you all for your input. I appreciate all of your opinions, even those of you who have been somewhat harsh in response. To be fair, there is actually some conflicting literature out there about the value/potential issues with both doppler and ultrasound prenatally, and I know women who have received different advice from different practitioners and who have opted both to have and not have the testing, which was part of the reason for my question. Also, to the poster who implied that I was being irresponsible by using a midwife and not an OB, my midwife is a CNM, has a large AMA practice, and is backed by an OB as she is legally required to be, but there is no medical reason to require an OB instead of a midwife simply because of age, at least not at my age. That being said, I appreciate your willingness to share you opinion.

harmonicbabe26 · September 2014

I kept hearig about NST this or that here on the Bump so I finally googled it and isn't it just checking the baby's HR and activity while you are resting?? What's so awful about that? And as for the u/s, I'm just not buying it that your baby had a bad reaction. Sounds kinda silly... Baby probably reacted to something pressing down on your belly or temp of the gel.
This sounds like such a NBD to me I can't imagine why someone would worry about it... Plus you'd have this done, what, 4 times? 5 if you go longer - in which case it's probably in your interest to have it done anyway...
But obviously if you feel very strongly about it then say no.

banana2020 · September 2014

harmonicbabe26 said:

I kept hearig about NST this or that here on the Bump so I finally googled it and isn't it just checking the baby's HR and activity while you are resting?? What's so awful about that? And as for the u/s, I'm just not buying it that your baby had a bad reaction. Sounds kinda silly... Baby probably reacted to something pressing down on your belly or temp of the gel. This sounds like such a NBD to me I can't imagine why someone would worry about it... Plus you'd have this done, what, 4 times? 5 if you go longer - in which case it's probably in your interest to have it done anyway... But obviously if you feel very strongly about it then say no.

NST is very non-invasive (it's a strap that basically goes around your belly and monitors the heart rate / contractions the very same way they do when you are in labor). I had them with my last son and it was the most restful 1/2 hour ever. LOL! Nothing remotely invasive about it (and I also read a lot about it when I was PG the first time). But I'm also a realist and know that we all tend to gravitate towards the data that supports our own personal reservations or preferences. So if there is data out there that says NSTs aren't safe or that they are disruptive, etc, I suppose I would grasp onto those as well if that was my own personal feeling to begin with. It's human nature and we all do it.

1more78 · September 2014

They told me I would have to have them twice a week starting at 34 weeks I think. It's completely safe and non-invasive. You sit in a chair watching TV with a "kick clicker" in your had. They are looking for the babies heart rate to react approprotaley when he/she moves. Like how our heart rate goes up when we move around, so should baby. So every time you feel baby kick you hit the clicker and it marks it on the print out. Doc will look at heart rate at that time and make sure it didn't decel.

Hope that helps

topaz7777 · September 2014

I had a lot of NST and U/S for being high risk at my last pregnancy and everything was always fine, so I really didn't feel like I was gaining much. My sister however was in there and the NST showed a low heart rate, they rushed her and induced her labor early and the baby had the cord around it's neck. Sometimes it can save you if there is a problem going on. Sometimes if everything is fine it's kinda useless. And sometimes problems happen and you can't prevent them. It's a very personal decision.

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