To have the test or to not have the test?

[Arimeh]

That is currently the question!

I went to the hospital for my GD test on Monday, they wouldn't let me do it because I wasn't 26 weeks until the next day.

I then went for my midwife appointment at the birth centre and she confirmed that I can go through there again for this birth (yayyyy!!) and we got talking about the GD test and I said that I hadn't done it yet. She tol me that I DIDN'T HAVE TO do it, if I didn't want to - because she doesnt usually get her clients to do it - said there are other symptoms of GD and she looks for those in her clients, rather than have everyone just do the test incase they have it.

So now I am undecided as to whether to get the test done or not? Can someone enlighten me as to the symptoms of GD that she would be talking about that she would be looking for?

I've had the test for all three prior pregnancies, and my blood sugar level has always been in the normal ranges. My last OB said I was at risk of developing it, because I am overweight and I have "big" babies. My babies have been:-

DS - 8 pound 2 at 39 weeks
DD1 - 8 pound 11 at 42 weeks
DD2 - 8 pound 10 at 41 + 5

I don't class them as overly big babies, yes DD1 was darn close to cracking that 4kg mark, but she was also 2 weeks overdue. I was under the impression that GD babies were around 4kg earlier than that - like 38 weeks or something?

Can someone help me make the decision about whether to get the test done? I'd rather not do it, just because I have to get the kids to wait there with me for the hour because you're not allowed to leave the pathology place in the hospital once you have taken the drink.

Help please!!

[Pandora]

I had the test with the first, didn't have GD bub 4.5 kg but not chubby just crazy long

Second time around similar advice as your mw gave u

She said I was very low risk and based on ds1 being big and not a gf bub and straight forward birth not to bother

She also said that it's a pretty subjective and questionable test anyway and that if I did choose to ha e I should sneak out and exercise between the Bts because " of you have GD a little walk wont make it gp away"

[Persephone1]

Can you have a look at Dr Sarah Buckley's Gentle Birth, Gentle Mothering? It has a whole section on the GD test, very informative.

If not, try this approach (as advocated by Sarah):
BRAIN
B - what are the BENEFITS of the test? what are the benefits of knowing that you have GD?
R - What are the RISKS of having the test? what are the risks of GD? what are the risks of knowing you have GD?
A - are there any ALTERNATIVES to the test?
I - (usually do this one last) what are your INSTINCTS telling you?
N - what happens if you do NOTHING (ie. don't have the test)?

When assessing the risks, you also need to consider the NOCEBO effect - which is, "what are the effects of having the test/knowing/not knowing I have GD on my stress levels? Am I better off NOT knowing, NOT doing the test, because the stress of the test outweighs the benefits?"

I hope that makes sense. I wasn't in a risk category for GD (and I don't think you are, based on your post), and I decided that I didn't need to be labelled as GD. There are other things to consider too - did you know that the diagnosis of GD is still really controversial, that some believe it doesn't actually exist, rather that women's blood sugar is different during pregnancy anyway? Did you know that there is no internationally agreed definition of what level constitutes GD? Will you be treated differently if your results come back positive? Did you know that the main treatment for GD (before insulin) is "healthy diet and exercise" - something you can implement without the diagnosis.

Anyway, I chose not to do the test cause my stress levels went up just with the threat of the label of GD. I wasn't in any risk category. Oh, and the Challenge test involves drinking a liquid consisting of over 20 spoonfuls of sugar. Blegh, no thanks.

If you apply the BRAIN method you can at least make an informed decision. We applied BRAIN to a lot of our pregnancy/birth decisions too, and found it really helped.

GL.

ETA: If you can't get a copy of Dr Sarah's book, I can give you some more notes out of my copy. BTW, her book is a great natural/homebirth resource as well.

[kirsty_lee]

Oh man if I ever have another baby (which is wayyyyyyyyyyyyyyyyyyyyyyyyy down the future lol) I would give anything not to do that test! I didn't have it with ava... this time I did and by crikey that drink was foul .. its like... flat bacardi and lemonade.. so bad.. i struggled drinking that crap lol but then the nurse was like you only have 5 minutes to drink it then you have to start again :O

[skybie]

some places do let u take the drink home hun, then just go in for the blood test.
would u feel better urself completely ruling it outor living with the checking for symptoms till u have bub? if it were me i'd have it done just so i didnt have to think about it again

[Heaven]

Sorry I don't know enough about it. I didn't want to do it this time but when it came time I hadn't researched and found out about it like you're doing now so I just had it again anyway. Hopefully it comes back ok and I don't have to worry but I was a bit worried about if it said I did have it and the implications for a VBAC you know? Next time I will look into it further.

[Traveller]

Perhaps you could ask your midwife to test for sugar in your urine instead and if there is something concerning then you can have the GTT. This is how GD is tested for in the UK to save women having the horrible drink test without a likelihood of it coming back positive.

[onthefly]

I like Trav's idea.
I did the test both times due to risk factors in my family.
After DS was born several midwives tried to tell me I must have had GD as DS was 4.3kg (at 42 weeks, mind) - I don't see what his weight has to do with it really.

[Arimeh]

Perhaps you could ask your midwife to test for sugar in your urine instead and if there is something concerning then you can have the GTT. This is how GD is tested for in the UK to save women having the horrible drink test without a likelihood of it coming back positive.

Maybe thats what she does? I remember last pregnancy when my midwife came around for the home visits (the other midwife - they worked together as a team) and she tested my urine at every appointment - would this have been what she was testing for?

[Pretty Butterfly]

I will NEVER have it again!!!

I had the test with the first 3, no worries.
Didn't bother with Za and Kane....
Most of my babies have been in the larger group, but no GD.!!

Because Z and K were "larger" babies, they pushed me to have the GD test with Harmony.
The one hour one came back "borderline", and they completly scared me into the 2 hr one....which also came back borderline... (btw, here we have to fast for a few hours, in other countries they give you a proper diet for a WEEK to get an accurate result!)

so from that minute, I was a "GD" patient..... monitoring, blood tests the works.. I had to go to the diabetics clinic regulary.. I was SO peeved, even the diabetic nurse couldnt understand why I had been sent. I was given the little finger ***** thingy, had to do it 4 times a day.... It NEVER went over average, but I was still a "GD" patient......

Once in labour, an Ob was called becasue of the GD, and he kept going on about a "large" baby.. idiot.... after she was born, we couldnt leave, becasue I had GD, so we BOTH had to have testing.... broke my heart.....

I will never have it again unless I have at least ONE symptom, which I never did....nor was ever one of my ***** tests over average....

If you go ahead with the test, you have to put up with the outcome, something I wont do again unless very neccessary......

[ACJ]

Got no advice for you Mel but I had GD with DS1 and he was 9lb8oz at 39+5 and with DS2 I didnt have GD and he was 8lb7oz at 39+4.

I think it is more a personal preference if that is what your MW is saying......I like the little BRAIN thing the Persephone1 said.

[maz]

I had so much stress with V over this
I apparently had GD...doc was more worried that I couldnt eat and threw up all the time, GD nurse only wanted me to go on insulin and cracked it big time when I told her were to jab her dame needed.....V was ment to be an 11pound plus baby....pfffttt try 7pound 2 oz! I loved throwing that back in the GD nurses face when I saw her.
With M I tested and my range was completely normal and they couldnt believe it so wanted me to do the big test anyway....told them also were to stick that.

YOu have to know for yourself what you'll get out of it...and honestly with your previous record id say you'd get diddly squat from it.

BUT
here is what you asked for

Gestational diabetes occurs during pregnancy. Symptoms may include excessive thirst, urination, fatigue or thrush infections. However symptoms are often not obvious in gestational diabetes.

High risk groups
Some women are at increased risk of developing gestational diabetes. High risk groups include:

Women over 30 years of age
Women with a family history of type 2 diabetes
Women who are overweight or obese
Indigenous Australians and Torres Strait Islanders
Women of some ethnic groups including Indian, Chinese, Vietnamese, Middle Eastern, Polynesian and Melanesian women
Women with a history of gestational diabetes in a previous pregnancy.

[Arimeh]

That's basically the same risk groups I read last night Maz, except the age was 35 - not 30. And on that list, I was only at risk because I am overweight - which I've been for the other pregnancies - but I was probably classed as obese with Eden's pregnancy and no GD there....

[Persephone1]

I think (for me) it was really stressful to consider how I might be treated if I was labelled as GD. My SIL, for example, was labelled as GD and then told that her Ob wouldn't "let" her go past 38 weeks because baby was going to be over 4kg. She was induced at 38 weeks and gave birth (via c-section) to a 3.1kg boy. He was smaller than my own DS born at 41 weeks (not that comparisons apply but ykwim). The whole saga made me very disappointed - particularly as a 4kg isn't that big and had my SIL been "allowed" to continue the pregnancy she might have had spontaneous labour and perhaps even avoided a c-section. (PS I don't judge my SIL, it's my issue, not her's).

I also know someone who birthed a 4.8kg baby with no GD diagnosis. For her it was just a case of "big genes" but no doubt she'll be classified as being in a risk category because she's had a previous large baby. Pfft!

[Persephone1]

Dr Sarah Buckley talks about the UK approach being to test women with GD risk factors, rather than the "test everyone" approach in Australia, hence the lack of universal consensus on GD testing.

The risk of false positives is another reason not to have it.

[Arimeh]

Thanks guys

I think DH is on the side of the midwife (since we are paying her!) and said that he is comfortable with my decision if I dont' want to do it.

So looks like I'm not going to do it - yeeehhhaaaa...

[*Efjay*]

I am planning on declining the GD test this time round. Never been out of the normal range with the other 4 & my babies just get bigger anyway.

[PumpkinZulu]

I know this thread is a tad old, but it really helped me make my decision Mel, did you end up getting it done?