Monday, September 16, 2013

Prenatal Testing & Informed Consent - Guest Post by Hannah Reasoner, BBCI, LMT, CD(DONA)

I asked Hannah Reasoner to write this post for Banned From Baby Showers readers for a couple of reasons.  I've known Hannah for a few years now.  We've worked together as in a number of capacities.  I respect her and love her.  Really, she's like a little sister. With her 2nd pregnancy, she developed gestational diabetes.  She's one of the healthiest people I know, so her diagnosis shook me up and all that I've taught about this topic over the years. She is a Birth Boot Camp Instructor and I asked her to write for us to talk about the testing and if her opinions have changed since her experience. 

Did the joy and excitement of expecting a baby become overwhelming when you began going to your prenatal visits, being inundated with an array of tests and procedures? Many women who are choosing to birth naturally often want a minimally invasive pregnancy as well. Did you know that you have the option of informed refusal and informed consent on all of these routine tests done during your pregnancy? So, what does that even mean?
Informed consent or denial means you are opting in or out of a certain procedure and that you have read and understand all of the risks involved. You will sign forms verifying your healthcare decision.

Understanding each and every test that will be administered during your pregnancy is very important.  This may involve asking your care provider to go over the consent forms for each test at an early stage in your pregnancy.  You should be allowed to take these forms home with you and review them with your partner, research the test and make a very informed decision. This will keep you from feeling rushed and surprised when the time comes for a particular test.

A few questions to ask your care provider about standard testing and procedures are:

Why is this test done?

What does the test involve?

How often do you see false negative or positive readings for that particular procedure?

Is this necessary for the health and well-being of mother and baby?

If I opt out now, can I choose to do the test at a later date?

Until I was pregnant with my second baby, I really didn’t thoroughly understand some of the routine testing, such as the Glucose Tolerance Test (GTT) for example. The GTT is typically administered between 24-28 weeks and does not give you a diagnosis of gestational diabetes. It is specifically designed to identify women who may have a problem and need more testing to find out. So, a positive result doesn't mean that you have gestational diabetes. In fact, only about a third of women who test positive on the glucose screen actually have the condition. With both of my pregnancies, I knew I wanted little to no testing unless absolutely necessary. As I was approaching the 24 weeks of pregnancy, my midwife became concerned with the amount of weight I had been gaining in a short, 4 week time frame. She was willing to work with me to opt out of the GTT test, and allowed me to monitor my blood sugars with a blood glucose monitor. Although this wasn’t considered their standard protocol of testing, I was able to get a more accurate account of what my fasting blood sugars were, as well as my one hour and two hours readings after each meal. And, while I had none of the other risk factors of a diabetic, including, sugar in my urine, a family history of diabetes, or being overweight, I was ultimately diagnosed with gestational diabetes at 32 weeks. I was thankful for the option to take a more accurate account of my blood sugar readings throughout my pregnancy with a blood glucose monitor. The licensed midwife and certified nurse midwife that I was working with were both very accommodating in that regard.

I believe it is very important to have a care provider that is willing to take the time to review the risks and benefits of all the testing involved during pregnancy and is agreeable to provide alternatives at his or her clients’ and patients’ request. It’s your pregnancy and your birth. Know your options!

1 comment:

ChiroMaMa said...

So what do you do to manage Gestational Diabetes? Did you have to change your diet? or take insulin? What is the protocol for being diagnosed with GD?