Induction does NOT improve outcomes for presumed large babies, part 1

[HeidiLJ]

At my 27 week appointment with my CNM yesterday, I had my glucose tolerance test.  I passed it with my first two children, but failed it with this pregnancy.  I've done a lot of looking about gestational diabetes.  What I have found is that even if it is a valid diagnosis, treatment of it with insulin and tight dietary control does not seem to improve pregnancy or fetal outcomes.  Essentially, many experts feel that the benefit of doing the glucose screening is to find women with undiagnosed diabetes.  I am confident this is not me.  I have no other symptoms of diabetes.  Yes, I am overweight but I do not urinate frequent, have excessive thirst or hunger, or recurrent yeast infections. Nonetheless, because I am seeing CNM rather than a direct-entry or lay midwife, here I am, stuck with this glucose tolerance testing.  Yes, I realize this could have been avoiding by a different choice of providers. I interviewed two homebirth midwives in our state, where homebirth by CNMs is illegal, and was comfortable with neither provider.  So, then.  Here I am with an elevated glucose screen.  I am refusing the three-hour test because I had one many years ago and it made me feel like crap.  Also, I am quite confident that I do NOT have GD.  My CNM and I compromised on four home glucose checks per week.  Two fasting, two 2-hours after eating.  I will then show her the record of my testing and have to convince her that, indeed, I am NOT gestational diabetic.  The next sentence after she told me my glucose result, she went on to say that we'd need to obtain a couple late-pregnancy ultrasounds to ensure the baby wouldn't be too big.  I will not be consenting to these.  First, all my research has led me to believe that ultrasounds are inaccurate for estimating fetal size by as much as 1-2 pounds.  Second, the recommendation if my baby was perceived as "too big" is induction.  And, again, research does NOT support induction for suspected large baby.  And, even if my baby is 9-10 pounds I am not worried.  I can give birth to a large baby!  My last baby was 8 pounds 1 ounce and I only pushed for ten minutes.  I will not have an epidural and will be able to assume any position needed to get the baby out-including the hands-and-knees maneuver if shoulder dystocia is a concern.

[Raintree]

Jan. 28, 2009 at 11:21 PM

Just be stubborn!! Or move over to Carol!

 

[charlierae]

Jan. 29, 2009 at 10:43 AM

oh heidi this is not good! It sounds eerily familiar to what my CNM tried to pull with me. I am hypoglycemic and failed all of my glucose tests (i did the stupid 3 hour) because HELLO, MY BLOOD SUGAR IS NATURALLY CRAZY. So she pulled the GD card with me...which ended in induction for my 6 POUND BABY. Sorry, Ill stop ranting now :-P Is there anyway you can see if there are other CPM's in your area? Have you considered UC? I mean...if I would want anyone at a birth it would be a nurse :-) But seriously, there are so many other options...you shouldnt have to be answering to a cnm.

good luck hun!