to wonder why people dont question drs?

[biddysmama]

i was talking to a woman in my 'due in' groups and she said she didnt want certain tests but had to ... i told her i refused those tests (downs and diabetes tests) and she said she didnt know she was allowed to refuse..

she was shocked when i told her i refused iron tablets (upped my iron in food instead),downs,cervix exams,diabetes test,induction,injection for placenta after labour..

is it not normal to question and/or opt out of things you dont want or really need?

I understand what you're saying about not blindly accepting tests and asking why they're done. I think they're so busy that they they don't always bother to explain why the tests are done. I don't understand refusing the diabetes test though. Really. I know a family whose daughter was damaged in utero by the mother's blood sugar levels (years ago). She went through operations, being fed by stomach tube, dialysis and has the functioning age of a 7/8 year old. All preventable. For later children, because the doctors knew there was likely to be an issue, the mother was closely monitored and had two completely healthy children.

Questioning is very different from disagreeing or refusing medical advice!

If you never question, you are being irresponsible. You need to at least try to understand. So many people don't understand what the doctor is telling them (why should we, we're not trained?), and don't ask for clarification so end up doing the wrong thing. You can't really blame the doctor for that - they need you to ask questions so they know what you are thinking.

it is true that you're never told that you're allowed to refuse.

when I went for my first scan, they did a fanjo-scan, which I wasn't expecting, and was rather annoyed about, because my big thing for this pregnancy is that i didn't want to have any unnecessary intervention or anything shoved up my fanjo. (was thinking mainly about the latter stages, not even thinking that something might be shoved up there in the early stages!)

of course, because the the guys doing the scan were so matter-of-fact about it, I didn't know i had the choice to refuse.

It was only because I saw in the procedures for the next scan list that it mentioned this fanjo-scan, so I put in my notes that i did not want that again, and my midwife told me that I could have refused it, and that I don't have to have any tests that I don't want - that I have the right to refuse any scans, tests etc.

Kladakka - whilst your husband may be a very clever man, knowing about "chemicals" is very different from knowing about pharmacology.

Why would anyone think that they arent allowed to refuse? In what other aspect of your life are people allowed to do something to your body without consent?

I think we do need to question the medical intervention that is offered to us in so far as we need to understand why, the evidence for (and against) and the risks of refusing. But I also think we need to accept that doctors, and other health professionals, are educated and trained to provide us with the best care they can, and that sometimes they really do know best. I didn't have a good experience when I had DS as the MW insisted that she knew best and dismissed my distress at my pain levels as me just not really knowing what childbirth involved! She was wrong (DS was OP and wasn't going to come out however much she shouted at me!), but this doesn't mean I now refuse to listen to anything they say.

I'm a HCP and one of the hardest parts of my job is trying to persuade people that what I am recommending really is the best / safest course of action for them. I had someone say "gah, it;s all just health and safety!" to me last week. At times it makes me want to weep.

But, I am still curious as to why someone would refuse the diabetes test. Has anyone explained that yet????

It's definitely good to question things. Why bother having abnormality scans if you and your OH know that you would continue with the pregnancy no matter what. Here drs are usually so pushed for time that they don't often explain why they are doing the things they are doing. It is important to understand why so you can make an informed decision.

I'm probably being very naive so please inform me if I am, but I can see the point of refusing testing for downs or other chromosomal anomalies if you're happy to have a child no matter what flavour and choice over things like managed 3rd stage etc. But I cannot understand why you would refuse testing for gestational diabetes when it could severely endanger the life of you and/or your baby if it was not treated. That aside, of course informed decision making should be the norm. But I tell you, medical professionals can be extremely forceful if they want you to do down a certain treatment route and there are times in your life like being in labour when its hard to say no.

Yup. Questioning is sensible. For example if you know that you would not consider an abortion you might well not want to bother having the Downs test. Equally iron tablets can have unpleasant side effects and you can get the same benefit from a change of diet. Refusing sweeps, induction and the injection for the placenta are all debatable issues. But the diabetes test?

Another one in the 'why on Earth would you refuse a diabetes test' camp here. I'm incredulous at that. I find it completely irresponsible, tbh. I totally understand not having abnormality screening tests but it is a little, um, odd to refuse a diabetes test which could prevent serious problems to both you and your baby. I had gestational diabetes and when you find out the scary things that unchecked diabetes can do to a mum and unborn baby, well - let's just say you want to avoid that. And if it can be checked by a method that is 100% harmless to both mother and baby then it's a no-brainer, surely?

I totally agree about the 'just lie like this whilst I stick this up your vagina' approach though. No explanation of why or suggestion that it isn't actually vitally necessary.

I'm actually wondering if OP really did mean the diabetes test - perhaps she was referring to something else?

Catsareevil, you are right that in no other aspect of your life are people allowed to do something to your body without consent; but it feels to many women/people that doctors do believe they have that right.

And if you refuse, they imply that you will die/really suffer if you don't comply.

i was offered the diabetes test because my dd was 8lb 12oz, not because of weight etc, not everyone is offered it here, i didnt have it in my first or second pregnancy, i had it and didnt have diabetes and my ds was 9lb 4oz, i just have big babies. diabetes can also be detected in urine, i spoke to my midwife about not having it and she was happy and told me she wasnt having it either

I'm struggling to understand why you would refuse the diabetes test too?

I was in two minds about the Downs test as I would have carried on anyway but it suited me to know one way or the other.

Mind you I was determined to have a natural 3rd stage with DS1 and ended up with an Emergency CS (ho hum! so much for the birth plan luckily DS1 was fine).

If any doctor did think that they had the right to force treatment on an adult outside of the limited circumstances where treatment can be imposed (ie Mental Health Act, Mental Capacity Act) then they would be under an enormous misunderstanding.

If you refuse treatment then the doctor has to ensure that they have informed you of the risks of refucing treatment, but the choice is yours.

you are only offered the diabetes (fasting bloods) if you are overweight or have had a big baby here, i just have big babies

You do know though, biddysmama, that diabetes can develop later? So if you didn't have it for your first children, doesn't mean you don't have it for your subsequent children?

Why on earth would your midwife not want to be tested herself, given that she must have been present at or studied births where it was an issue which badly affected the child?

Mind you, my community midwife was very overweight. I asked her about whether it was OK to drink Coke when breastfeeding. She said, "Well they say you shouldn't, but I take no notice of that - it's the only thing I drink." Just because she does it, doesn't make it right, does it?

X post
Fair enough in your case but I wouldn't be suggesting to others that they refuse the diabetes test it going to depend on their medical history.

Diabetes isn't always detectable in urine until the sugar levels are quite high

ginmakesitallok I'm not always very good at explaining exactly what I mean. I said 'chemicals' because that was the easiest way to say what I meant. But he doesn't just know 'chemicals'. I can't explain it, but I can give you an example.

My daughter's doctor wanted to give her sleeping tablets. I was very worried and asked lots of questions. The doctor answered as best he could but his knowledge wasn't any greater than what's in the BNF. So I asked my husband. He pulled up and read all the research papers and even contacted those who carried out the research directly (professional to professional). By the time he was done, he knew absolutely everything about the drug, how it was made, chemical structure, how it works on the brain, detailed results of clinical trials etc. All of a level that make my eyes bleed and my brain go 'huh'?

She now has the pills and her doctor has emailed my husband a few times to pick his brains on this particular drug and also to ask him about others.

Risk factors from Wiki:

Risk FactorsClassical risk factors for developing gestational diabetes are the following:

a previous diagnosis of gestational diabetes or prediabetes, impaired glucose tolerance, or impaired fasting glycaemia
a family history revealing a first degree relative with type 2 diabetes
maternal age - a woman's risk factor increases as she gets older (especially for women over 35 years of age)
ethnic background (those with higher risk factors include African-Americans, Afro-Caribbeans, Native Americans, Hispanics, Pacific Islanders, and people originating from South Asia)
being overweight, obese or severely obese increases the risk by a factor 2.1, 3.6 and 8.6, respectively.
a previous pregnancy which resulted in a child with a high birth weight (>90th centile, or >4000 g (8 lbs 12.8 oz))
previous poor obstetric history

The urine test isn't reliable enough. Why do you think the NHS pay for blood tests when the urine one is so cheap!

Sorry, it's not always blood.

I also missed off:

In addition to this, statistics show a double risk of GDM in smokers.[10] Polycystic ovarian syndrome is also a risk factor, although relevant evidence remains controversial.[11] Some studies have looked at more controversial potential risk factors, such as short stature.

About 40-60% of women with GDM have no demonstrable risk factor; for this reason many advocate to screen all women. Typically women with gestational diabetes exhibit no symptoms (another reason for universal screening), but some women may demonstrate increased thirst, increased urination, fatigue, nausea and vomiting, bladder infection, yeast infections and blurred vision.

Following on from Imperial's post. Despite all the urine tests my SiL's 2nd baby was 9lb+ with no GD picked up. With her 3rd baby she was found to have GD and had to inject insulin.

I always question. Whatever the outcome might be i known damn well i am entitled to refuse ANY treatment i so wish. And that is my right as a patient. I dont usually but it is my right to should i want to , whatever my reasons.

This makes depressing reading. I am a doctor and pregnant so have a foot in both camps. I work with old people and do not, for one second, think I know more than my midwife or the doctors because it is not my specialty. I want what is best for my baby and I and that means trusting those who work in that speciality.

I'm not saying we are perfect but we don't go around sticking things up peoples fanjos for fun. Of course people should ask why something is being done/prescribed but to assume everything we do is to 'cover our back' or just for the hell of it is absurd.

Why would any sane person refuse the diabetes test? As said earlier the urine test isn't always positive until very late.

I try my best and spend ages explaining things to patients and relatives but I pull my hair out when I read stuff like this. Sometimes I think "why did I bother studying at university for 6 years then taking more exams and doing more studying at work for another 10 years?" It seems there are a small minority of people who think they know better than doctors and are now advising total strangers to avoid the tests those evil doctors are suggesting. By all means question us, ask if there are alternatives but please don't think you can possibly know more about ALL of medicine than someone who has dedicated their life to it.

Rant over