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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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Original poster

to refuse this test?

90 replies

toddlerama · 13/02/2012 15:53

I'm 28+ wks pregnant and measuring 33. By my own dates, I'm actually 30 weeks, but whatever.

I have been asked to make an appointment for a glucose tolerance test which I have declined to do. My midwife isn't worried, but my consultant just shuts me down and states "make the appointment". Wont discuss it at all.

My reasons for declining it are these:

They want me to spend 2.5 hours at the hospital for it. I can't go home and I can't bring my children (aged 3 and 4). No negotiations on this, and I have no childcare available.

I will be having my 3rd elective section. My understanding is that the biggest risk relating to gestational diabetes is "a big baby". So what? I don't have to push it out. My last 2 were 9 and 10 pounds respectively. I know I'm having a big baby. This isn't news.

Because my last 2 measured large, I had the GTT with both of them. Negative both times. With DD2 I actually had to have it twice because they couldn't believe I was having a child that size for any other reasons.

The fasting nature of the blood test means I will be vomiting into the cardboard bowler hat until I can eat and drink again (from waking up until after midday if previous waits are anything to go by).

I can only have blood drawn from the back of my hand. The vacuum-tube things don't work as they pull too fast and I have to have it done with a manual syringe and squirted into the tubes afterwards. They can rarely get enough for what they need. This is due to really low blood pressure/crap veins/genetics - my mum and grandfather have the same issue. My sister has had to have it drawn from her ankle, so could be worse....

Because it's so hard to get into the vein, at my last section we nearly reached an impasse as my hand veins were so scarred on both sides they couldn't fit a canula. I don't know what would have happened if they hadn't called in another anaesthetist. I had one hand split right open and the other no-one wanted to try in case it happened again. They just stood there looking at each other. Another guy poked his head round the door, yelled at them, made the original anaesthetist stand in the corner (!!!) whilst he did it. Thank God he turned up, but honestly... I don't want to have any blood work I don't absolutely need because of this. I don't want a repeat performance. I want my veins in tip top shape on the day.

I have to have the 28 wk bloods done asap anyway, and I think 3 blood tests in this space of time is going to cause the same problems.

I invariably faint when they take blood. Don't know why. Just fade out as it goes on. I don't want to. It makes me feel sick and then I have to drive home all woozy.

I have no symptoms of diabetes at all. Except the big baby, which I always have!

Sorry for the epic post but I'm trying to articulate all the reasons to give a full picture. I don't just 'think I know best' (well, maybe a little bit ) but with these factors, would you bother?

OP posts:

TheGrandOldDuke · 13/02/2012 15:55

YANBU. Sounds reasonable. As long as you're willing to accept the risks of if you actually do have gestational diabetes. I don't know what these might be. But if the midwife also thinks not necessary, then I'd be doing the same as you.

Grumpla · 13/02/2012 16:00

Sounds grim. Is there no way you can compromise and have it somewhere more convenient? I was initially told I would have to have it in hospital but when I fussed a bit they scheduled it for my local surgery instead which was way easier.

Tbh if they aren't prepared to make it possible for you to do it I would be inclined not to bother, especially given your history. Have they told you what (if any) treatments / differences in care they would implement you if you DID have GD? My understanding is that it would basically be managed via diet - could you do this anyway?

fedupofnamechanging · 13/02/2012 16:01

I think the hospital are wrong to tell you that you must have this test and you can't bring your children. What do they propose you do with them?

If you are sure there are no serious side effects of refusing the test, then your reasoning sounds fine to me.

Original poster

toddlerama · 13/02/2012 16:03

That's what I'm thinking Grumpla. Proceed as if I DO have it (minus any drugs at all) and therefore manage the risk that way.

They wont do it anywhere but the hospital because no-one at the doctors will even try to get blood because of my notes. I've moved since the last pregnancies and they've been forewarned...

OP posts:

DamnBamboo · 13/02/2012 16:05

It's not just about having a big baby though is it?

The baby could have other issues like low levels of minerals in the blood, respiratory issues, need a glucose IV at birth amongst other things.

How do you know that this time you don't have GD? Wouldn't you rather know you didn't have it?

Original poster

toddlerama · 13/02/2012 16:05

Karma, this was my point. My children sat through the appointment in near silence and were good as gold, but they can't come to the hospital. I understand that - 2.5 hours isn't the same as 20 mins, but why can't I leave in between bloods? I did last time. Just promised not to eat!

OP posts:

MissCoffeeNWine · 13/02/2012 16:05

AFAIK the biggest risk of GD isn't big baby, but stillbirth due to poorly functioning placenta and that's the reason many women with GD choose to take the early induction offered. That is just my understanding, I don't have personal experience, I'm sure someone will have better info.

They are being unreasonable in not discussing that with you, and insisting on the test, which is always and will always be your choice - if you have no other symptoms of GD it seems reasonable to assume you do not have it.

Original poster

toddlerama · 13/02/2012 16:06

Well, I don't know Bamboo. This is what I was wondering. What happens if you do have it? I don't know anyone who has and the midwife wouldn't go into it really.

OP posts:

DamnBamboo · 13/02/2012 16:06

p.s. all of the above can be relatively easily treated but don't have to happen at all

Original poster

toddlerama · 13/02/2012 16:06

I am having an 'early' c/s at 38 weeks. How much earlier would it be if GTT showed diabetes?

OP posts:

DamnBamboo · 13/02/2012 16:07

If not taking the kids is an issue, then just take them.

Fuck 'em.

It's not great for them or you, but what can you do?

TheVermiciousKnid · 13/02/2012 16:07

YANBU. Having this test, or not having it, is entirely your decision. The consultant is wrong to put pressure on you. If you're feeling assertive, just thank him for his advice and tell him that you have made an informed decision to decline the test, or, if you can't be bothered, just don't make the appointment.

lisaro · 13/02/2012 16:07

YANBU. the fact you can't take the kids and have no childcare makes it impossible anyway, so it's a moot point. Just repeat over and over if anyone goes on about it 'It's impossible'. Bit PA I know, but sometimes it's the only way. I would also consider complaining about being ignored by your consultant.

Idocrazythings · 13/02/2012 16:08

Biggest risk isn't big baby but abnormal unstable sugars which can affect the the baby and placenta? un-diagnosed you can run into big problems (I'm surprised your doctor hasn't gone into specifics with you). Have you asked about the glucose challenge which doesn't require fasting and goes for 1 hour- however you still need two blood tests. And if it comes back positive you'll need the glucose tolerance test to completely rule out gestational diabetes. At the end of the day it's your call. :-). (not sure if it's an option in uk though- we do it in Australia)

DamnBamboo · 13/02/2012 16:08

Not an Obgyn, so can't comment.
But there are other things that you may be able to do.

It's all very well saying proceed as if you have GD but you should really be seeing a consultant if you do

Original poster

toddlerama · 13/02/2012 16:09

I don't know if this is relevant at all, but as well as large babies, I have had mega-placentas. They froze them to show off. DD2s was 1.5kg

OP posts:

HappyCamel · 13/02/2012 16:09

I had the test in the community. Fasted from night before, sugar drink in the morning, bloods taken at local childn's centre so I don't understand the hospital malarkey. I had GD so I would normally say get tested but overall though I'd say YANBU. You have sound reasoning and it's got to be healthcare by consent.

Original poster

toddlerama · 13/02/2012 16:10

Oh bollocks. I'm going to feel guilty if I don't have it and I don't see how I can actually do it either!!

OP posts:

eosmum · 13/02/2012 16:11

Sorry I think YABU, my niece Alison was stillborn due to undiagnosed GD, I just wouldn't take the chance.

Idocrazythings · 13/02/2012 16:11

Sorry I didn't see the above similar replys- they didn't show up before- unless I took too long to type

IUseTooMuchKitchenRoll · 13/02/2012 16:11

If you don't want the test then don't have it. The hospital aren't telling you to have it just to give themselves a cheap thrill you know, there is a reason for wanting you to have this test. That reason would be that they want to ensure they can give you and more importantly you baby, the best possible care.

But if you don't want to have it, that is entirely your prerogative. Give them a call and ask if there is something to can sign saying that they have recommended you have the test but you have refused. That way, if anything does go wrong that could have been prevented by the results of the test, then the hospital don't have to worry that you will sue them.

Original poster

toddlerama · 13/02/2012 16:12

I hadn't realised it could be the reason for still birth. The only risk my midwife mentioned was 'the baby could be very large', and I just thought well yeah, no shit.

OP posts:

YellowDinosaur · 13/02/2012 16:12

I'm with the poster who said get them to tell you how it would change your management if it was positive. They should do this anyway. Your reasons are very valid but without knowing how it would change thinness for you its not possible to be absolutely sure imho.

Your doc is very unprofessional to say just do it imho. And I say this as a doctor myself. You are perfectly entitled to refuse anything you like a long as you have all the information. how arrogant to dismiss you like this!

Make another appointment and take someone with you for moral support if that would help you. insist they give you the bottom line about how it would change your management. They may convince you or they may not but at least you will have all the facts.

Good luck

mummakaz · 13/02/2012 16:13

yanbu

when I had a glucose test I was allowed to drink a bottle of lucozade at home then go to the hospital after a certain amount of time for a blood test. Was in and out within 10 minutes. Perhaps ask if you can do that? if they insist you have the test and tell them you will have to take your kids, end of or just turn up with them

elliejjtiny · 13/02/2012 16:13

My veins are like yours and I was told I needed a gtt when pregnant with DS3. I refused but agreed to a random blood sugar test where they just prick your finger and only a tiny amount is needed. I said I would have the proper gtt if the finger prick one was high but it was fine.

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