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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

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 Grin) but with these factors, would you bother?

OP posts:
HappyCamel · 13/02/2012 16:14

Biggest risk of GD is failing placenta so babies are induced at term. Also, when mum's sugary blood supply is cut but baby has high insulin levels to cope with it can cause baby's blood sugar to crash causing (potentially) brain problems. Baby should have a test immediately after birth.

DamnBamboo · 13/02/2012 16:14

Mega-placenta's?

This can often be the sign of other pathologies (although not always)

I would get the test if I were you.

FutureNannyOgg · 13/02/2012 16:15

Lots of people do refuse it, or simply book and not turn up. It's worth asking what they would do differently if they knew you had GD. IIRC there are studies out there that show no difference in outcome whether GTT is done or not, but I would discuss this with your midwife.

Original poster
toddlerama · 13/02/2012 16:16

Who would I ask about the finger prick test? The midwife? That sounds like a good interim plan. Was it in the UK that you were offered this elliejjtiny?

OP posts:
DamnBamboo · 13/02/2012 16:17

Yellow I agree. Clearly OP doesn't have enough information; it is really very unacceptable of the HCP's invovled not to have done a better job explaining the risks, if any, to you and baby.

WombOnTheBroom · 13/02/2012 16:18

At our hospital they no longer routinely induce for GD, provided it is diet controlled. If they do induce, they wait until 38 weeks unless there are very good reasons not to - ie other complications. Different hospitals have different policies, however.

As a PP said, GD can potentially cause issues for the baby post-natally with low blood sugar levels.

With regards to your veins - this is what would worry me most in your situation. If you really don't want the test, I would have thought that the consultant could refer you to the diabetic clinic/nurse/consultant for a discussion about whether there is an alternative test (perhaps you could do pin prick monitoring) and for discussions about whether you need to take additional precautions (ante- or post-natally).

Original poster
toddlerama · 13/02/2012 16:19

TBH, since I went under consultant care, I feel like I haven't communicated with anyone Confused. This is only the 2nd midwife app I've had since she was on holiday and it takes 3 weeks to get an appointment to see her! I need to go back and ask more questions don't I...

OP posts:
WombOnTheBroom · 13/02/2012 16:19

Sorry - x-posted with others...

fedupofnamechanging · 13/02/2012 16:21

Been thinking about this and I think when my dad had a glucose test, they said he couldn't go anywhere (not even to his car, outside) because the test is affected by your activity levels. this might be why they've said no to you bringing the dc, because you can't guarantee that they will be still and peaceful.

That said, if you have no childcare, and you decide you do need the test, then I would just take them (with a lot of books/sweets/bribes) and tell the hospital that there was no other option. If they refuse to do the test, then they are depriving you of proper care, not you refusing to take it.

keepingupwiththejoneses · 13/02/2012 16:28

I really don't want to scare you but a friend of mine had GD and she was closely monitored throughout, she was so careful and really looked after herself, ate well, everything. She was booked in for an ELCS at 38 week. She was told baby was big and to come in for another scan 4 days before ELCS was due, she had been having scans every 2 weeks and seeing the doc every week so watched. On the scan before the ELCS they found the baby had died due to complications from the GD. So to me YABU you don't say why you have no childcare but who is going to care for your dc when you have your CS? Would it be possible for them to look after them while you go and have this test?

MarmiteMagic · 13/02/2012 16:30

I agree with karma. Just take your kids with you -what exactly are the hcp's going to do about it? I'd think it was highly unlikely you'll be turned away.

Fwiw I had hardly any communication from the consultants either. One talked about me over my head to my midwife when I asked him a question and the other told me dd2 would probably die because I didn't want to be induced.....lovely woman she was.

takingiteasy · 13/02/2012 16:30

Not read all the replies but I so could have wrote this.

In the 5 years since DS and this pregnancy I've gained a couple of stone. They are all over me determined to find something wrong. I done the GTT at 18 weeks which was perfect. I had to repeat it at 30 weeks.

And again all I had been told by my midwife was that it was because of the risk of a big baby (my son was 'big' so this doesn't concern me). Not once did she explain properly what GD could mean. I had to find that out for myself via another forum and good old google - and I never google health things.

I was annoyed at her approach but went for the second test. It makes me feel so ill but I was able to nip into the surgery at 8.20 for the first bloods, drink the lucozade (bleugh) and go back two hours later. To have to wait is awful.

YANBU but I'd say go for it. I'm waiting for the results of this second test, hoping all is ok.

Original poster
toddlerama · 13/02/2012 16:33

hmmm. keepingup I think on some level I needed to hear that. My mum is going to come and stay when I go in for the c/s but she's quite a drive away. I think I'll just have to ask her if she wouldn't mind coming for this too. I know it sounds ridiculous to say there is no-one who could have the kids, but we moved here, in part, in order to help out another family member with childcare and as a result, I already know I can't ask her to have mine on top of her own. I just know anyone well enough to ask yet. Or rather the children don't.

OP posts:
YellowDinosaur · 13/02/2012 16:33

Thing is keepingup by your argument it makes no difference if the op has her test or not. Your friend lost her baby despite them knowing and monitoring her closely :( so even if she hadn't been for the test it wouldn't have changed the outcome.

Definitely go back and ask more questions op then you can make a proper informed decision about what is best in your situation

FredFredGeorge · 13/02/2012 16:37

You should make a complaint against your consultant, regardless of anything else any refusal to discuss is utterly wrong. Make sure you document the failure to be informed of your choices, and the lack of ability to give consent due to inadequate information.

On the test - I think it would really depend what other risk factors you have, if you can genuinely tell yourself you have few, I think you should not feel bad about declining the test, it certainly souns a horrible way to spend a few hours. I thought it was unreliable after 30 weeks anyway, or am I misrembering from our research.

keepingupwiththejoneses · 13/02/2012 16:39

yellow I understand that but my point is that OP was under the impression that the only risk was a big baby. The fact that my friend was known to have it was why she was closely monitored but if it is not known the chances of it happening are much higher IMO.
toddler As I said I didn't want to scare you but there are real risks with GD and if it is not known, then those risks are much higher IMO. I understand about not feeling like you have anyone to ask but I am sure if you explain to your mum she would come, it is yours and your baby's health in the end.

keepingupwiththejoneses · 13/02/2012 16:41

I agree the HCP are out of order not to give you the full facts. Have they even told you why they want you to have it? I had one with 2 out of 3 of mine due to my weight.

Original poster
toddlerama · 13/02/2012 16:43

Just got off the phone to midwife and asked her about finger prick option. She said that I would have to have it from the diabetic nurse, who wouldn't want to see me without a high GTT reading, so not possible. She has offered to double check with the diabetic nurse anyway. The thing is, she said even with a low reading from the finger prick, she wouldn't say that really proved anything. She thinks it's inaccurate Confused

OP posts:
Original poster
toddlerama · 13/02/2012 16:45

keeping I think it's because I'm measuring so large. That's why with the last two anyway. They haven't spelled it out, but I'm measuring pretty far ahead again

OP posts:
elliejjtiny · 13/02/2012 16:45

toddlerama yes it was in the uk. I had it done by a midwife in the hospital antenatal clinic.

oiwheresthecoffee · 13/02/2012 16:50

I dont think YABU as its your body and your child and therefore you are entitled to do whatever you like if you so choose.

And its really out of order for the consultant not to discuss it at all. I wouldnt put up with that. Complaint maybe ?

Original poster
toddlerama · 13/02/2012 16:58

I don't really want to complain about the consultant, as she is very highly regarded and I lucked out getting her. I don't want to piss her off! I don't need to like her/have her like me but she wouldn't refuse to treat me if I just ignore her would she? If I make a complaint against her then I should probably expect a different one, shouldn't I? I want her! Just not her conversational gems...

OP posts:
strawberrypenguin · 13/02/2012 17:02

Sorry not read the whole thread but just wanted to say if it was me I would have the test despite the problems it would cause you ( and they are food reasons for not wanting it) I had a GTT for no other reason than family history of GD no sugar in my urine or anything. Turned out I had quite bad GD and was put on insulin to control my sugar levels and was induced at 38 weeks. My DS was fine but large although he did get close to needing scbu because his sugar levels took a while to stabilise. Potentially GD can lead to health problems in the baby and I had consultant monitoring because of it. If you do refuse the test I would make sure you at least get more frequent monitoring from your MW. Good luck with whatever you choose

BeyondTheLimitsOfAcceptability · 13/02/2012 17:16

Just curious...
Someone said upthread that if a woman has GD she will be induced at 40w. The OP said she is already being induced at 38w. What else would happen if she did the test and it was positive?

theDevilHasTheBestMNNames · 13/02/2012 17:22

I have three such tests - diabetic parent type 2 but insulin dependent.

All negative - all babies between 9 - 10lb but not fat just long and muscular - mothers side of family all larger than normal babies with according to MW good placentas.

Second and third glucose tolerance test I wasn't allowed to have DC with me which was a major pain with childcare. MWs said they needed me still between taking blood apparently not contemptible with looking after young DC apparently.

It was a pain but it was nice knowing there wasn't an issue and the babies didn't then need additional checks at birth.