Prenatal tests and conversations

As a pregnant mom, women get a crash course in the tests that many care providers suggest, recommend, or require as they progress through the 40 weeks of gestation. Or do they? Many women don't know a thing about these tests or dare I say, what to expect in preganacy whatsoever. Nothing, that is, besides old wive's tales, rumors, or secondhand accounts from a friend or family member. Then the buying of "What to Expect when your Expecting", is sometimes the only and I should say, one of the worst books they read. On that subject I just want to direct you to my website and suggest you click on the recommended reading list there. www.danawren-nurture.com

In this week's post I want to try and address some of the important conversations pregnant mom's should have with their care providers and tests that will be required and how to prepare for them.

Common tests

Ultrasound
Glucose test
Sonogram to test amniotic fluid level
GBS test (strep B test)

Ultrasounds

One baseline ultrasound is usually required to assess gestational date and heartbeat.
Beyond that........ they are optional and you can decline them. There is information which questions the effect multiple ultrasounds have on a fetus. There are evidence-based reports to be found on the subject at www.childbirthconnection.org http://www.childbirthconnection.org/article.asp?ck=10022&ClickedLink=433&area=27

Glucose Test

There is a high incidence of false positives in these test results. So I suggest moms not to panic.
If you test positive for the first test you will be told to return for a second longer test. When you get settled with your decison as to who you are delivering with as your care provider, I suggest getting a list of prenatal tests and the dates on which these tests will be preformed. 2-3 weeks before you are to be tested for Gestational Diabetes, you should cut way back on sweets. Anything with refined sugar, light on white rice, pastas, and days before the test you should even cutback on fruits. After you clear that hurdle you can resume your normal diet. Many women are missed diagnosed, there are many factors in this testing proceedure that increase the false positives. You can again go to www.childbirthconnection.org and find very good evidence-based studies on this test. http://www.childbirthconnection.org/article.asp?ck=10034



Amniotic fluid level sonogram test

Later in your preganacy a sonogram will be suggested to assess the level of amniotic fluid present surrounding your baby. Drink LOTS of water before your appt. Amniotid fluid is composed partly of the waste of your baby. What you drink and eat the baby does as well. When you drink fluids the baby passes this out into the amniotic sac. Therefore, this amniotic fluid is replaced as it is excreted. If you drink copious amounts of water prior to this test your fluid levels will be just fine. No reason for induction alarms. http://www.childbirthconnection.org/article.asp?ck=10026&ClickedLink=433&area=27

GBS Test (Strep B)

This test will be done around 34 weeks gestation. To aid in a negative result, we suggest our clients take 2-3 garlic cloves or 3-6 garlic capsules per day 3 days to 1 week prior to your GBS test. We have had clients who have followed this preventative measure have negative test results.
Scroll down to view the Strep B articles and view links, http://midwiferytoday.com/enews/enews0337.asp

Important topics to discuss with your care provider

% of vaginal deliveries
% of cesarean deliveries
% of patients who deliver drug free
% of episiotomies
How they manage post dates (mother who goes over 40 weeks gestation)

What is their protocol for premature rupture of membranes? (water breaking)
If fluid is clear?
If contractions aren't accompanying rupture? (water breaking)
How long after rupture of membranes must you be delivered?

Induction protocols
How often do you find it necessary to induce patients?
What are the most common reasons you induce patients?

Second stage management (pushing)
What positions can I push to bring my baby down?
What positions can I ultimately push my baby out into the world?
Do you provide counter pressure on my perineum?
Can I push as I wish, without holding my breath?

This is just a snapshot of some of the most recurring and persistent topics women should discuss
with their care provider. If your questions are met with impatience, irritation, or answers that don't align with your vision, I suggest you speak to other obstetricians or midwives and find someone who respects your desire to be informed and have the birth you would like to create.
The most important decision you will make in this part of the journey, is who will be your doctor or midwife. Do your homework. Trust your instincts and make your decisions from an informed place and not out of fear.

Be Well,
Dana