Non-stress tests, why so often and so early?

I have had to receive care at a less than stellar OB/GYN office. I have seen 5 different residents in 8 visits. 3 weeks ago I was told I had to go for non-stress tests twice a week. So, I signed up at the local hospital the practice is affiliated with. The nurse running it has a big mouth. She keeps telling me to remind her that I do not know the sex of the baby nor do I want to know. I am 30 weeks along. I have had to cancel twice because like most of you I have had so many other appointments with specialists that I have forgotten about and realized I double booked.

    I have asked if she can book the appointments for 8 weeks in advance and she refuses to do this. Has anyone gone through this? I think this early the amount of testing is excessive. Every test with this office and anything else has been perfect. I want to insist that I cut back to once a week but I know the residents will whine and then call the head doctor in who always comes and then lectures me. Every time I have a question or suggestion they run to get the head doctor. Yes, I have tried looking for another practice but my health insurance is awful and few offices accept it. Has anyone else asked their doctor to back the non-stress test down to once a week? It seems as though I have been lectured my entire life. Today while I was at the fetal echo I was lectured by the doctor all about breast feeding. I told her I had planned to breast feed and she still went on and on about it. I am looking into acupuncture to help with induction too so that I can have a normal delivery. If I could I would insist that I carry until 40 weeks but it does not look like they are going to let that happen. I guess all of you can relate. For those of you who are old enough we can remember when we were all told that we would not live until past 25 and we would have no legs, kidneys, or eyes, let alone be able to be pregnant.

It seems like non-stress tests have become really popular in the last couple years.  I get the reasoning behind them, but I also know healthcare professionals go a little overboard with type 1 moms.  Glucose meters, pumps and CGMs have dramatically changed diabetes and especially diabetic pregnancies.  You know how your pregnancy is progressing.  It's legally within your rights to refuse treatment or a procedure if you feel it is unnecessary.  Just listen to the doctor's lecture and insist that you understand the risks but are choosing to have the test done less often (or not at all).  

You reminded me of how crazed healthcare providers are about promoting breastfeeding.  My favorite were the lactation consultants who never breastfed when they were parents, but were now advocating that it's child abuse if you don't do so now.  Best advice I got was from a co-worker who said it doesn't have to be all or nothing.  Most babies do totally fine with a mixture of breastmilk and formula.  Allowing your husband to do the 10pm feeding with a bottle will allow you to have 5-6 hours of uninterrupted sleep... priceless!  I loved breastfeeding my son but it worked best when I fed him in the mornings before going to work and then again in the evenings, before going to bed.  He's now a completely healthy 6-year-old with no food allergies, obesity or any of the other terrible issues that are supposed to be caused by formula.   The biggest downside to formula is the cost.  Figure out what works best for you and your baby.

Just like we used to hear that as diabetics we'd be blind, amputees, or dead at a young age, as an expectant type 1 mom you'll probably also have people ask you if you've seen "Steele Magnolias."  It's kind of like how expectant moms get to hear everybody's horrific child birth stories.  For some reason people like freaking out the moms-to-be!  Guess its a right of passage for motherhood.  

Take care and congratulation on becoming a mom.  It is a wonderful blessing.   -Jenna

What are non-stress tests for?

Diabetics can be at risk for higher or lower levels of amniotic fluid.   Low amniotic fluid can be a serious stress on the baby and require early delivery.  A non-stress test measures baby's heart rate, movement and other vitals to make sure everything is okay.

As a diabetic mom you're considered a high risk pregnancy, so some doctors order non-stress tests.  

www.americanpregnancy.org/.../non-stresstest.html

Jenna,

That is SO funny how exactly right you are about the breast feeding, stress tests and Steel Magnolias, and of course the best one - the horror stories. Why would people tell you their horror stories (especially when you’re a first time mom?) I can understand now if I'm talking to my friends who have already had babies and we share stories b/c each person knows how different they all are - but to a 1st time mom to be!!! I went home in  tears a few times.

Gina,

My pregnancy was great and I had to do those tests twice a week. They sent me to the ER twice because they didn't like the readings. 1 time it was a dip b/c my little boy grabbed the umbilical cord. The other time they just weren't getting a lot of readings b/c I hadn't eaten in a while and most likely he was asleep. It was a pain to go all the time but I just kept telling myself they are just wanting to make sure everything is 100% perfect for the good of my baby. When they said they wanted to do an AMNIOCENTISES, then I freaked out. I called my high risk doctor (that told me I wasn't high risk enough for him to deliver me or see me more than once every 6-8 weeks for an ultra sound) he told me he would call them (my regular OB's) and tell them I didn't need an AMNIO - that I was perfect and the baby looked perfect.

Normal Ob's seem to go way over board because this is out of their comfort zone. But they are not doing it to annoy you or be rude. They are just being as cautious as they can be.

My OBs wanted me to start non-stress tests twice a week at 28-32 weeks of pregnancy. My perinatologist (high risk doctor) said he doesn't usually start them until 34 weeks in a well controlled diabetic. We compromised and I did once a week at 32 and 33 weeks, and then twice a week (Mondays and Thursdays) starting at 34 weeks. I didn't question my perinatologist because I actually work with him, he is an excellent doctor, and he was following recommended guidelines. And, as I learned in my pregnancy, things can change over a matter of days, and that is why they have you come in twice a week.

My NSTs at 32, 33, and 34 weeks were all fine. Around 34 weeks I noticed my blood sugar dropping when I wasn't expecting it... it seemed like "insulin resistance" from pregnancy was wearing off (which can happen if the placenta is starting to fail). My NSTs at 34 weeks were fine, as was the first at 35 weeks. When I went in at 35 1/2 weeks fetal heart rate and movement were normal, but amniotic fluid was very low. The peri asked if I had been leaking fluid, and I said no. He told me I had to go deliver my daughter because the placenta was starting to fail. I went to the hospital that night and when my OB broke the sac she said there was almost no amniotic fluid (see my post regarding the whole delivery). My daughter is now 6 1/2 weeks old and amazing and healthy. She was in the NICU for 8 days because her lungs were underdeveloped. However, if I had not done the NSTs and had continued the pregnancy, I'm sure she would have become distressed in utero which could have caused more complications for both of us!