Prenatal testing, and me.

I have never had a gestational diabetes test. I've had great prenatal care from very qualified and experienced midwives in non-hospital-based practices, and none have seen the need to recommend this test to me. They don't recommend it to many of their clients, really. Plus, there are better ways to test for gestational diabetes than drinking whatever that nasty stuff is that people ingest, and then sit in a doctor's office for x amount of hours trying not to barf. A good midwife knows which of her clients would benefit from this sort of testing, and recommend it to them. I have never been that person, so I have never taken a gestational diabetes test. If Alyson recommended one to me on Tuesday when she's over here for my 28 week appointment, I'd take it. She hasn't, though, and I don't think she will. We've actually discussed this before.

I think it's also really important and relevant to point out that I have never once told someone who wants to take this, or any other, test, NOT to take it. On the contrary, I've told people that if they would feel more comfortable having taken some test or another, then they SHOULD take it. Again, though, I am not that person. I have read the recommendations. I know that the majority of OB and hospital CNM practices don't even follow ACOG's recommendations on this testing. They test everyone who walks through the door. ACOG doesn't even recommend that. They have clear guidelines for who needs to be tested and who doesn't. Why does it never occur to people to question this across the board testing when even the professional organization governing OB/GYN's does not recommend that?

What's more, I really am tired of it always turning into people grabbing their torches and pitchforks, and coming at me with their mainstream group-think the minute I say I don't take x or y test, and never have. They accuse me of horrible things, putting my baby's life at risk, risking my own life, being selfish. I'm not being selfish and I'm not risking anyone's life. I have talked with Alyson, whom I trust very much, about this. She doesn't see a single reason at this point why I should be tested. She's also cared for women who have diabetes, and gotten them through healthy pregnancies and homebirths without a single pharmaceutical intervention, so even if something did go wrong, I know it's not the mainstream thing that I need. I am with a knowledgeable and experienced homebirth midwife, one with way better outcomes than any OB or hospital midwife I've ever heard of.

I really bristle at the logic that since the vast majority of practitioners recommend something, it must be good. Let's look for a minute at some things the vast majority of practitioners recommend, as pertaining to pregnancy and birth:

-The vast majority of practitioners recommend routine induction at 42 weeks, despite countless studies which show that there's NO reason for it. (There is a slight increase in risk at 43 weeks, but not at 42.)

-The vast majority of practitioners recommend not eating during labor, despite the well proven fact that this slows progress, and even can create complications for the baby and the mom.

-The vast majority of practitioners put women in the lithotomy position to push, despite the fact that this position narrows the pelvis significantly when compared with nearly any other position out there, thus necessitating instrument-assisted delivery, "purple" pushing, and sometimes even c-section. It also increases the rate and severity of tearing.

-The vast majority of practitioners recommend antibiotic treatment during labor for women who test positive for Group B Strep, despite the fact that we're the only country in the world that does that (and have the second worst birth outcomes in the industrialized world, might I add), and a 1997 study done by Kaiser in California, showed NO difference in outcomes for those treated with antibiotics compared to those who were not.

-The vast majority of practitioners perform c-sections on at least 30% (some more like 50-60%) of their patients, despite the fact that the World Health Organization states that a c-section rate above 15% does more harm than good, AND c-section delivery increases the risk of death by 400% for both mom and baby.


As you can see, I don't put a huge amount of stock in what the masses are doing. I don't understand why anyone would swallow the pill and accept these things for themselves, despite the fact that the standard procedure is a little crazy when you really think about it. Even so, I don't tell people not to go that route if that's what they want. When it comes to this gestational diabetes testing thing, I explicitly tell people, "If you want this test, then you should take it." I am respecting what they're doing in this. I don't receive the same in return, though, and that really sucks.

You know how my kids are healthier than most other people's kids that we know? Yeah, how neither of them has ever had anything more severe than a cold, how they're not on any medications, how neither has ever been hospitalized? Yeah, I didn't have any prenatal testing with either of them either. Obviously it's a recipe for certain disaster, right?