PSA for pregnant mothers

so i had a pre-natal appointment last week, and i was up for the dreaded (at least for me) glucose tolerance test.

i dread it because:

1. i do not care for orange flavored drinks, candies, treats, foods, etc.  even orange infused dressings, orange marmalade or orange juice.  [i do however like oranges.  fresh oranges.  navel oranges, mandarin oranges, clementines.  they're yummy.  as long as in fruit form.]

2. there is a ridiculously high amount of sugar in the glucola drink and it's very hard to chug it all down in one sitting.

3. the fake flavor and fake orange coloring makes me gag.

4. i have to go the hospital to get my blood drawn at the lab which takes for.ever.

this bottle is for 100g but i've only ever had to take the 50g bottle

after 3 pregnancies where i have tested negative (and let me again emphasize NEGATIVE) for gestational diabetes (GD), i decided that there really was no reason for me to take this test for baby #4.  with the exception of emma, i have measured big towards the end of my pregnancy.  this one is no different.  i was at 30 weeks for my appointment and i measured 31 weeks.  that's right.  yet another possibility of a "big" baby.  while i understand the dangers and risks of having gestational diabetes, my track record doesn't indicate that i'll be at risk for it.  so why take it? plus, it's just going to cost us extra money to have a lab tell me something i already know.

so during my may appointment, when they informed me that i'd be taking the glucose test at my next appointment, i declined.

surprisingly, i didn't get off that easy.  i thought for sure that being surrounded by midwives, i wouldn't experience any resistance to the request.  [i have to add here, that i was discussing this with a student, who obviously was not my regular midwife.  i'm sure, because she was a student, she was still learning and navigating her way through all the political medical policies.]

"well, it's part of hospital protocol."

i was insistent that i didn't want to drink the orange stuff, and pushed to skip the test all together. can't i just sign a waiver that i understand the risks of skipping the test and promise not to sue if something happens?

"no.  you have to take it."

actually, i don't think i have to.  so i was offered "the diet."  that's right.  a diet, which must be followed precisely, containing 50 grams of carbohydrates (a substitute for the 50 grams of glucose you consume from drinking the orange stuff). why didn't i know about this before??

you want me to eat eggs, an english muffin, and buttter?  ok.  twist my arm.

now, i don't drink milk straight so i ended up mixing some of the milk in my eggs and the rest in my coffee (ended up being more milk than coffee, but that was fine with me).  it was a most enjoyable breakfast, which was made even more enjoyable knowing that i didn't have to drink any orange soda stuff.

but here was the best part.  i went to my appointment under the assumption that i would have to go to the lab to get my blood drawn for the glucose tolerance test.  but instead of sending me off, all i got was a finger prick using one of those little readers that i believe diabetics use when they have to measure their blood glucose levels.  that's it?  are you kidding me?  why didn't i do this with the other pregnancies?  why wasn't i made aware of this option before?

i was surprised and pleased.  i asked the office how long they've had this alternative option, and apparently they've always offered it.  they just don't make it public unless a patient specifically asks for an alternative or wants to refuse the test (guess that was me).  the primary reason the diet was not presented as an option was because the hospital prefers patients to take the drink and go to the lab for the test.  while there are some in the medical profession that claim the glucola drink provides the most accurate test results for glucose tolerance, there have been some other studies (though from what i've been able to find not much research has been done all together on the effectiveness of glucola for measuring GD compared to alternatives) that suggest that alternatives, like the diet i did, is just as sufficient in measuring glucose levels in pregnant mamas.

here's my (cynical) take: money.  what costs more and who stands to profit?  blood work at a lab or a finger prick test?  an orange drink supplied by your doctor's office or making your own breakfast at home?  while i think the glucola drink might possibly be a more accurate option for the test for a pregnant woman going through her first pregnancy, why does it have to be so for women who have had previous pregnancies with negative results? or why isn't information for other options presented to even first-time pregnant women so that they are able to make an informed decision, especially if there are alternatives out there?

i feel that the "protocol" claim for this test, treats women as all the same (not as individuals), and undermines the pregnant woman's ability to trust in her own instincts and intuition about the state of her body.  and apparently some women don't tolerate the drink well (maybe it's the abnormally high amount of sugar they have to ingest in a short period of time. or the food coloring. who knows.).  and for some it gives a false positive, because consuming sugars or carbs as part of their regular diet is not a daily occurrence. 

quiet honestly, i haven't done any research into the glucose tolerance test until now.  with the amount of research i've done in other areas of my current and previous pregnancies, i don't know why i've never paid much attention to this one area.  i guess i just thought that it was something all pregnant women did.  i mean really, it's just an orange drink.  what's the big deal, right?  in the grand scheme of things, it's probably not a big deal.  but i really don't like orange flavored drinks.  and this is is my 4th pregnancy, so i would like to think that i kind of have a good grasp on what's going on with my body and how it will react to things.  plus, our insurance gets more and more pricey each year so if it's not a medical necessity why should i have to shell out money and time (i have 3 little ones to tend to now) on something that will give me the same exact results as the last 3 times?  so for us, considering to opt out of a test like this had its merits.

i don't know how it's like for other OB offices, but i did feel it was important to share this new discovery.  like i said, there isn't a whole lot of information about alternate options to the oral glucose tolerance test (OGTT) except for the fact that it's something all pregnant women get to take during their pregnancy.  but there are options if you choose to consider them.

listed are links to more information related to the glucose tolerance test (i tried to stick with medical journals, etc.):


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