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Ronnie Falcao, LM MS, a homebirth midwife in Mountain View, CA

A Mother Summarizes Her Reasons for Declining Glucose Screen

After doing some reading about the screening and chatting with my midwife, I'm pretty sure I'm *not* going to do the test. I haven't yet discussed my decision with my doctor (whom we're seeing in case our planned homebirth doesn't go as planned), so I don't yet know what she'll say. She's pretty non-interventionist herself (had all three of her children at home), but when I protested about the sugar test, she immediately offered me a pretty reasonable "carbo" diet as an alternative (rather than going into the possibility of my not doing the test at all). I posted a similar question as yours on the "attachment parenting" group (pgap), and was surprised more people weren't turning down the test. What follows is the response I gave someone on that group who wanted to know *why* I was not wanting to do it. This may be helpful to you since my reasons are based on research, not on a fear of needles. I would welcome any response from anyone since my mind is not *entirely* made up!

The reasons I'm considering *not* doing the test are:

• I don't like the idea of bombarding my body and baby with sugar (especially after a fast!)...can't imagine it's good for either.
• The fast alone not only sounds like a bad idea for the baby, but it can often make women ill b/c low blood sugar can trigger nausea. Drinking Glucola on an empty stomach may cause nausea, vomiting or fainting as well.
• I don't understand why they'd test me on a sugar high when that's such an unusual state given the healthy way I'm eating. (In addition, the better a woman's nutrition, the less likely her body is to be accustomed to large doses of straight sugar.)
• The test is not reproducible at least 50-70% of the time.
• From the research I've done, 30% of women fail the first test and have to go on to do further testing (somewhat of an ordeal as I understand it), even though only 2-3% are ultimately diagnosed with Gestational Diabetes, resulting in less than 1% (.45%) of all pregnant women needing insulin. (Incidentally, no clear improvement in perinatal mortality has been demonstrated with insulin treatment for GD.)
• While it is true that an abnormal glucose tolerance test (GTT) is associated with a 2-3 -fold increase in large babies, the majority of large babies are born to mothers with a normal GTT.
• If the treatment for GD is following a healthy diet, why not just eat a healthy diet to begin with (bearing in mind the specifics of watching carbo intake, etc.)?
• If I test positive with their test(s), my pregnancy would officially be considered "high risk," invoking an extensive program of tests and interventions of unproven benefit *and* automatically dictating a series of interventionist methods should I wind up birthing in a hospital.