thinking about pregnancy

Here is some more info on my decision to forego routine gestational diabetes testing (which is not routine in many other developed countries with better birth outcomes than we have, by the numbers)

ARTICLE 1

ARTICLE 2

Of course, I will have the test if any syptoms of risk factors develop, and maybe even if my midwife just feel really strongly about it and urges me to do it. But at this point, I am leaning toward no.

I have had a lot of screening testing in all my pregnancies, and even more in this one due to my "advanced maternal age" and my recently-discovered thrombophilia gene mutations. I am not opposed to screening tests I believe serve a purpose. But I am trying to have a pregnancy/birth where I feel like I am making truly informed, empowered decisions at every step. Sometimes this may actually involve asking my doctor or midwife for MORE testing. For example, I have read the research and ultrasounds don't worry me, so I have no problem asking for one if I have a concern or worry the ultrasound might alleviate.

But I am not willing to just blindly go along/get along - either direction.

Another example: I wasn't going to be able to have the birth I want with the perinatologists I was seeing because of how and where they deliver babies. So I spoke up to them about this and they were very open to working with midwives at another hospital to make sure I get what I want. I am glad I spoke up and didn't just accept what appeared to be the only option. I feel really good about taking some control over my care, and I continue to feel like I am still in very good hands for both my routine care (certified nurse midwives), as well as for any back-up or more advanced care I might need (my perinatologists).

For my birth, I plan to be assertive about what I do and do not want, recognizing that sometimes I may have to trust the judgment of my caregivers if they say I really do need to have some sort of intervention I would ideally like to avoid, like continuous fetal monitoring.

On the other hand, I may choose one intervention in particular - an epidural - that my midwives don't generally offer, because for 95% of their births, they are working in a freestanding birth setting rather than at the hospital where I will be having my baby.

Bottom line: my body, my baby, my brain, my birth, my decisions. We are lucky to live in an age where good info about pregnancy and birth are available to most women in the U.S., if they know where to look. I am lucky enough to have health insurance that allows me some choice and flexibility in choosing the caregivers I really want, so I know that I can trust their judgment and guidance in deciding how my care will proceed. And I am also lucky enough to have a husband who is equally involved in making pregnancy and birth decisions, but who supports my right to "drive the bus," as it were.

You might make different decisions for your own pregnancy, and I may make a misstep along the way, but at least I'm thinking as I go.