Anonymous
Post 05/03/2019 00:12     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why do people second guess doctors so much re pregnancy?



Maybe because of the ridiculously high infant mortality rate in the US and the horrible outcome for pregnant women?

By the time you’ve had a kid, you’ve probably experienced first hand some medical mistakes. Doctors are not gods.


That's fine, go and get 2nd and 3rd opinions. But don't decide based on internets boards and what feels more convenient for you. They stress test for a reason.

Look up S S K, ET AL. v. Dr. Russell Bridges, Capital Women's Care, ET AL. , No. 2017 CA 3143 M. - The patient declined NTS, despite declined fetal activity, sadly the baby died, then she sued the Dr and won because he didn't insist on immediate NTS strongly enough.

There are risks, shit can happen, 4 hours of your precious leave time vs well being of your baby - don't make these decisions based on convenience, the protocols are there for a reason.



“Despite decreased fetal activity*

That’s a totally different story.


No, it's exactly the same issue: not listening to a doctor. Distress is not always associated with decreased activity or any other one consistent symptom, this is why NSTs are needed.
Anonymous
Post 05/02/2019 13:12     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:I had both my kids at AMA. For my second, at 37, they made me do the non stress test at 40 weeks. Induced at 41 weeks.


OP here, at 40 weeks it might make some sense.

I had a great appointment today with a different doctor at the same practice. She said it was true that the chances of catching something with a once-weekly NST were probably smaller than the chances of a false positive that leads to unnecessary intervention. She also said to keep close attention to fetal movement patterns, and just get into a cab immediately and come in if I had a concern. That (fetal movement patterns) was the one thing that was strongly correlated with outcomes. She called the NST "unreliable" in low risk pregnancies (although they have their use in high risk situation). I walked out very happy and understood.

That's great! What a difference it makes when they discuss your actual risks, and alternatives.


I know, right?

Thanks to all the PPs above sharing experiences, very helpful!
Anonymous
Post 05/02/2019 10:12     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:I had both my kids at AMA. For my second, at 37, they made me do the non stress test at 40 weeks. Induced at 41 weeks.


OP here, at 40 weeks it might make some sense.

I had a great appointment today with a different doctor at the same practice. She said it was true that the chances of catching something with a once-weekly NST were probably smaller than the chances of a false positive that leads to unnecessary intervention. She also said to keep close attention to fetal movement patterns, and just get into a cab immediately and come in if I had a concern. That (fetal movement patterns) was the one thing that was strongly correlated with outcomes. She called the NST "unreliable" in low risk pregnancies (although they have their use in high risk situation). I walked out very happy and understood.

That's great! What a difference it makes when they discuss your actual risks, and alternatives.
Anonymous
Post 05/02/2019 10:01     Subject: S/O How many non-stress tests do AMA women really need
I delivered at 37yo with a practice of CNM in a hospital setting. No NSTs; DD was born a few days before her due date. I was told that their age cutoff for doing NSTs on a low-risk pregnancy at that time was 38yo. Now at 40 and TTC #2, I've been told that they would recommend weekly NSTs starting at 36w, and induction at 40w if I'm able to get pregnant again.
Anonymous
Post 05/02/2019 09:50     Subject: S/O How many non-stress tests do AMA women really need
I had exactly one NST with each pregnancy, both AMA - first at 36 and second at 38. Any particular reason you're seeing an MFM that makes you more high risk? I go to Foxhall and delivered at Sibley.
Anonymous
Post 05/02/2019 09:47     Subject: Re:S/O How many non-stress tests do AMA women really need
I delivered at 36. I only had one NST, which was requested by my OB after a routine visit where she had some concerns about the baby's heartbeat that she identified during the visit. The test didn't indicate any problems.

I was induced at 39w6d (IVF pregnancy so dates were exact). Pretty "easy" induction with epidural, vaginal birth, no complications.
Anonymous
Post 05/02/2019 09:02     Subject: S/O How many non-stress tests do AMA women really need
I was 41 when I delivered. Total number on NST=0.

Was assessed weekly by midwife (including urine glucose /protein, Doppler), plus daily kick checks. Despite my age, I was deemed a low risk pregnancy.

Interestingly enough, one of DHs employees and his wife (well under age 30) were deemed as a high risk pregnancy. She had GD and a host of other issues.

Age isn’t the whole picture.
Anonymous
Post 05/02/2019 07:32     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:There is more evidence in favor of antenatal testing in women over age 38 as compared to home doppler use or fetal kick counts. Stop using evidence based practices only when it serves your purpose.

If you want antenatal testing, do it.
If you don’t and you think you know better then your doctor and SMFM, don’t.

If you are going to “agree” please do it closer to the end of your pregnancy.

Also, the website you wanted folks to read up on has basic information which is incorrect including the definition of stillbirth. (Gestational age of 20+ weeks not 24+ weeks). If the author can not even get this simple fact straight, how can you trust her critical evaluation of the evidence which is also outdated?

You may be thinking of a different site. The one I quoted has well organized, complex and nuanced information, all of it referenced with studies from peer reviewed medical journals. Of course every one of us has biases and no study is perfect. I've done a much broader literature review but posting links to medical journals individually wouldn't work for most people because they are often behind pay walls, so that site seemed like second best choice. I haven't seen anyone point to studies that show effectiveness of NST in low risk pregnancies, though I would be very interested in reading those if they exist.

Anyway, thanks all for weighing in, and especially to those who shared their experiences.



Anonymous
Post 05/02/2019 07:22     Subject: S/O How many non-stress tests do AMA women really need
The test is designed to help prevent stillbirth and other complications but has been proven to be ineffective at that, especially in low risk pregnancies, and to lead to false positives which then lead to unnecessary interventions that can have very real risks.

Risks in pregnancy (and life generally) cannot be eliminated, and they don't come from one place, we can only try to understand them and manage them.

Anonymous
Post 05/02/2019 07:15     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:Why do people second guess doctors so much re pregnancy?



Maybe because of the ridiculously high infant mortality rate in the US and the horrible outcome for pregnant women?

By the time you’ve had a kid, you’ve probably experienced first hand some medical mistakes. Doctors are not gods.


That's fine, go and get 2nd and 3rd opinions. But don't decide based on internets boards and what feels more convenient for you. They stress test for a reason.

Look up S S K, ET AL. v. Dr. Russell Bridges, Capital Women's Care, ET AL. , No. 2017 CA 3143 M. - The patient declined NTS, despite declined fetal activity, sadly the baby died, then she sued the Dr and won because he didn't insist on immediate NTS strongly enough.

There are risks, shit can happen, 4 hours of your precious leave time vs well being of your baby - don't make these decisions based on convenience, the protocols are there for a reason.



“Despite decreased fetal activity*

That’s a totally different story.
Anonymous
Post 05/02/2019 06:59     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:Why do people second guess doctors so much re pregnancy?



Maybe because of the ridiculously high infant mortality rate in the US and the horrible outcome for pregnant women?

By the time you’ve had a kid, you’ve probably experienced first hand some medical mistakes. Doctors are not gods.


And if you follow these issues closely you know that they are largely attributable to health care disparities, racism, increased chronic conditions among pregnant women who are growing increasingly older, and lack of treatment/intervention at the correct time. The answer to these challenges is not less care or testing.
Anonymous
Post 05/02/2019 06:13     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:
Anonymous wrote:Why do people second guess doctors so much re pregnancy?



Maybe because of the ridiculously high infant mortality rate in the US and the horrible outcome for pregnant women?

By the time you’ve had a kid, you’ve probably experienced first hand some medical mistakes. Doctors are not gods.


That's fine, go and get 2nd and 3rd opinions. But don't decide based on internets boards and what feels more convenient for you. They stress test for a reason.

Look up S S K, ET AL. v. Dr. Russell Bridges, Capital Women's Care, ET AL. , No. 2017 CA 3143 M. - The patient declined NTS, despite declined fetal activity, sadly the baby died, then she sued the Dr and won because he didn't insist on immediate NTS strongly enough.

There are risks, shit can happen, 4 hours of your precious leave time vs well being of your baby - don't make these decisions based on convenience, the protocols are there for a reason.

Anonymous
Post 05/02/2019 05:35     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:Why do people second guess doctors so much re pregnancy?



Maybe because of the ridiculously high infant mortality rate in the US and the horrible outcome for pregnant women?

By the time you’ve had a kid, you’ve probably experienced first hand some medical mistakes. Doctors are not gods.
Anonymous
Post 05/02/2019 04:42     Subject: S/O How many non-stress tests do AMA women really need
Why do people second guess doctors so much re pregnancy?
Anonymous
Post 05/02/2019 01:10     Subject: S/O How many non-stress tests do AMA women really need
Anonymous wrote:Okay, I agree with everything you said. These tests are bs and designed to make money and cover asses. Advocate for yourself. Push back. Good luck.


No, they are designed to prevent stillbirth and avoid other pregnancy complications. Mother Nature is a terrible obstetrician.
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm4838a2.htm