In two weeks I am schedule to have a Glucose Tolerance Test (GTT). (I’m going to explain what it is and why It’s done because I didn’t know what it was up until recently. If you already know about it, don’t care, or are bored, skip to the 3rd paragraph.) During pregnancy, hormones suppress insulin release in order to provide more nourishment for the baby. The baby depends on a regular and steady supply of glucose, (which could explain why I’m constantly craving pasta, potatoes, and vanilla milkshakes.) During that time, about 2 to 10 percent of all pregnant women develop a temporary condition referred to “gestational glucose intolerance” (once referred to as gestational diabetes). Basically, women who have this condition have blood-sugar higher than average.
Babies born to mothers with gestational glucose intolerance can be excessively large. This can lead to prematurity, respiratory problems, and difficult deliveries. (I’m worried about a 7.5 pound baby passing through my vagina, anything larger than that scares the crap out of me, and literally, quite possibly.) The GTT is now offered to pregnant women between 24 and 28 weeks during which time a woman is asked to drink a glass of sweet liquid called “glucola” on an empty stomach. (They say it tastes like extra sweet Coke or Pepsi. Of course, that sounds much more appealing than what some women have told me. I have been told it tastes awful.) An hour later, the woman’s blood-sugar is tested. If the test results come back with elevated blood-sugar, it is suggested that the woman go in for a more advanced, 3-hour test. Only about 15% of women who show an abnormal 1-hour glucose test come back with an abnormal 3-hour glucose test. If that test comes back high as well, the doctor will recommend that a woman go on a diabetic diet for the remainder of her pregnancy.
I wrote about genetic testing a few months back. I am so absolutely grateful for having a baby in a day and age where science has advanced so much. Now more women are able to sit back and enjoy their pregnancies, this is especially important as more and more women are having children at an older age. But I have to admit, over the past several months I have had myself an eye roll or two. It’s when one starts to combine all these tests and rules – pillows one must buy, tests one must have, exercises one must follow, and ways in which one must lie down – that it all starts to look a little silly. How did women have babies before now? How am I even here at all?
About a year ago, I was in a meeting. There were several of us present; we were discussing an upcoming conference. (I worked in the creative department of a massive corporate meeting planning firm.) There was a woman present who was 3 months pregnant. She happened to be one of the account executives on the massive job we were discussing. Her team wanted reassurance that she was able to see it through, attend the meetings to plan the event, and finally attend the conference. That’s when she pulled out her calendar and did the most peculiar thing. She flipped 6 months ahead and said, “I’m going to schedule my birth for that Friday. I’ll be out for two weeks. I will return to work 17 days later.”
“Are you sure?” Someone asked.
“That’s what I did with Jacob. I could schedule the cesarean for earlier.”
“No, that won’t be necessary.”
And that was that. A pregnant woman had just scheduled her birth, her recovery time, and her return to the office 6 months ahead of time. It was one of the strangest conversations I had ever heard. Does this sort of thing actually happen? Do people schedule their births? They do in New York City apparently, especially the working girl. Nevertheless, it was one strange concept for me to accept.
When our mothers were pregnant with us they probably didn’t buy 70-dollar body pillows to help them sleep at night. They probably didn’t get all hopped up on prenatal vitamins, drink a glass of ground flax seeds every morning, have blood tests done 6 months prior conception in order to determine whether or not they were susceptible to certain genetic disorders. They probably didn’t receive an ultrasound every four weeks. I’m guessing they weren’t given a glucose test at 26-weeks. And I know for a fact they weren’t scheduling their births 6 months in advance. Granted, more women and babies probably died back then; I’m not saying that scientific advancement isn’t a good thing. I can’t imagine knowing what I know now and going back to how it was then. But is it all really necessary?
When you bring up things like 70-dollar body pillows to some women over 50, they roll their eyes. When you mention paying a doula for help during delivery, some of the older women may laugh at you. When you mention things like blood tests and genetic counseling, they may shake their heads in disbelief, muttering the words, “They do that now?” And when you ask some of them if they made sure that they slept on their left side, they may call you silly. Over the past several months I have even laughed at myself. There have been times I feel as though I have turned this natural event – one of the most natural things I’ll ever do here on planet earth – into something entirely more difficult than it should be. It’s as if I’m planning a trip to outer space rather than childbirth.
Are we turning the natural into some more unnatural? What will happen when I am my mother’s age and my son is the age I am now? Will a mother be able to choose between a boy or girl, blond or brunette? Will they have sticks you can pee on to check your baby’s sex? Not too long ago they were injecting rabbits with urine to test for pregnancy. Had you said to those folks their technique was absurd and that one day they’d be able to spare the rabbit and pee on a piece of plastic instead, they probably would have laughed at you. (Now we laugh at them for killing so many helpless rabbits.)
I keep wondering how childbirth will change down the road and because of that weird conversation I witnessed with a woman at work, I have taken my wonderment to the extreme. Will working women schedule their cesareans at 7 months instead of 9 because they don’t want to get too, too fat or deal with stretch marks? Is it not entirely inconceivable that some mothers will cut the gestation period short in order to spend more time at the office? Will babies one day naturally live the first few months of their lives in an incubator? Will vaginal births become a thing of the past, done by hippie mothers, religious fanatics, and teenage girls who don’t even know they’re pregnant to begin with?
I know. This all probably sounds pretty absurd. But if you had told a woman a 100 years ago that one day we’d be able to tell her the sex of her child using only sound waves, and count her baby’s fingers and toes before her child was even born, she probably would have laughed in your face.
There are many contributing factors that have led to the “scheduled birth” phenomenon. Also, scheduled includes being induced as well as c-sections. Here’s my take on it.
Malpractice insurance is highest for ob/gyns. Why risk being sued for a botched delivery when you can cut and make more money doing it?
The age of women giving birth is rising. Older women are at higher risk and I speculate a better candidate for a c-sect. And once you have had a c-sect it is more likely that successive births will be via c-sect.
Convenience and fear. Scheduled deliveries take away a lot of uncertainty.
Having said that, I think c-sections and inducing are valid medical procedures and have reduced perinatal mortality significantly. I just wish that they weren’t over-used.
Disclaimer: The preceding opinions are for entertainment purposes only and should not be considered medical advice.
stfarmer, I love your disclaimers.
Does anyone know when c-sections began? And then when they took off?
“In 1988, the rate had peaked at 24.7% of all deliveries, and declined gradually over the next decade.[1] Rates elsewhere in the world have continued to rise; the cesarean delivery rate in Brazil in 1996 was 36.4% and in some regions was more than 50%.[2] A national health goal for the United States has been to decrease the cesarean delivery rate to less than 15%.[3]”
Strategies to Reduce the Incidence of Cesarean Delivery – Part I: Management of Breech Presentation, Peter S. Bernstein, MD, MPH
http://www.medscape.com/viewarticle/424238
So they are trying to cut down on them here in the States. Interesting.
Wonder why it’s so high in Brazil. Weird.
P.S. for some reason, your comment was marked as spam at first. I fixed it. I think it was the link in combination with the stats. Not sure.
I would guess they are trying to cut down on the percentage of c-sections b/c it costs insurance companies more when a baby is delivered that way. Maybe I am cynical though!
C-sections have been around since Roman times (hence the name). I think they were originally done if the mother died in birth to try and save the baby. Could be wrong on that though.
I’ll try to avoid the combination of stats and links in the future!
re: the disclaimer… it’s probably the confluence of the pediatricians, lawyers and insurance people I work with. Either that or I was trying to be funny. :{)
melhow, it’s funny, I thought they were doing c-sections because the insurance companies stood to make more money that way. I’ll have to figure out where i read that, tho.
stfarmer, no, no need to cut down on that stuff, all is going to be fine now. It shouldn’t ever do that to you again now that I corrected it. No worries at all.
Melhow: I’m sure that c-sections do cost more but they are also riskier than a non-problematic vaginal delivery. That’s why you should only have one if you need one. It’s the public health advocates who are driving the reduction in that procedure.
Disclaimer: I do work as a researcher for an insurance company but my area is auto, not health.
Yep. Roman times indeed and it was used to save babies from dead or dying mothers.
Despite rare references to the operation on living women, the initial purpose was essentially to retrieve the infant from a dead or dying mother; this was conducted either in the rather vain hope of saving the baby’s life, or as commonly required by religious edicts, so the infant might be buried separately from the mother. Above all it was a measure of last resort, and the operation was not intended to preserve the mother’s life. It was not until the nineteenth century that such a possibility really came within the grasp of the medical profession.
Oops, that should have been a disclosure, not a disclaimer.
The percentage of babies born via c-section has been increasing in my province, I think we’re up to 30%. Mind you, that includes planned and emergency c-sections. I have heard people want elective c-sections so they can plan the day..avoid the stress and pain of labour, and so they don’t lose any..um how shall I put this politely, tone? of their lower bits. Like it or not, pushing a baby out naturally changes your body permanently. However, not many doctors around my area will agree to elective c-sections, unless you have a damn good reason. C-sections can be quite dangerous too, it IS a major surgery.
Regarding the GTT, when I took it last year, they gave me a bottle of orange fizzy drink that tasted exactly like Orange Crush. It didn’t taste any sweeter, even though I had not had any sugar in 3 months by that point. My OB thought I was definately going to get gestational diabetes, as my dad is a diabetic, so she cut me off all sugars during the first trimester. But I passed the test, so all was well. I had also heard horror stories, but it was perfectly fine.
Wendy, did you then run out and eat as many cupcakes as humanly possible? Because I would have! (Seriously, I haven’t craved one thing over another throughout this whole ordeal, but cupcakes come up quite a bit. Not sure why that is.)
Is it true a woman can’t walk up stairs after having a c-section? And if so, how long does that period last?
Oh man…. can you say, “kegel exercises”? I knew you could.
You can walk up and down stairs after a c-section. Just don’t do it constantly. You shouldn’t over exert yourself. At least that was what I was told. Take it slow and easy and don’t carry the laundry. I was up and down just fine after Simone. We don’t have stairs now so it wasn’t an issue with Shep. I just had to be careful picking up Simone after Shep was born.
I have had several friends elect for c-sections. I think with most of them it was out of fear not their schedule. Most had seen bad experiences with sisters and didn’t want to go through that. I know my sister was all about the elected c-section after seeing what happened to me with Simone.
Pain and fear is why God invented (or was it man discovered) the epidural.
My motto is better living through chemistry.
Disclaimer: Should not be construded as an endorsement of the use of pharmaceuticals legal or illegal.