Non-Stress Tests and First time Mom.
I get weekly NST’s ever since 32 weeks, and up until this point it has been a fun way to visit the doctor and get extra time with baby. Thanks to an earlier history with high blood pressure I get all sorts of extra monitoring. 4 months ago I had AFI ( Amniotic fluid ) levels at 28 that gave me a lovely diagnosis of Polyhydraminos. Thankfully that was a fluke month, but I have to get it checked weekly now. It is nice to see baby every week, and it is reassuring to get so much attention. Google has taken me to dark places when it comes to the “what if’s”. Do listen when people say NO GOOGLE.
I am also a first time mom. I have NO clue at all what to expect, no matter how many books I read or questions I ask my doctor. Well I have something I DO know now and want to share. Not to scare, but to tell my experience. I did not want the label of that paranoid over reacting mom to-be, but now I know you need to listen when you think something is going on.
If you feel something is not right, be that crazy woman who goes to Labor and Delivery for it.
I have been able to tell once we hit 36 weeks Baby S has slowed down tremendously. It was unnerving at first but since everyone said it was normal, and I always got my morning and night kick counts ( or movement counts) with ease; I was not worried. Until a few days ago. He wasn’t moving like he has been since 25 weeks along. He was not moving at all. FEAR PANIC OMG THE INTERNET- Kind of – I stayed calm and asked the husband for a huge Icee, and within 10 minutes I started to feel squirming. Thank you little baby. Never do that again.
Then Tuesday came along, no movement. I poked. I bounced. I layed on my side. I drank juice. I guzzled frozen water. I went to the BX and got a Mt. Dew Freeze from Taco Bell. Radio fricken silence in my belly.
Since I have a weekly appointment standing I went in Wednesday morning and I talked about the last few days… AS we failed the Non stress test. Baby was not moving then either. We could see the print out of his heart beat, so he obviously was alive, but the point of a NST is to check for fetal wellbeing. We already saw him on our weekly umbilical cord and fluid check, so we knew he was there but he was not moving very well then either.
Then my OB reviewed my failing NST scribbles, and ordered the next step- BioPhysical Profile(BPP). This is the test where if he did not get 100%- at this point in pregnancy we just take him out. Insert freaking out He eventually passed but it took him a super long time, all which I was running questions ” How can his vitals be found, cord good, fluids good, my vitals good, and he is not MOVING !?” Well he passed. Baby is still in the belly. For now. IF at any point he fails an NST, and does not pass his Biophysical- he is evicted. Immediately.
Insert the doctor and her scolding. I have new/different protocol than The American Congress of Obstetricians and Gynecologists (ACOG) handout I was given in the big packet after confirmed pregnancy. I now call if I do not feel him squirm, move, etc within an hour at any point of the day. Day or night if I have not felt him and I run through the to-do’s to get him to move and he does not? – Off to Labor and Delivery we go. This differs from the 10 movements in 2 hours as advised to me previously.
It is not normal to not feel your baby.
I head back this Friday for another NST, and hopefully not another BPP. Which most people get 2 NST’s a week if high risk, but since I have better blood pressure pregnant( than when I was a normal weight healthy person), and Baby S has been thriving- Once a week has sufficed.
Now here is where I urge people to talk to their doctors!! Clearly a do as I say not- Do as I did.
Do not talk to people. Out of the 10 or so people I talk to about my weekly baby bump dates, most people found the if I fail a test, he gets evicted asap extreme. My parents were one of the few that responded that didn’t try to blow off the tests. ” We will be on a plane as soon as you tell us, we are ready!” Bless my supportive parents.
I got so many comments about how it is normal for him to not move at this point, and about how poor baby just ran out of room. That it seemed rash or extreme to evict him for failing an ultrasound. So I felt weird. On one hand my doctor is informing me of the terrifying facts of lack of movement and evicting him to save his life. Then on the other people are providing comments I already had in my head. It was hard to deal with actually. I felt SO guilty I didn’t go get him checked Tuesday. I felt like a terrible mom I waited until my appointment because I feel so over monitored, and nothing has been wrong. Yet. The guilt. The what if’s. After this appointment I felt horrible for not calling, and snuffing out the voice in the back of my head that said “Call the doctor!”. I will not ignore that voice. Even if I end up at the Hospital daily.
So here are some basic facts I want to leave for this little space of the internet, and hopefully you just get the message- Call the doctor. Go in. It does not matter. Your baby is likely 100% fine, but it honestly never hurts to check. That “better safe than sorry” truly applies to your baby.
The Non Stress Test– What checks for normal pregnancies when you have a lack of movement, or other concerning symptoms your doctor may order this for you.
- Non invasive. Can be done different ways.
- Monitors the health of your baby.
- A normal NST shows that your baby is getting enough oxygen and is doing well.
- The test is not checking “movement,” but evaluating reactivity of the heartbeat.
- If a baby is not moving, or is not giving the heart accelerations in the allotted time- more tests may be ordered. This is called non-reactive.
The Biophysical Profile- BPP
- A biophysical profile(BPP) is a prenatal ultrasound evaluation of Baby well-being involving a scoring system.
- The test combines Baby heart rate monitoring (non stress test) and ultrasound. During a BPP , a baby’s heart rate, breathing, movements, muscle tone and amniotic fluid level are evaluated and given a score.Typically, a biophysical profile is recommended for women at risk of pregnancy loss.
- You get points per area evaluated, mine were giving during the test.
- Fetal heart rate. Results of this part of the test (nonstress test) are called reactive or nonreactive. If your baby’s heartbeat accelerates twice or more within a 20-minute period, the results are considered reactive and 2 points will be given. If not enough accelerations occur within a 40-minute period, the results are nonreactive and 0 points will be given.
- Fetal breathing. If your baby displays at least one episode of rhythmic breathing for 30 seconds or more within 30 minutes, 2 points will be given. If your baby’s breathing doesn’t meet the criteria, 0 points will be given.
- Fetal movement. If your baby moves his or her body or limbs three times or more within 30 minutes, 2 points will be given. If your baby’s movements don’t meet the criteria, 0 points will be given.
- Fetal muscle tone. If your baby moves a limb from a bent position to an extended position and quickly back to a bent position, 2 points will be given. If your baby’s muscle tone doesn’t meet the criteria, 0 points will be given.
- Amniotic fluid level. The ultrasound technician will look for the largest visible pocket of amniotic fluid. To get a score of 2 points, the pocket must be a certain size. If your amniotic fluid level doesn’t meet the criteria, 0 points will be given.
The individual scores are then added together for a total score. Typically, a score of 8 to 10 is good, but your doctor may request more testing, or give you more directions. For me I am full term, already showing signs I am preparing for an early labor, so if Baby S at any point fails the BPP, we are headed to deliver him. Your doctor will have scoring, and their own protocol. This is just my experience and all I can do is ask you to trust your gut, call your doctor, and listen to your body. No one is a perfect expert but I really got a scare and want to help others with my stressful NST story!