February 15, 2011,
T.S. asks from Langhorne, PA on November 11, 2010
Anyone over 40 Have a Non-stress Test Done During Pregnancy?
I'm 41 and expecting baby #2 at the end of December (I'm 32 weeks along). I had my first non-stress test done on Tuesday and was told that it wasn't covered by my crappy insurance and would be considered a 'specialist'. My specialist co-pay is $50. We pay our own insurance, Aetna, because my husband is considered an independant contractor in the Philadelphia Stock Exchange, so the person he 'works' for doesn't offer health. And I'm supposed to have the test twice a week which means $100 a week until I deliver (that will be $700), PLUS we have a hospital maternity copay of $550 per day. The only reason the doctor wanted this test done was because I'm over 40... that's all. So far I''ve had no problem with my pregnancy (or my first). $700 is alot that my husband doesn't want to pay. Did anyone ever turn the test down? I'm wondering how neccesary it is.
R.B. answers from New York on November 11, 2010
I am 40 and I just had a baby in May and I never had one single non stress test. I have very good insurance and a fantastic OB. Why are so many people having 2 per week? My baby is fine, my delivery was easy, my labor was quick.
3 moms found this helpful
J.L. answers from Clarksville on November 11, 2010
When I was pregnant with my 3rd, I would be turning 35 around her due date. At the time, I had dual care with an OB practice and saw their midwives while also seeing my home birth midwife. The OB practice had me so stressed with just 3 appointments that I never went back. They wanted to do test after test because of my "Advanced Maternal Age"...My first two children were born in a free standing birthing center, attended by midwives so my past birth experiences were not a medical event, they were normal. I didn't like the direction things were going with the OB practice. I refused all because I was healthy and there was no indication that those tests were medically necessary. They were strictly routine because of my being AMA. I birthed our baby at 38 wks, at home, without any problems and had an uncomplicated pregnancy.
Three years later @ 38 I gave birth to our 4th. For this pregnancy, I never entertained the idea of dual care. My home birth midwife took care of all prenatals and wasn't concerned about my "Advanced Maternal Age" because I was healthy and there were no red flags with my health. Had there been, she would have referred me to her back up for further testing.
I encourage you to ask if this NST is medically necessary and why or is this simply routine because of your age. I am an ALACE trained doula and I find that these routine procedures are the bread and butter of these practices. I would seek a second opinion or possibly switch providers.
Your $700 copay for the next 7 weeks + $550 for one day in the hospital is what I paid for our out of pocket, home birth (our insurance wouldn't cover it.) This included all prenatal visits(iron, blood sugar, urine, bp, fetal heart tones and positioning) in my home, normally not less than 1 hour or no more than 2, with our children, care during labor, the birth, and 3 post-partum visits including my 8 wk womanly exam. My care from my midwives far exceeded any care I ever received from an OB.
I encourage you to check out Henci Goer's, The Thinking Woman's Guide to a Better Birth and Your Best Birth by Ricki Lake and Abbey Epstein. They may be helpful as you decide what you need to do.
For the record, I'm not telling you to have a home birth, I'm simply sharing my experience with you to let you know that I chose not to have those routine tests and had exceptional prenatal care without feeling guilty or pressured about the choices I made. I didn't put myself or my baby in any harm or danger by not having them because there were no red flags warranting those tests. If you're feeling like the tests are not warranted, then talk to you provider and voice your concerns. Your provider works for you...you can decline any procedures or testings because YOU ARE IN CHARGE!!!
Best of luck in advocating for yourself and your baby.
Peace & Light,
2 moms found this helpful
L.M. answers from Philadelphia on November 12, 2010
I was 38 when I had my first and 40 when I had my second. I never had a non-stress test.
2 moms found this helpful
K.O. answers from Columbus on November 11, 2010
I would talk to your doctor about it...let them know about the financial situation. If they feel that it isn't really needed then they may reduce or not order the tests.
BTW...I had them done every week at the end of my pregnancy. I was 38. My dd didn't have a normal delivery, though. I ended up having an emergency C-section. Nothing wrong ever turned up during the non-stress tests.
One funny note...during one of the tests, my dd ended up having the hiccups. I cracked up. It sounded weird.
Good luck and congrats!
1 mom found this helpful
L.S. answers from Spokane on November 11, 2010
I'm not over 40, but have had numerous NST's done throughout all 3 of my pregnancies (due to high BP and fetal heart rates). This is the easiest and least-invasive way for doctors to monitor your baby and possibly detect an issue before it becomes a real problem.
Look at it this way, is $700 (and yes, it's a lot of $$) worth the peace of mind knowing that your baby is doing well? Maybe your doctor will let you go once a week instead of twice? Anyone over 35 is considered 'advanced maternal age' and is usually subjected to closer observation, more testing etc. BUT it's only because the likelyhood of complications 'generally' increase with age.
1 mom found this helpful
A.J. answers from Williamsport on November 12, 2010
Ah yes. American health care system. The best in the world. And so good to moms. I skipped those too as an older mom paying out of pocket for our kids births. As working adults, my husband and I have never had insurance because the only types we could afford privately had such ridiculous deductibles we would just be adding a monthly premium to all the doctor appointments etc we were paying for. And this was for 20 years before "obamacare" that everyone is blaming now for trying to make us europeans. I WISH! We actually moved here to use an Amish /Mennonite out of pocket pricing plan to have the kids and we'll be in debt for a long time. But they're worth it! Skip the tests. I did. You need your money. Do the bare minimum. You're not alone.
1 mom found this helpful
S.H. answers from Honolulu on November 11, 2010
*Here is a link about the test:
... I have 2 kids. I was over 35 years old with my 1st pregnancy.
The second one, was when I was pregnant and was OLDER than you.
My OB/GYN... NEVER EVER had any stress tests for me. At all. Nor required it. Nor recommended it.
Why is your Doctor having you do this? Only because of age??? That is a crock.
I never had to have those tests.
I would question your Doctor's reasons for it.... and ask him/her WHY?
1 mom found this helpful
M.F. answers from Philadelphia on February 15, 2011
I am going through similar situation (Crappy insurance, #2 baby, 30 weeks pregnant, hubby consultant in Philly, advised by OB to get the NST 2/week done).
I was wondering how you are doing and whether you have ever had those tests done or not. I'm inclining not get them done as I am physically great. Baby is moving very good.
Hope all is well with you and the baby. Looking forward to hearing from you.
K.R. answers from San Diego on November 11, 2010
I'm not your age, but had NST done 2x/week when my baby was measuring small. My doctor was open to discussion about it but we played it safe and did them. They are super easy but were just a hassle b/c I had to leave work by a certain time 2x/week for a month. Ask your doc what the concerns are and what they are looking for... I can't remember it, but there was a reason for 2x week rather than less often... something about if things change, then it would happen within a few days and if you don't check that often, then you could miss a danger sign...
I hope some other over-40 moms write in, b/c there are certain risks at older ages, but if you have had a healthy pregnancy, then it seems over-cautionary. It would also depend on how you would handle it if the worst happened. OBs are really into playing it safe I think....(they also have the highest insurance for their practice!)
C.R. answers from Philadelphia on November 12, 2010
I am also older than you and having my second in Jan. (I am 32 weeks) My OB has never mentioned stress tests, but I have been told to have ultrasounds every 2 weeks. This is quite expensive as I do have insurance, but not the pregnancy add-on. They wouldn't allow me to add on after I got pregnant. What good is it to have insurance-sometimes I wonder??
I am going to ask if once a month would sufice at this point!
good luck with your pregnancy and your decision!
D.S. answers from Tulsa on November 11, 2010
i was over 40 and had numerous nst done. the reason they do it is so if the baby goes in stress during delivery they know how to deal with it better what is normal for your child and what is not. can you qualify for state health care? I wouldnt do 2x a week if I was paying out of pocket maybe 2x a month. ask the doctor why he wants you to do them and that they are very expensive and why he feels the need for them and what is the least he would consider acceptable.
D.W. answers from Philadelphia on November 12, 2010
Anyone over 35 years old is considered high risk. I had to have them done every week. I was 38 when I had my son. I also had gestational diabetes. I would tell you that yes, it is necessary. They are monitoring your baby and making sure he or she is moving every so often.Risk of genetic defects and death in utero can also occur at a higher rate over the age of 40. They should also have you doing kick counts at home to monitor his or her movements. I think once a week is enough. I would tell your doctor that your insurance does not cover this and could he cut it down to once a week? I am glad your pregnancy is progressing well. As a mother and a father I would think that it is important to do everything to ensure the good health and well being of your unborn child.
R.E. answers from Sacramento on November 11, 2010
I am not over 40 but I had non-stress tests during both of my pregnancies due to being high-risk. I had them twice a week for last 8 weeks. They checked amniotic fluid level, maternal blood pressure, contraction patterns, and fetal activity in response to contractions. The NSTs were completely covered by my insurance but I certainly would have paid a copay rather than skip them. In your case, I believe that the health and well-being of the baby is worth $100 a week. Also, I don't think that once a week (as PP mentioned) is often enough. A lot can happen in a week's time, and problems should be detected sooner rather than later. Every pregnancy is different but once you are considered high-risk and recommended for NSTs I think you should put your baby's health above financial considerations and follow through with them.
J.V. answers from Chicago on November 11, 2010
I actually thought it was 35 and over? I know they made me do it at 36.
M.R. answers from Chicago on November 11, 2010
I was 36 (so, advanced maternal age) and had bi-weekly NSTs for the last twelve weeks of my pregnancy.
Fortunately my insurance required a one-time copay of $20 for the entire pregnancy, including every visit, ultrasound, and the labor/delivery/postpartum. And *gasp* it is an HMO!
J.L. answers from Philadelphia on November 12, 2010
Twice weekly non- tress tests are done on moms who are considered high-risk for a variety of reasons because statistically their babies are at higher risk of dying in utero before birth. It includes advance maternal age but that can be 40 or 59yo so physically those moms can be very different. All babies move till the very end of pregnancy so movement of the fetus should be something you are aware of every day; 10 kicks in one hr. one time daily or call your OB immediately for decreased fetal movements. Midwives at a birth center generally handle moms who want a natural birth; epidurals are fairly common in hospitals in 85% or more of the cases so know that before you pick a birth center because epidurals are not available there.If you choose any course of action that is different from what a doctor recommends make sure you make an educated decision; your baby's life could be in your hands.