The Non-Stress Test: What it is and how to out smart it

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Often when expectant mothers approach their 41st week of pregnancy obstetricians will call for a non-stress test to test for fetal well-being. The idea of the test is to get a record of the baby's heartbeat using an external fetal monitor (the same kind often used in labor) for a standard period of time (20 to 40 minutes) with the assumption that a healthy baby's heartbeat will increase by about 15bps for an average of 15 seconds every time he moves. If baby moves twice and the heart beat acceleration is recorded this is considered a normal or reactive test and there is no need for worry. If the test is done for 40 minutes and no movement is recorded the test is deemed abnormal or non-reactive and further testing is needed to ensure baby is a-okay.

Here's the tricky part: what happens if baby is asleep? What happens if you move and the monitor falsely records a deceleration? Both of these things are common and also avoidable. Dr. Sear's notes in The Birth Book that although "a reactive NST correlates well with a healthy infant, more than 75% of the time a nonreactive NST is a false alarm" (emphasis mine). Incredibly there are some very simple things you an do to ensure that your baby has the best chance possible of passing this test with flying colors.

• Before your test drink a sugary juice or caffeinated beverage. Orange juice is great if you're not experiencing heart burn, but you could just go for that nice cold iced coffee you've been craving. There's no need to worry about the sugar or caffeine affecting baby that late in pregnancy. 
• Arrange for the test to happen during a time of day baby is usually active.
• If the monitor moves on your belly at all immediately remove the device and call for the nurse. She will then restart the strip. 
• Give your baby a good prodding before you sit down (don't worry there's so much padding that you can't hurt your baby by feeling around). I know that by the end of my pregnancy every time I poked the Peanut she gave me a good kick in the ribs as retaliation.