Wednesday, February 10, 2010

To screen, or not to screen?

We had a first trimester screen scheduled for tomorrow. And I cancelled it.

A first trimester screen (also called a nuchal fold screen) is a non-invasive test to check for chromosomal abnormalities in your developing baby. Basically, they do an ultrasound (fun!) to measure fluid behind the baby's neck. Excess fluid can be an early indicator for certain problems, like down syndrome or trisome 18. But it can only be measured before week 14 of pregnancy.

My doctor (nurse midwife) didn't personally recommend this test, but supported our decision to pursue it. I learned about the test from M, who found it really reassuring in her first trimester.

The test doesn't definitively diagnosis a problem, but rather estimates your risk. If you're deemed high risk, more invasive diagnostic testing is recommended, like CVS or amniocentesis. Unfortunately, these tests come with a slight risk of miscarriage (1-2%), which I personally feel is completely unacceptable.

Ben was all for the first trimester screen. He wants to know our risk factors for a special needs baby. And admittedly, it would be nice to see the baby again before 20 weeks.

But I started getting really anxious about the screening last night. If we're deemed high risk, I flat out refuse to have a diagnostic test that presents any risk of miscarriage. So while a low risk reading might be reassuring, a high risk reading would cause undue stress and anxiety throughout the rest of my pregnancy. False positives aren't common (only 2%), but they do happen. And if I'm not willing to do the diagnostic testing required to know for sure, I don't want to open myself up to that kind of stress.

Plus, I'm quite sure our baby is perfectly healthy. And if he's not (I think it's a boy, in case you're wondering), we'll take it one day at a time.

It's hard to explain how much I love this baby already. I talk to him all day long, and rest my hand on my stomach at night when I can't sleep. Every decision I make is influenced by the fact that I'm pregnant. And he's ours whether he's medically "normal" or requires special care. He's perfect either way.


  1. Sounds like you guys really thought it through and made the perfect decision for your baby and you. I'm glad we did it the first time around because I had a reassuring answer, but I don't think I would do it with subsequent pregnancies. It was awesome to see the babe, but I don't think I would feel the need to do it again.

    P.S. I agree that the risk of miscarriage associated with amnios is totally unacceptable. Com'on modern medicine, is that the best you can do?!

  2. hey now, modern medicine does pretty well thank you ;) just think of what things were like back in the days before prenatal vitamins and junk like that...we do our best, but we are still human.


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