Tuesday, April 5, 2011

To Test or Not To Test...

We got the first trimester screening done last week.  This is what they call the Nuchal Translucency Scan.  What they do is have a specially trained radiologist do an ultrasound of the fetus between 11 and 14 weeks.  The NT test uses ultrasound to measure the clear (translucent) space in the tissue at the back of your developing baby's neck. Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this clear space to be larger than average.  Having a thicker nuchal fold is a marker for Down Syndrome.  They also look for other things and check out the heart and such, but the main measurement they want it of that nuchal fold.  Then they do a maternal blood test to look for proteins and other blood markers that would further help identify babies with potential genetic abnormalities.  It sounds great, but it is only about 85% accurate.  This means that around 15% of women get falsely normal or abnormal results.  So everyone has the possibilities of having falsely normal results, since it is a screening test which only assesses the risk of having a baby with Down Syndrome, Trisomy 13 or Trisomy 18.  I was given a 1 in 5283 chance of having a baby with Down Syndrome and less than 1 in 10,000 chance of having a baby with Trisomy 13 or 18.  Those are excellent odds, yes, and I am reassure, but ultimately it doesn't mean anything.  We weren't going to get an amniocentesis to verify any genetic disorders.  We weren't going to terminate the pregnancy with any of the information we received.  Now we have the reassurance that we have a minuscule chance of having a baby with a genetic disorder...but it didn't rule it out completely.  So why did we do it? 

Kevin wanted to get it done to use the pregnancy to educate ourselves on a possible Down Syndrome baby.  We now know the chance is very small, so we aren't going to do that.  But what if...?  We might have considered giving birth at the hospital if it were likely that this babe would have heart troubles due to Down Syndrome.  But now we know that the chance is very small, so we aren't going to do that.  But what if...?  So really, what was the point?  I know that some people would have had an amnio to confirm possible abnormal results, but we would have just worried about it for 6 more months, for possibly no reason at all.  If I had been given a 1 in 12 chance of having a baby with Down Syndrome, how would I have spent the next 6 months?  Crying?  Stressed?  Worried?  Probably.  And I STILL might have had a perfectly normal, healthy baby.  Now I am happy and reassured, but I STILL might have a baby with a genetic disorder.

This is not to poo-poo the test.  I think it is a good tool in many cases, especially for women who either have a family history of Down Syndrome or are older mothers.  And it IS very reassuring.  But the genetic counseling they give you before the scan when you get to the ripe old age of 35 is a little frightening.  They show you this graph of exponential increasing risk as you get older.  It is scary and makes me want to not have any more kids.  And it makes you feel like you are old.  When my mom had my older brother in the early seventies, she was called labeled as AMA - Advanced Maternal Age - at 28 years old!  I must be having a positively geriatric pregnancy!  Well, actually, according to official definition, I AM!  GERIATRIC!  At 34 years old! Anyway, I digress.

This baby - like its sister - will be born at home. I will have a natural birth, possibly in a pool.  We are seeing lovely all-green midwives.  We cloth diaper.  I breastfeed (still breastfeeding my 19 month old).  What made us decide, amidst all this return-to-nature, keep-it-simple child birth choices and parenting made us decide to go all high tech for information that is, generally speaking, fairly useless? 

My question is - did you get the First Trimester Screening done?  Why?  Why not? 

I guess we DID get a great picture of the little nipper, though.  So that's something.