Bundled up at one weekBut part of my coming out of the maternity closet had to do with a Hot Topic on which I need your wise thoughts. It's pregnancy screening tests. To have them or not to have them?
When I was pregnant with Miss Dub, I had a series of events that didn't even make screening an option. Like, we moved to Colorado and had to figure out insurance at the exact time of most screening tests and therefore missed the window of opportunity. Not to mention, I had a doctor in Chicago who told me to forgo them since I was healthy, under 35 and having a perfectly normal pregnancy. (I actually hated this doctor - he once told me labor wasn't painful, just "stimulating" - but he was good at reassuring me that nearly all pregnancies proceed healthfully and normally when I would occasionally worry.)
But this time, my new doc made such a big deal about deciding whether or not to be screened that I started to think:"Is it a sign?" "Should I get the tests?" "Does she know something she's not telling me?" Because while no amount of bad news would ever affect my decision about bearing or rearing a baby, it could be nice to have a little warning, right?
HOWEVER - note the use of caps - I've had THREE friends recently who were healthy, under 35 and having perfectly normal pregnancies who opted to be screened and were told something appeared to be wrong with their child. All of them had to agonize and worry for weeks until further test results proved, in each case, that the babies were fine. But, just in case, the doctors continued to treat their pregnancies as high-risk and monitored them constantly, always reminding them that something could still be wrong with their child upon delivery.
And I don't know if my nerves could handle that. So I'm leaning towards saying no. I should also mention that I'm lazy. And anything that requires extra time, effort or appoint-making generally discourages me.
But what do you think?
Have any of you been screened? How did you make your decision? What were the results? How did you deal with the news?
Start advising!
35 comments:
i have no say on the screening tests... good luck with that. i (obviously) know very little about things of this sort, but i've heard that it is a pretty hot topic.
the pic is awesome though. i almost forgot that miss dub used to be that small!
I've had... ahem, issues... that make screening tests not optional for me. I've had them all. Since we don't believe in terminating a pregnancy, the outcome of one of those tests would not have changed the decisions we made about continuing the pregnancy. What it did change is how we prepared ourselves for what was to come and what we needed to do to have the best chance of having a healthy baby. We were able to plan the births at a hospital where they were skilled at dealing with our baby's specific issues and have a pediatric team standing by as well as monitor activities during the pregnancy that could help or hinder.
Personally, I think everyone needs to make an informed decision because those tests are not without risk and may be unnecessary in most folks.
What I really wish that people who didn't choose to have them wouldn't make uninformed judgments about those who did. It's a decision that each person makes with her family and doctor (hopefully with some prayer) and the "right" decision isn't the same thing for everyone.
Climbing down off my soapbox now...
My husband and I elect to not have the screenings done but we aren't against them. I think that everyone should be able to have the knowledge if available/desired to help them if there is a problem.
For us we just feel that most things can be detected during the 20 week scan, that said I have 2 friends whose children have had serious heart issues that were missed during their regular scans.
good luck.
Hi! I just found your blog and it made me smile!
I am on # 3 and I never get the tests, I would stress the whole time which would prob. make it worse, so I would rather wait and deal with whatever when its time.
hope you don't mind me stopping by.
I have never had the screening tests done myself, but my sister just told me about one of her best friends that had them done and was told some things that helped prepare her for the birth of her baby that did have some issues and died shortly after he was born. She said she was thankful that she had gotten the tests done so she was able to prepare. So I guess it depends on what kind of person you are...would the preparation time be helpful if there was a problem or just stress you out and make things worse?
I say don't get screened unless there is an indicator that it is necessary. See if dr. will do an early ultrasound, and if thats normal, move on.
My cousin was screened because of something they found on an ultrasound and her son had a cleft palate. She was told he would be severely mentally handicapped. He's totally normal. He's smart and adorable after some facial surgery. So the screening didn't change the outcome, in fact it rocked them to the core and to have it all come to nothing after all that stress just seems a waste. But thats just me.
This is a hard one because while I think when you are pregnant the more info you can have the better, I also think so many of these tests show something small and the doctors have to be conservative so they tell you there is a chance your baby has whatever and then you stress just to find out you have a healthy baby. I don't think I did any extra screening, just the normal stuff and whatever they could tell from the ultrasounds. I decided that if from the results the only treatment they can do is terminate the pregnancy then I don't need it because I wouldn't do that.
I opted to have the "bun" test done at 12 weeks or whenever that was exactly - basically in the first trimester. My reasons included:
-I wanted another ultrasound to prove to myself that yes, we were really having a baby
-I have a brother with mental handicaps and disabilites, and for me, I would need a lot of time to emotionally prepare if there was the possibility that my child had problems
-It wasn't invasive and posed no risk to the baby - just a blood test and ultrasound.
I say Yes on the tests. I was recently talking to a Delivery Nurse who told me that any information you can give the doctor and nurses before delivery (in the case of a problem) futher's the babies chances immensely. If you get the test and find out there is a problem, then you can be prepared with the best hospital and best medical personell on hand. I have heard of a lot of false positives as well, but in my opinion it is better to be prepared in the slight chance of a problem and be happily surprised if there is nothing wrong.
I had screening tests done because 1) I have crohns disease, a blood clotting disorder and was on coumadin for the first 4 wks of pregnancy (not a good combo) 2) I would rather stress and agonize about my child if I new something was wrong, because that way I would be able to be prepared for a sick/special needs child.
I was a high risk pregnancy anyway, because of my medical issues so I was already being monitored very closely. Anyway, the only thing found wrong (which wasn't a huge deal) was that my daughter consistantly measured smaller then she should have been. And at only 3 wks early she was only 4 lbs.
oops...I wasn't finished
I also think the choice is different for everyone for different reasons. I am grateful that we have the opportunity to have the testing available if we choose to have them done.
I think it is a personal choice for every family.
CONGRATULATIONS friend! My boys are 20 months apart and although the first year kicked my trash, I love love LOVE it now. They are the best of friends and so protective of each other. It is a great age gap for kids, really.
As for your questions here, I was screened with both boys because I'm young and dumb and didn't even think about questioning my doctor's recommendations. I did exactly what I was told (but he didn't recommend invasive testing, just ultrasounds and minor blood testing).
A few days after a routine blood test during my second pregnancy, I received a phone call at the office. "Hi there, this is Sally from the doctor's office. Our test results show there's a 90% chance your son has downs syndrome. See ya later!"
Okay, it wasn't quite that non chalant, but it was seriously the worst phone call of all time. Fortunately, further testing revealed there was nothing wrong other than an off due-date, but it was the hardest 10 days of my life. And the first time I ever questioned screening.
I don't know if I would rather know and have time to prepare IF there should be something wrong. But really, is there anyway to truly prepare for a disabled child? I think I might dread having the baby knowing something was wrong, and that would take away from the miracle of having that baby -- healthy or not.
That said, both of my boys had minor birth defects (Jack was born deaf due to retaining fluid in his ears; Ty had hypospadias), neither which showed up on any test and were both huge challenges for me as a new mother.
As with most of your Hot Topics, I don't think there's a right or wrong answer. Everyone has to make this decision based on their own personal and medical histories, and no one is in a position to judge someone for that.
congrats again! muah!
i had no idea these tests existed until i read my first pregnancy book about them. i thought 'wow! the technology!' then i went to my dad, the doctor, and he said he never gave any of his patients the tests unless they specifically asked. AND, controversally, his partner (my technical dr) always gave the test without even asking. he just wrote it down in the chart at the 16th week visit. i didn't like that one bit.
my dad said 'i just ask my patients if the outcome of the test will affect whether or not they will have the baby. if not, why worry.' so i didn't. i never got the test with gracie, specifically said no at my first visit with gus, and avoided the whole topic and heartache.
even if the test had told me i'd lose gus at 5 weeks while he was away from me and i was suffering from the worst post-partum depression ever, i'd still have done it. but think of the sickness up to the day of sending him off.
as a friend, and as someone who knows her way around a doctors office (your doc is pushing those tests on you to avoid any malpractice, it's in their insurance contract), please do not get the tests.
Just the reason why I was so excited that you are prego at the same time! Our doctor just brought this up at my appointment last week and so it has been a hot topic at our house too. She told us that there is a 30% rate of false positives. 30%! We have friends that fell into that false positive 30% too.
At first I was a little more open to it but after having some time to think about it we are opting not to have the test. Reasons being 1) we would never terminate a pregnancy, 2) there are enough things to worry about already without adding that to the mix, 3) like you said all the additional time and emotional investment if you get the dreaded positive result.
Good luck!
I say the only reason to have the tests is if you are wanting an abortion if something is wrong. I guess some people would do better with knowing to plan, but so often it is better to know something when you have a face to put with it. I say, enjoy pregnancy...there is enough to worry about after the baby is born. (I must say I was thrilled to be pregnant with my 2 until the week she was due and I though...Why did I do this. Of course I was scared of the pain, which I choose to deal with naturally, with no drugs, for some strange reason. I actually think the second baby is better in a way because you know what to expect and are able to deal with it)
I agree with Lizzie and say no. Have your regular ultrasound & see what that turns up. Why get stressed out, when you're not at risk, especially given the high rate of false-positives, etc. If you're going to give birth in a good hospital and have a good doctor, they can take care of whatever might happen when/after the baby's born anyway. I think it's more often than not that doctors create unnecessary worry.
The was a big disparity between the sizes of my twins in utero (and to this day - they're almost 4, and about 6" different in height!) and I was told that they would most likely have to be delivered at least 7 weeks early at a moment's noticed when the little one stopped thriving. Obviously that freaked me out. But after a while I was convinced that Zoe just had small genes & Lucy had big genes, and they were both just fine... which is the way it was. Turns out they were only 3 weeks early, healthy, and came home with me at the regular time. Obviously in some cases there is real cause for concern but as someone else mentioned, due to malpractice suits I think the doctors worry us more than they need to sometimes.
And I think the spacing of your kids is just right!! My spaces are 21 months & 21.5 months. They're all the best of friends; I love it!
I wouldn't do invasive tests (CVS, amnio, etc.) but I'm a yes on the others. I had a result with my fourth baby that caused them to monitor me more closely -- she was born healthy, but there was clearly an issue with my placenta and she weighed two pounds less than my other babies at birth. I was grateful that they watched her so closely.
In 1971 (before any of these tests were available), my mother gave birth to a baby with severe spina bifida, who never came home from the hospital. His head was enlarged, which made the delivery dangerous and difficult. She came home to a lovingly decorated nursery, and no baby. She would definitely tell you it would have been better to be prepared.
This is difficult for a pregnant woman, but can't we have a test knowing that a false-positive is likely and approach the whole thing in a logical fashion? Yes I was worried when my triple-screen was abnormal, but the sensitive staff at my doctor's office assured me that we'd do more tests and proceed.
I guess I'm a "knowledge is power" type -- I never want to be in the dark about anything. Good luck making the best decision for you and your family.
i can't advise you either way, mrs dub, but this discussion is making me move even closer to knowing 100% that i am done having babies. my pregnancies are high risky and this is just way too much for me to worry about again!
thanks for the push. :)
again... no babies yet, so my opinions on these matters are limited, but i do have one opinion... i don't really like doctors. i don't like most medical tests. i don't like that in so many instances, you're pigeon holed into a category rather than dealt with on an individual basis. i don't like that most doctors appointments take at least two hours -- 1:45 of which you're sitting in various waiting rooms, and :15 of which you're talking to a doctor between your legs. and i don't like that doctors have been put in a position to exaggerate everything to protect themselves from malpractice suits. generally speaking, i'm all about being informed... but i'm pretty sick of "good guesses" from doctors. uh, bitter? :) what would make you think that?
my two cents... just be careful. listen to your body. if something doesn't feel quite right to you, don't let the doctor (or anyone else, for that matter) pressure you into doing it or not doing it.
Interesting discussion! Would you believe I have had four kids and never really considered the pros and cons of pregnancy screenings? When the doctor asked me if I wanted them I figured that if they were optional they weren't really necessary. If we have a baby #5 I'll have to think about it a little more. I've enjoyed reading the different points of view.
Hi there Mrs. Dub,
Long time lurker here but felt the need to chime in on this topic.
My oldest child has autism. I have two other kiddos that don't have it. My last pregnancy I decided against the testing (there is no "autism marker" yet)...it was a big debate for me. But to me, it didn't matter what the tests said- we would keep the child no matter what. It was an ongoing debate for me personally because the question always arose, "what if there WAS a test for autism? would it have helped me?" No- it would have freaked me out. I am normally a very planned out (and I mean VERY) planned out- don't like surprises and do lots of research (even more so now that I am an Autism Mom). But I really think that I would have taken my pregnancy to a level of worry that I would have been better without. And bottom line- you get what you are supposed to have. I have my oldest child for 5 million reasons. And had I gotten a test to say 'Yes indeed there is something WRONG with your child,' I think it would have ruined the bond I had with him for the first two years of his "normal" life.....
and on a side note- I have had 3 friends with false postives as well that have lived through the agony only to find out everything was fine with their baby.
Sorry for the novel- especially from a first time commenter. I obviously have a strong opinion.
Love your blog- visit through Bloglines often...come say hi to me!
i don't do the screening tests. i would never abort the pregnancy if something were wrong, and i too have heard of a lot of false results, where they say something is wrong, and then nothing is wrong! why worry like that when you don't need to. and if there is something wrong, then that is just a few more months that you will have to not be burdened with that information.
i do agree with the reader who said that it has been beneficial for her and her family to be prepared and be at the best hospital and receive the best possible care for their particular needs. so that is something to think about. but i also agree that a lot of problems can be detected in the 20 week uls, and you would still be able to be prepared, such as with heart problems or any surgery needs.
but since i am healthy and don't have any complications during pregnancy, i would rather not take the risks that come with the tests.
I am a natural worrier and DO NOT NEED the stress of one more worry in pregnancy. I don't test. If someone else wants to test because it will make them not worry, or prepare, that is fantastic for them.
janaya- I felt the same way about my doctors, especially after my first experience with an OB. I decided on the midwives for my second baby and I could not have been more thrilled with the entire experience. I cannot recommend midwives more highly when your turn comes (not lay midwives who don't have actual medical training, but nurse midwives who have masters degrees in midwifery.)
I believe there is no right answer.
However, my sister did not have the tests. Her baby was born with a life-threatening illness, which would have been picked up in the tests. If they had been tested, they would have given birth at a hospital with the facilities to treat the inevitable complications of this illness at delivery. This sweet little baby almost lost his life due to having to be airlifted to a major medical center. He lived but lost his hearing due to the rushed treatments at his birth.
My sister and her husband did have their second child tested and all went well. It's a hard choice. But once you've seen things go wrong that could go have gone right, you tend to be more cautious.
I'm with Liz. I think that knowledge is power as well. If they do detect something and further check it out, they can and should treat you more differently. There are things they can fix before the baby is even born, like Spina Bifida. I would totally have the tests, I would like to be forewarned as well.
Glad your'e telling everyone now! I almost commented about it a while back, so YAAAAAAAAA! and WOW, 50 comments on yesterdays blog! I feel lucky to know and love you even before you were famous and we all called you Pete.
I'm a little late with today's HTT...
But I just wanted to say that I have a close friend who didn't have an amnio. with her first two kids, but got talked into it by a new doctor with her 3rd baby. The test came back when she was 18 weeks that the baby was positive for Down Syndrome. And like REALLY positive. She was devastated, but started to do research and get prepared. And this August she was shocked to give birth to a COMPLETELY healthy little girl. They are so grateful for her good health and nothing could be better. But she is SO mad about the tests results and the many months of worry. She will never have the test again. I haven't yet and don't plan to with #4.
By the way CONGRATS!!! Our babies will be pretty much the exact same age! It'll be awesome!!! I say no on the screening. I have a quite a bit of experience about worrying and thats all it will do....make you worry! I do not need one more thing to worry about! Whatever happens....happens.
On my third baby, I did have the testing done. The testing they did then involved more testing to confirm the first set of test results (no kidneys, major heart problems) and then more testing. I was put on bed rest for the rest of the pregnancy, and had all sorts of tests done every single week. The Dr.s then insisted that I be induced 4 weeks early so that they could "Save the baby"... needless to say (if you can't sense my sarcasm/frustration) my daughter was born perfectly healthy and had ALL internal organs and they were all functioning quite nicely. For me, I will NEVER have any sort of testing done again. They were dead wrong and caused me so much stress and many many nights of crying. The results of the tests they did did not change my mind about keeping the baby... (i would never abort, regardless.)all that information did was cause me severe anxiety. There is no real way to prepare yourself for a baby with disabilities... and then to be told you are having a baby with disabilities and you have one that is healthy.( i am SO not complaining...)
Well.
You get the idea. It took an act of GOD to get me to agree to be pregnant again (due in march) because of how stressful it was last time. So, after that long ridiculous story, my theory is this: if you have strong feelings against aborting the baby, and will keep it and love it no matter what... how do the tests help, other than to give you more time to stress out, and worry and think the worst?? IMO, for me, it would be better to just jump in feet first and love the baby and do my very best to provide the baby with what it needs.
The end.
:o)
Follow your gut! Mother's intuition can be one of the most powerful indicators in life! :)
My kids are 21 months apart and although I had a difficult first year...they are so fun now. They play together and are best friends! :)
Good luck with all!
i'm with you on the "no amount of bad news would ever affect my decision about bearing or rearing a baby" part and also the laziness! i also agree with quite a few of the other comments about NOT getting screened. i have 4 and never had the screening done. i don't need the stress of a false-positive. i usually have a split second of 'maybe i would want to know if there was something wrong' but it's never a thought long enough for me to say 'yes please poke me one MORE time!'
I was screened on some things but not on others - blood tests/ultrasounds, etc. everything came back negative, so I didn't have to consider getting an amnio, but I might have had anything abnormal showed on the screening.
I know there are false-positives or false-negatives or whatever that cause some people to worry needlessly, but for me I just wanted time to "prep" in case something was seriously wrong. because I know I would have needed prep time.
I'm all for screening for preparation NOT TERMINATION purposes. My third child was born with a club foot, but because we knew this we were able to go to a specialist two days after he was born to begin the correction process. (He's great now.) With some problems even a few days can make a difference in the baby's response to treatment. If there was something wrong what Mom wouldn't want to do all they could to help??
P.S. My oldest two are 20 months apart. Perfect Spacing!
congrats on being preggers! that is such great news! my kids are 20 months apart and i really love seeing how they interact with each other. hope the pregnancy goes well! maybe you'll make it to your own baby shower this time!! ps...i LOVE your blog!
ashley shontz
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