Mothers over 35 – to integrated screening with you!

As every hopeful parent knows too well, women do have a biological clock. Like it or not, your chances of getting pregnant decrease with age and the health of your baby is at a higher risk from 35 and up. So, routinely, if you are 35 or older at time of birth, you will be sent for an integrated screening between 11 and 13 weeks. The benefit of the test is that you get an additional ultrasound. The downfall is that you hear about the risk of chromosomal abnormalities and while your probabilities are still probably very low (depending on your family history), this is a scary conversation.

I’ll tell you all about the sequence of events, but here’s what you need to consider when going in for these tests. Why are you having the test done? You can refuse it of course, so consider this before you start: if there’s a 99% probability (according to the test) that your child will have Down Syndrome, what will you do? You’ll find out at about 18-20 weeks. Around half way through your pregnancy and right around the time you’ll find out the gender. You’re over 35, so you may have had some help getting pregnant as I did. Will you abort? Will you take the risk? Do you think finding out will help you prepare better?

I’ll tell you what we learned and then the decision I made:

We met with a genetic counselor first. She was amazing but scary. She gave us all of the probabilities of chromo abnormalities and then told us about the different tests. Basically, you go through three steps of the integrated screening: the ultrasound where they measure the folds in the baby’s neck and the length of the nose amongst other things. Then a blood test the same day. About 4 weeks later you go back for more blood tests (testing for a series of 4 abnormalities).

The first two parts of the screening have a 60% follow through rate, meaning if there’s nothing wrong showing up here, then there’s a 60% chance that nothing will show up in following tests.

If the integrated screening (all 3 parts) comes back without issue, you’re probably done. The doctor will not recommend any further tests. If anything does shoe up, anything at all, you can choose to do CVS or amniocentesis. The counselor gave us the fail proof percentages – amnio has a higher probability of being correct (something like 98.9%) and amnio also has a lower probability of causing miscarriage. Yet another negative against CVS is that no one in my county performs the procedure.

So, I weighed the options. Do I do the test and hope that it comes back absolutely fine or do I take my chances with nature? What would I do if the baby came back with Down Syndrome or a high probability of infant death? Would I abort? I am pro choice, but I don’t believe I have the right to decide whether this child’s chance are good enough. In my eyes, I started this and I’ll see it through. So, in that case, will knowing make me more ready? There’s a chance that something may show up that would need surgery right after birth, so it could help there… but I would worry for the next 8 weeks, on top of everything I’m already dealing with (see last post); that alone could be putting my body in jeopardizing situations. And then, if there is a problem, would I prepare or would I just send the next 6 months panicking? So, I made my decision and, in the end, I am quite confident in it. No tests for me. I’ll love this baby with all my heart and protect it with everything I have. Come what may.


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