25 answers

Fetal Testing?

I was wondering what some of you older Moms think about doing fetal testing. I'm 40 years old, pregnant with my second child. (First is almost 4 yrs old). When I was pregnant with the first one I had the ultrasound/blood test combo for downs screening but that's it. Now that I'm older I feel the pressure to have an amnio done. I'm not sure how I feel about it, and I would have to pay for it myself. It's about $1600. The thing is if you find something out would you really terminate a pregnancy at 16-17 weeks? And is there really that much more risk of problems at 40 yrs old?

So I'm looking for some feedback from you Moms as to what you think about the whole thing. Thanks!

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I had the ultrasound/blood test combo for downs screening, too. That is really all you need, if the results were in the window considered a small risk.
I told my husband, that regardless of the results of that test, I wouldn't have the amino test, because I was keeping my baby no matter what the results.
I didn't want to risk a problem with and invasive test such as the amino test. My babies, first and second, were just fine.

If you're not that far along you can do CVS... similar to amnio but done MUCH earlier, between 11-12 weeks. I'm older and had genetic problems with previous pregnancies due to my age (40). I had to know the baby was (as far as we could tell) healthy and felt such uch relief when those results came back ok. Here's a link explaining CVS: http://www.babycenter.com/0_chorionic-villus-sampling-cvs...

I did the nt testing at like 10 weeks combo of blood work and ultrasound then a level 2 at 18 weeks. Everything came up clear and Neither me nor my doctors found a need to do anymore.
I personally would not do an amino.

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I guess the question you really have to ask yourself is, if you found out that your baby were to have some kind of major problem, would you want to terminate the pregnancy? If you think you might, then have the test. If you feel strongly that you wouldn't, then there is really no need to have the test.

I guess when it comes down to it though, women had babies for thousands of years before the amnio was available, and the human race survived just fine... so obviously it's more of a "nice to have" test than an absolute necessity.

Congrats on your pregnancy!

3 moms found this helpful

The biggest reason is to mentally prepare if there was a problem with the baby. It gives you time to grieve the loss of the "perfect" baby you think about when you are pregnant before the baby is born. From what I have seen the parents who know before birth have emotionally worked through much of that and are ready to great the baby with joy at birth. If you don't know until birth, then that mental work has to be done after birth. Also if the baby has downs or another genetic problem you can make sure the correct doctors will be involved. You also can make sure you deliver at the correct hospital. It's hard when the baby has to be transferred to another hospital for care leaving the mother behind until she is discharged. The statistics are hard to know what to do with. One doctor I know says it doesn't matter what the statistics are, if it's you or your child it's 100%. As far as aborting at 16-18 weeks, I think no one ever really knows until they find themselves in that situation. There are some conditions that are fatal. I would not have continued a pregnancy in that case. For Downs I don't know. Luckily I never had to make that decision. For me the decision would not have been about me, but about the kids I already have. My mother has a younger brother with Downs. My Grandmother was 44 when he was born. He is now 61 and my grandparents have been dead for over 20 years. The responsibility passed to my mother. My mother is 81. If she dies before him, the responsibility will be passed to my sister and myself. So for me the decision would be about the kids I already have and their future children.
Yes there are more risks the older you are. If you are healthy there are less risks, but its still more than if you are in your 20s or 30s. It's just a fact of life. Good luck to you!

2 moms found this helpful

I would not do the testing. I have three children and a genetic kidney disease. When I was pregnant with my second, the ultrasound showed some major damage to my son's brain. When he was born, he was totally fine. The ultrasound had been wrong. We were strongly encouraged to terminate, but I could not do it. I take that back... I WOULD NOT do it.

This morning, the son that was supposed to be severely brain damaged "read" a story to his four-month-old sister. He is two. Life is good.

I have come to rely less and less on that testing as I get older. If it shows something, I cannot change my heart. I will continue to love that child until its natural death, or until I stop breathing. If we become pregnant with another, I will get only the minimal amount of tests done. I will not even do the blood test because of my experience with my son.

2 moms found this helpful

I'm a young mom, so I didn't have the age factor to worry about. But I didn't do any screenings because I knew I wouldn't terminate. I'm pro-choice, but in my case I wanted a child and I felt that I would take whatever was given to me. You could have a perfectly healthy baby and a year later get into a car accident and end up with a child who has severe brain damage. Or your child could have severe autism, which they can't pick up in a prenatal screening. In either of those cases you wouldn't stop loving or caring for the child. I felt the same applied to my unborn child. Just sharing my personal thought process, it's not really an opinion of what you should do. That's only for you to decide. Good luck mama!

2 moms found this helpful

I am 42. Will be 43 in March actually. Just had my 2nd child 3 weeks ago. A beautiful healthy girl. With the 1st baby I did the blood work testing & I was 39yrs. old. My husband & I decided to the the same route with this one also. We declined the amino testing. We both felt that whatever the results we would not terminate. Also, the amino test could harm the baby. If you are satisfied with the blood test don't let fear set in. We prayed over the baby while it was in the womb. The test are not 100% anyway. Just pray about it. Congrats to you:-)

2 moms found this helpful

I wouldn't do it. It's a risky procedure and expensive. It is what it is. A life, precious no matter what. My doctor said the risk for having the problem is low and I was 39. I didn't have the test nor did I do the ultrasound/blood test combo either. They tried to do it but munchkin wouldn't cooperate and I wouldn't allow a retest. He is fine and healthy. Good luck and congratulations!

1 mom found this helpful

Hi L.,
I had my first at 37 and my second 13 weeks ago at age 41 (concieved) - am now 42. Both children I just did that triple screen (?) where they do blood work and then I had the more advanace US at 20 weeks. All my numbers and US looked good so I didnt have to do anything further. My son is a healthy baby boy. I would just hold out until you get the numbers back and then decide if an amnio is necessary. Good luck with the rest of your pregnancy!!

I have my first and only at 40. I had the amniocentesis and absolutely would have terminated the pregnancy. No matter what people on this board say, the statistics are that well over 90% of trisomy 21 pregnancies are terminated. And even if the risk of miscarriage were the same as the risk of Downs, the outcomes are not equivalent. If you miscarry (rare), you will still have a healthy 4 year old, family and a uterus that is only 4 months older than the last time you tried. If you have a Down's baby - you will have a (generally happy) child with a substantial risk of heart defects, gastrointestinal complications, good chance of needing lifelong care and a reasonable chance of outliving you (will your 4 year old need to assume that care and what impact will that have on his chances for his own family down the road). While you may chose to carry the pregnancy to term, there are definitely things to consider.

I would just stick with the testing you had done with your previous pregnancy and possibly get it amnio of things appear problematic. While on the one hand it would be good to know about something that may be wrong so you could prepare yourself, on the other hand having that test done can cause other problems. I have heard that it's best to wait until later in the pregnancy to have it so there is much less risk of miscarriage even if the risk is already low. And if you did know, besides being prepared, what would it do for you? I certainly wouldn't terminate so for me, it would have been a waste of money.

I have heard risks can be higher but from what I understand risks are higher for women having their first child at your age, not a second. One of my closest friends had her first (and only) son at your age and her only problem was how long labor was. Other than that she was fit as a horse and very hardworking. I think the state of her health also benefited her pregnancy greatly. I do know that it's not like that for everyone though. I guess my thinking is that an amnio doesn't screen for everything and if something did happen that it didn't catch, you still wouldn't be prepared for it.

Best of luck on your decision and congratulations on your new little one.

If you're not that far along you can do CVS... similar to amnio but done MUCH earlier, between 11-12 weeks. I'm older and had genetic problems with previous pregnancies due to my age (40). I had to know the baby was (as far as we could tell) healthy and felt such uch relief when those results came back ok. Here's a link explaining CVS: http://www.babycenter.com/0_chorionic-villus-sampling-cvs...

Hi L., this is a tough one that ultimately only you can answer. I ended up doing CVS which is even more conclusive but has the reputation of being more risky. It's actually not if you go to a good doctor that performs the test regularly. It's done early - at 12 weeks - so you know the results a bit sooner. The counselor we saw said you never know until you're in the position if you'll terminate or not - she had seen people flip one way or the other once they knew. But that it was nice to prepare if there was an issue and you did not want to terminate. But here's the good news: you still don't have a really high chance of having a baby with any issues. I can't remember the stats - you can look them up -- but it was something like you had a 1 in a million chance at 21 (I'm making numbers up) and then a 2 in a hundred chance at 40. Which sounds incredibly more risky, but still means you have a 98% chance of a healthy baby! Still, I wanted to know for sure so there were no surprises on birth day. Talk to your doctor -- I was really reassured by all those I spoke with and all my research. The high risk docs that performed my CVS said that when figuring the stats for how often miscarriage is "caused" by CVS, they include all miscarriages that happen in the entire pregnancy not just immediately following CVS. So the number is even higher since some of those miscarriages are clearly not related to the test. Not pushing CVS, just saying the protocol is probably similar with amnio. I think if you have a great, experienced doctor performing whichever test you go with, the chances of complications are minimal. Statistically, I'm sure it's more risky to get in the car and drive to the grocery store. Ultimately only you can make this decision, and I guess I based mine on how willing I was to arrive at the baby's birth and be surprised by a problem there. I couldn't imagine that or the stress I'd feel in the months prior. I made sure I was as confident and trusting as possible in the doctors I worked with and was then thrilled - at 41 - to find everything was just perfect. Best of luck to you whatever you decide.

I did the nt testing at like 10 weeks combo of blood work and ultrasound then a level 2 at 18 weeks. Everything came up clear and Neither me nor my doctors found a need to do anymore.
I personally would not do an amino.

what matters is would you terminate? do you know how many people are always on here with high probability of an issue and then everything is fine? do you want that stress throughout pregnancy? i wouldnt but that is me

Well, I'm a mom under 30, but never had any pretnatal screening done. They way I saw it was, if God was going to give me a child with special needs then that's the child I was meant to have. I would not have terminated a pregnancy because of any results, so why bother?

If you think you *would* terminated the pregnancy based on amnio results, then it might be worth it to have the test. If not, then isn't it a waste of money?

I was 40 when we had our second child. They asked me about that every time I was in the office for a check. I decided no, the question I kept asking myself is, would I change things if there was something? My answer was no. My OB told me that people are waiting longer and longer to have children.

I felt a lot of pressure, but knew that this was the best thing for me. She is fine and healthy and we feel blessed. We left it in God's hands.

I had my daughter at 41 and I did have the amnio. My insurance at the time paid for it. I'm certainly glad it showed no problems, because I didn't want to have to answer the question you ask here "would [I] really terminate a pregnancy at 18 weeks?" Before I was pregnant I thought I would, but at that time, it would have been a devastating decision. Of course, the amnio can show other, more serious issues besides Down Syndrome. I would have wanted to know if my fetus wasn't viable, for instance. Better then than at the very end of the pregnancy.

The question of risk vs. age is an on-going debate, and understanding the question requires a knowledge and understanding of statistics (a class I'm taking right now, BTW :-) The numbers "1 out of 98" sound so scary because you can picture a room full of 100 people, and those odds sound terrible. But this is misleading, as these numbers are generalized over a large population. I told myself that those numbers meant that I had a 98% chance of having a perfectly healthy baby (turns out I did have one).

So, if you answer your own question "no" that you wouldn't terminate a pregnancy, then the next question is, is $1600 worth spending to be prepared if you are expecting a baby with special needs? Maybe it is, that would depend on your finances and your personal needs. It could also buy you reassurance if you feel you need that. (My husband needed some reassurance, in our case).

Another recent debate I read about is the small risk of miscarriage from the amnio procedure. It is a very small risk statistically, but is even that risk too large for a woman in her 40s that might have difficulty conceiving and carrying another baby because of age?

In the end it is a personal decision, after you have weighed the scientific data, and your personal needs.

I had my first child when I was almost 41 and my second when I was almost 44. We did the bare minimum of testing. We had the ultrasound (basic) and blood tests that checked for all the detectable problems with blood work. If you check your stats you do have a greater chance of problems with having babies over 40. You will freak yourself out if you check the stats, don't do that to yourself. If you have the amnio there are risks of something going wrong there too.

If you do the testing you would be better prepared with knowledge if something is wrong. You could educate yourself ahead of time on the care of a child with special needs. I am very, very, very PROLIFE, we wanted our children no matter what. A baby is a miracle from heaven.

I had my first baby at 41 and second at 43. I did the first trimester US and blood tests. Non were significantly elevated and even if they were, my husband and I would not terminate the pregnancy therefore we did not have an amnio done. Why take the risk of losing the baby or having a complication when you are not going to end the pregnancy. Plus in your situation, $1600 is ALOT of money.

The only new thing I have to add vs everyone else's response is this:

Are the risks of miscarriage from the amnio the same as your risks for having a non-"normal" baby?

So, if there's a 1 in 500 chance of miscarrying from the amnio and a 1 in 600 chance of a non-"normal" baby...I wouldn't take the risk of the amnio. I don't know the actual statistics. If the doctors told you there was a 1 in 2 chance of a problem, keep in mind that that means there is still an equal chance of having a child WITHOUT that problem!

I'm a relatively young mother (26 & 32 with my 2 kids) and I only did the ultrasound/blood/triple screen tests. However, my sister-in-law was 39 when she had her first and she's currently trying for her second at 41. Given her age plus her weight, she did opt for the amnio with her first. Not to find something that would cause her to terminate, but more to prepare herself for IF there was an issue, she could do her research and be ready to tackle whatever challenges a special baby brings and to love that baby for however long she was given. Her amnio came back normal, but the baby was born 3 months early, which brought it's own set of challenges plus a long NICU stay.

Who was it that said "Tis better to have loved and lost than to have never loved at all"?

In the end, getting the amnio is your choice and what you do with the information is something that only you (& your husband) will have to live with, not any of us.

Good luck to you and remember, the good statistics are on your side since there is a greater chance of a "normal" child than otherwise!

I turned 39 a couple months after my third was born. My midwife at our first apt asked all the questions they usually ask. Basically she said that your healthy and everything so just because you're a little older doesn't matter. We did not do the amnio just because I was older type deal. We did the blood work which (not surprisingly honestly) came back with a possible downs. We did the ultrasound and they found nothing wrong so we didn't do the amnio at all. I have a completely healthy, beautiful little girl. She was born with no complications, all natural in a birth center. She was almost a water birth but my legs got all cramped up while in the tub and I couldn't get comfortable in the last stage of labor so moved to the bed where she was born. Age just isn't the factor it once was.
We had an amnio done with our second. We got a possible for downs and there was fluid buildup in his lungs and heart at the ultrasound. If it turned out to be one particular thing I could have carried to term and have him die almost immediately after birth so, yes, it was a possibility that we would have terminated were he to have the particular disorder. The amnio started contractions that put me on bedrest the rest of the weekend, amnio was done on a Friday. The good news is the contractions did stop and didn't do anything. The test results came back completely normal. The fluid turned out to be an immature circulatory system that reslolved itself before birth. I went on to have a perfectly healthy, amazing little boy at the same birth center my third was born with no complications and no problems.
Because of the issues and stress I had with the amnio with my second we knew that unless they saw something wrong it was not an option. Just because I was pushing 40 was certainly not a reason to risk anything!
OBs seem to be trained to expect worse case senario no matter what. If it turns out fine then they feel lucky.

Ultimately only you can know the answer - you already asked the question. Would you terminate the pregnancy if ......? If your answer is no, you would absolutely not terminate a pregnancy, then don't get the amnio done. There really is no need, unless you want to be able to prepare yourself. There is also that slight risk of miscarriage to consider. If your answer is yes or maybe, then you might sway to the amnio. In both my pregnancies at 37 and 41, I had amnio's done. I came through both just fine. We would have realistically considered our alternatives if something were amiss. We weren't absolutely put in the position of having to make that decision - who knows what ultimately we would have decided, but more than likely we would have been prepared to terminate either pregnancy. As you are probably aware they give you extensive counseling up until you have the amnio done - so even at the last minute/second, you can bow out if you feel it is really not for you. Good luck in your decision.

I see you have a lot of answers here, but I wanted to throw in one more. I have a friend who decided to do an amnio because she was terrified the baby had Downs. Her initial triple screen had indicated it. She went through with the amnio and the results showed the baby definitively did NOT have Downs. However, tragically, she lost the baby as the result of the amnio, which carries I believe a 33% chance of miscarriage.

That story right there would be enough for me to say NEVER to an amnio. At least, me personally. I don't feel the risk of the procedure outweighs the benefits of the results. Any real issues will be discovered during the 20 week ultrasound anyway, including Downs. And in Illinois you can willfully terminate up to 22 weeks (not that I am advocating this, just stating what is lawful). If what was found in your ultrasound was so devastating that you could not birth the child (a neural tube deformity, for example), there would still be time to handle it after the u/s. Better to make the decision at that point with 100% certainty then to enter into a very risky procedure based on a what-if.

I had the ultrasound/blood test combo for downs screening, too. That is really all you need, if the results were in the window considered a small risk.
I told my husband, that regardless of the results of that test, I wouldn't have the amino test, because I was keeping my baby no matter what the results.
I didn't want to risk a problem with and invasive test such as the amino test. My babies, first and second, were just fine.

I decided against the amnio, because my risks didn't seem high enough. If my risks came back very high, I would have done the amnio. NOT because I would ever terminate. But, because I would want to prepare. Babies with downs can be born with risks of heart problems and other disorders. I would want the correct doctors there to make sure my child was taken care of. There is different protocol in dealing with special needs children right after birth. I would also want to prepare myself with the different challenges of a special needs baby. Terminating is not the only reason to get an amnio.

Yes, people in an "advanced maternal age" age are at a elevated risk for chromosomal abnormalities. Only your Dr. can walk you through the risks thoroughly. They will also do the blood test and then send you to a genetic specialist and high level ultrasound...if needed. If your blood tests come back with a low risk, then I don't see why an amnio is needed.

I was 39 and my ultra sound and blood work numbers came back 1/2000 chance so I never did the amnio. I would have that done and then wait for the results to schedule an amnio... as you may not need it, like our situation.

If you do get numbers that would cause you to go forward (my girlfriend had a 1/99 after her blood work - did the amnio and baby was GREAT!) then I would do it. Even if you know that you would not terminate a pregnancy - wouldn't you want to start preparing yourself, reading up on what to expect, possible support groups, DS associated therapy? Or do you think you're 'strong enough' to find out in the delivery room? I know I'm not so I would need to know. Good luck with your decision.

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