“Are you going to have another baby?” It’s the question to ask these days. It seems like I get asked that question about once a week, though it would probably happen more often if I went out more. Apparently it’s everybody’s business - from my mother’s to that lady on the steps in front of the county building. I let my husband know that I’m not open to even having the conversation about if I’m open to giving our baby a younger sibling yet. That will come with time.
Speaking of time, I just came across an article that reminded me that I would be labeled “Advanced Maternal Age”, or AMA, if I were to get pregnant again.
AMA is a label that doctors give to women who will give birth over the age of 35. It’s a reason for them to offer extra testing. Statistically, the rates of certain genetic risks increase significantly when a woman is over 35 years old, including Down syndrome.
In my time working with pregnant women, a common question is: “Should I get _____ test?” My answer is always to ask: “Do you need to know?”
Let’s use the example of Down syndrome. Doctors initially use a blood test and ultrasound to screen for Down syndrome. It’s minimally invasive, but they also has a high false-positive rate. That means, you could get all stressed out over nothing, and the stress hormones you produce can stress your baby’s body out. If there is an indication that your baby could have Down syndrome, Chorionic Villus Sampling (CVS) or Amniocentesis will be offered. Both tests could cause a miscarriage at a rate of just over 1-2 miscarriages for every 1,000 tests performed. Amniocentesis could also cause needle injury to the baby if it moves while the procedure is being done. There are also new tests that are being offered by certain practitioners.
Currently, my feeling is that I would not get tested - for anything. I do not need to know. My thinking is that, if there is something I need to know before the baby is born, my baby will give some kind of indication.
Down syndrome screening is always offered for AMA pregnancies. In the case of Down syndrome, nothing can be done to change it while pregnant, so I am OK with finding out after the baby is born. If I were to find out while I was pregnant, the extra stress could further impact the health of the baby. It is hard for a baby to grow when stressed, so keeping extra stress to a minimum is ideal.
However, you might want to do something to physically or emotionally prepare for a baby with Down syndrome before the baby is born. In which case, the screening tests might be right for you. There are lots of online resources that would help you prepare.
Down syndrome is just one of the genetic risks that could arise during any pregnancy, but statistically increases with AMA pregnancy. But, let’s continue to use that example. Down syndrome often pairs with other health issues. If the baby had a heart defect during pregnancy, that would alert a healthcare practitioner that something needed a closer look. If that occurred during one of my pregnancies, then of course I would get the care needed to address the problem at the appropriate time. If, in the course of that, I were to find out the defect was associated with Down syndrome, then so be it.
I would not be open to an abortion because of a Down syndrome diagnosis (which is the main reason you’d need to know). If you need to know because you’re open to abortion in the case of a baby with Down syndrome, then that is something you would need to consider when considering getting the screening test. But, if you’re not open to abortion, you need to ask yourself if you really want or need to know in advance.
In my last two pregnancies, trust, acceptance, and intuition won out over medical testing. I believe that’s how both of my babys' spirits wanted it to be and both had very different outcomes. But I listened to my body and my babies and I feel good about every choice I made for them. However, when the energy of another being is thrown in the mix, who knows what my intuition might pick up! Perhaps that spirit will incarnate wanting to have a completely medicalized pregnancy and birth. If that’s the case, then I would do my best (if I were to host that spirit as my baby) to release my “plan" and give that baby what it needs.
If you’re entering into an AMA pregnancy, be aware of what tests will be offered when, why they are being offered, and what the physical and emotional consequences might be. Then listen to your intuition and decide if those tests are right for you and your family. Pregnancy mentoring can help you figure out what tests you’ll be offered and what you want.
Best wishes on your journey!
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