It's been three years since the last time I was pregnant. And somehow, in those three years, there have been more tests available for expectant moms and their babies. Now, pregnant with my third, I am faced with the same questions as my first two pregnancies. How much do I want to know about the baby I'm gestating? If there was a problem with the pregnancy, would it change what I did? Do I want medical procedures or try to be hands off? My first appointment with my midwife was full of options. Even as a mom who has now gone through this three times, I found all the information and the choices entirely overwhelming.
I'm fortunate in the prenatal care I receive. My midwife spends a lot of time with me at each appointment, so going through the options and asking for her recommendations made the process easier. Mainly, I opted for the tests that would give me information on my own health, but declined anything that told me much about my growing baby. I didn't get the new cell-free DNA analysis (the one that can tell you the sex of the baby as early as 10 weeks). And I said no to the nuchal translucency test and scan, which screens for Down Syndrome and heart defects.
I opted to get an HIV test, mostly because I never decline an HIV test. I feel like it's important for people to get tested even if they don't have traditional risk factors. I know I tend to be anemic, so I'm going to be getting blood counts throughout the pregnancy, as well as the normal work up. I think any medical caregiver would likely almost insist on this. I know I'm Rh-negative, for example, so I can see how information on our blood is crucial to making decisions in pregnancy. (Like that I need rhogam shots so I don't develop antibodies that would attack the fetus.) I have a cat, so I opted for a toxoplasmosis test, because if it was positive, I could treat it with antibiotics. For each of these tests, there are things I could do to address any issues that arose, such as taking supplements, additional medication, or getting my rhogam shot. As a result of the vitamin D test, I found out I was deficient, so I could supplement that, which is important to me since my body is growing an entire skeleton from scratch.
But those tests that check for genetic abnormalities, the ones that can tell me the sex of the baby early — I firmly declined those. Sure, I felt a little jealous when I'd see people finding out the sex of their baby at during their first trimester. But I didn't want to find out if there were possible abnormalities, especially since these tests can be inconclusive. There are some things I just don't need to know, and I'm absolutely OK with that.
In general, I see the tests I've opted out of having as pretty conservative measures. If there's even a chance at an issue, it'll get flagged. Plus, I've heard from friends and friends of friends there can often be a lot of false positives. And a positive on these simple blood tests can make further testing necessary, such as a chorionic villus sampling or amniocentesis. I'd rather not go down a road of worry and medicalization when it wouldn't change the outcome.
If someone told me there was a one in 100 chance of X, Y, or Z being wrong with my baby, I would obsess. I'd Google worst-case scenarios for hours, trying to find out what exactly the likelihood is and what a diagnosis would mean. I'd read each horrifying report and cry. I probably wouldn't be able to think about much else.
I realize all of these tests and procedures are highly personal things. I don't blame anyone who chooses to get every test under the sun. Some people do better with all the information. But I know myself. I know that any little bump or hiccup will cause me to obsess. I tend to be anxious. (That's sort of an understatement.) If someone told me there was a one in 100 chance of X, Y, or Z being wrong with my baby, I would obsess. I'd Google worst-case scenarios for hours, trying to find out what exactly the likelihood is and what a diagnosis would mean. I'd read each horrifying report and cry. I probably wouldn't be able to think about much else. None of that — the crying or the worrying — would probably actually help me prepare.
But I know for many women, the results of these types of screenings can be very reassuring. Of course getting a report back that there is very little chance of a genetic abnormality is a great comfort. And there are more tests offered if there is a possibility of an abnormality. I recognize that some women would want to do everything they could and know as much as possible. But I've made myself crazy consulting Google with medical questions. So I try, as much as possible, to leave the internet alone, opting instead to talk about my anxieties with my midwife.
With my first miscarriage, the bleeding would start and stop. So in this pregnancy, when my bleeding stopped after one day, I didn't sigh with relief; I just waited for more information. But in those cases I had clear signs that something might have been amiss. I'm not about to welcome that sort of uncertainty to my pregnancy if I don't have to.
When I experienced spotting early on in this pregnancy, I didn't hesitate to call my midwife and request an ultrasound for viability and to ask for my hCG levels to see if things were going as they should. I have a history of early miscarriages, and when I did miscarry, I felt a great deal of peace when the miscarriage was confirmed. The limbo of worrying about bleeding is and was torturous for me. Since hCG numbers only give an accurate picture when you get more than one reading and by looking at what the numbers do over a span of a few days, I went in for that first blood test knowing I wouldn't really know much for another three days. With my first miscarriage, the bleeding would start and stop. So in this pregnancy, when my bleeding stopped after one day, I didn't sigh with relief; I just waited for more information. But in those cases I had clear signs that something might have been amiss. I'm not about to welcome that sort of uncertainty to my pregnancy if I don't have to.
Making these decisions for me has been about weighing the peace of knowledge with the pain of worrying. I know that every phase of parenting has its challenges and uncertainties. First I worry about a pregnancy's viability, then about the baby being born healthy. Next thing I know I'm worrying about SIDS and whether my baby's head is flat. Then I worry about those early developmental milestones. Suddenly I'm sending my kid to school on a school bus and worrying about being away from him all day. In my opinion, it's a supremely slippery slope. I'm learning that I don't need to stress every little thing.
As someone who has to actively work to keep anxiety at bay, it's important for me to take care of my emotional health during pregnancy. What works for me won't work for everyone. But it helps me to trust myself to deal with whatever this child brings.
To me, being pregnant is preparing for all of that. I have to let a lot of control go. I do my best for myself and my baby and I try to be in the moment. If there is something abnormal about my baby, I will still do my best to love him/her and care for him/her the best way I can. For now, my pregnancy is going well, and I'm thankful. As someone who has to actively work to keep anxiety at bay, it's important for me to take care of my emotional health during pregnancy. What works for me won't work for everyone. But it helps me to trust myself to deal with whatever this child brings. Because you just never know. Everything is uncertain about a new baby. Will the baby sleep well? Will she be cheerful? Will he look like me? And no amount of testing will erase that uncertainty.