Oh, modern medicine. I have such a love-hate relationship with you. So much of the time you do so much good. When I had a heart condition that needed surgery, you were there for me, giving me a non-invasive, fairly low-risk cure. When my father-in-law was recently ill with an infection that was not responding to treatment and his life expectancy suddenly looked like days, rather than years, you came through again with the ability to scan the body, pinpoint the infection and provide treatment, bringing him back to life.
However, on the subject of the care of pregnant women over 35, I'm a bit more on the fence. Sure, you've helped many of my friends have children who otherwise would have been unable to conceive. You provided me with a safe environment to deliver my first child with pain managed (thank you very much) and a flawless birth. And, most of the time knowledge is power, but sometimes knowledge is unnecessary and anxiety producing. Sometimes it is possible to get information that probably never needed to be known in the first place.
Since I'm over 35 I get to have all kinds of genetic testing done. An ERA blood test to calculate risk for Downs and Trisomy 18 (my risk was 1 in 3700 and 1 in 10,000 respectively based on solely bloodwork. For perspective, the average risk for a 38 year old woman is 1 in 150), an ultrasound at 11-13 weeks, an AFP blood test to give further risk for Downs, Trisomy 18 and Spina Bifida and another ultrasound at 18-20 weeks.
Yesterday was my 18-20 week ultrasound. We found out we're having a boy (yay!) and we also saw what are called soft markers for both Downs and Trisomy. Ella had the same soft marker for Downs - a light spot on the heart. It doubles my risk, so I'm now 1 in 1850, or, put another way I have a .05% chance of having a baby with Downs. The Trisomy 18 soft marker is a cyst in the brain, which doesn't effect anything after birth and, in fact, most fetuses outgrow the cyst and it won't be seen on later ultrasounds. I can't remember what that does to my risk, but let's assume it doubles it as well so I have a .02% chance of having a baby with Trisomy 18. To look at it another way, I'd have to give birth 1850 times to have a baby with Downs or 5000 times to have a baby with Trisomy 18 (PERISH THE THOUGHT OF GOING THROUGH THIS THAT MANY TIMES!).
The only way to definitively know whether I'll have a baby with either is to have an amniocentisis, but the risk of having a miscarriage as a result of an amnio is 1 in 300, or .33%. That's a greater risk by far than actually having either in my baby, so it isn't worth it.
What the doctor recommended is to come back in 3 weeks for another ultrasound to be sure the baby is growing. With T18, I guess they just don't grow. From there, if growth is stunted, I could have the amnio, get results and still be in the window of time to terminate (T18 babies rarely survive past the first week of life) if it came back positive.
It is all so horrible to think about and honestly, I think I stopped comprehending at the point the doctor told me there was a cyst in my child's brain. Once I left the office and we had lunch and I had a chance to process, I began to wonder why we even had to be told any of this. I also felt a sense of calm come over me with a strong sense that no matter what we'd be okay and the best way for me to proceed is as though I have a totally normal, healthy child (so I went shopping for baby boy clothes).
I've long believed that there has to be more than a mother's age to predict the potential to have a child with issues. I understand that western medicine needs to quantify and qualify and age is the one common factor they have found, but surely your own family history, that of your husband's, how you and he take care of yourself and the environment you live in also have to play a role. Hard to quantify those because they vary so much from person to person.
Hopefully the next 3 weeks will pass quickly and on June 1 at 11:30 we'll see a strapping, young lad who has grown beyond the 9 ounces he weighs right now. Lord knows if I keep gaining weight, but he doesn't I'll be pretty pissed. Until then, I'm planning to stay positive, hopefully not wake up in the middle of the night and play the what-if game and put this mostly useless knowledge provided by modern medicine out of my head.
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