Let’s be clear: This is not a public service announcement. The doctors and technicians at my hospital did not seem to approve of what I did (they looked kind of dismayed, actually). But what I did—or more accurately, what I didn’t do—felt right for me.
I did not get an amnio.
I was well past 35 when I became pregnant, the age that doctors start recommending prenatal testing. Amniocentesis, usually done between 15 and 18 weeks of pregnancy, was the gold standard for determining whether a baby has a chromosomal abnormality, such as Down syndrome. By sticking a needle through my uterus and into the amniotic sac, drawing up some amniotic fluid and examining the cells inside it, my doctor could tell me if my baby had any such abnormality, in a little over a week and with 98 to 99 percent certainty. (At the time, cell-free DNA testing—a non-invasive, low-risk blood test screening that has a 99 percent accurate detection rate and a very low false-positive rate—wasn’t yet available.) Women typically want to know if there are any chromosomal abnormalities, my doctor explained, so they can make the necessary preparations for delivering a special needs child, or decide whether to terminate the pregnancy.
Here’s the catch: I was also told that there was a 1 in 200 chance that the amnio would lead to an infection or cause the amniotic fluid to leak, which would effectively end my pregnancy. Being older, I knew it was possibly my last chance to have a child, and I didn’t want to screw it up—or have my doctor do that for me.
I can’t tell you why I felt that the risk of 1 miscarriage out of every 200 amnio procedures sounded so frightening to me. What if we called it a 0.5 percent chance of miscarriage? Put that way, it sounded a little better. What’s more, the decades-old stat is probably out of date. The chance of miscarriage in centers that do many of these amnio procedures is more like 1 in 400, and at least according to one study] done in a New York City hospital, the figure is more like 1 in 1,600. But tell that to the one mom who lost her baby. It’s as if my maternal instincts had kicked in, even though my child was little more than the size of an apple. One in 200 sounded pretty safe, but I wanted totally safe. And what if the news from an amnio wasn’t good? What would we do? I didn’t want to make that decision, and neither did my husband. So we decided to wait and see, betting on the fact that the standard first and second trimester prenatal screenings would reveal, without a doubt, a chromosomally perfect child, making the need for an invasive diagnostic test moot.
Little did we know, when it comes to pregnancy, there is always doubt. Scientists have created lasers that slice through the cornea of an eye with utmost precision. They’ve found ways to keep people alive with an artificial heart. But exactly how your baby will turn out, if it will turn out, seems to be anyone’s guess, especially if you’re an older mom-to-be. Between age 35 and 45, there is a 20 to 35 percent chance of miscarrying, regardless of whether the woman has an amnio or not. At age 35, 1 in 365 women will have a child with Down syndrome, and that stat jumps to 1 out of 100 once you reach age 40. For me, the process of having a baby felt like an endless series of probabilities…