How to Think About and Approach Testing
It can be easy to worry too much about prenatal testing and to make your entire pregnancy revolve around the tests and their results. Test results can be very helpful for you and your health-care provider if you approach them in the right way. One important thing to understand up front is that studies do not show that increased age is linked to an increased risk of miscarriage after an invasive test, such as amniocentesis.
Risk Versus Information
There are many prenatal tests that pose little if any risk to you or your baby. Blood tests, ultrasounds, physical exams, and so on provide your health-care provider with a lot of important information and are unlikely to cause you any problems. Other tests do carry some risks, particularly the risk of miscarriage when you are looking at amniocentesis or chorionic villus sampling.
Because some of these tests do carry a small but real risk of miscarriage, it is essential that you and your health-care provider talk frankly about what the real risk is to you and your baby. This chapter provides the national averages for risks; your health-care provider may be able to advise you further based on his own practice and on your particular pregnancy.
It can be easy to become nervous about prenatal testing. Reassure yourself by remembering that the odds of the test causing a problem for your pregnancy are quite small. The odds of an abnormal result are also quite small. In over 99 percent of cases, the test confirms the normality of the baby.
When deciding whether or not to have a test that a carries a risk, you need to evaluate whether the risk you face is worth the information you will get. Is there another way to get information that is as good? Would having the information change your plans for the pregnancy? Even if it would not change your decision about carrying the pregnancy to term, would it offer you information that would allow you to be prepared? Would it allow your health-care provider to take some precautions he might not otherwise?
Ultimately, the decision about whether or not to have a test is completely up to you. If you don't want the test, simply tell your provider this is the case. Before you make a decision, though, completely educate yourself about the following:
How the test is done and what it feels like
When in the pregnancy it is done
How accurate it is
What type of information it can provide
Dangers of a Test Compared to Risk
Another important factor you and your health-care provider need to consider is whether the risk of complications from the test itself is higher or lower than your risk for the abnormality being tested for. It is because of this comparison that age 35 is the age at which amniocentesis may be a reasonable option for some women.
At this age, the risk of having a child with a chromosomal trisomy, such as Down syndrome, is higher than the risk of miscarrying from the test itself, so it is considered to be a risk worth taking. This merely indicates that from a risk-benefit point of view, the medical establishment considers it reasonable to offer the test. This does not mean that it should necessarily be done, particularly since there are other tests that are less invasive and that can provide good information with much less risk.
Dealing with Testing Fears
At your first prenatal visit, your health-care provider will do an internal and take a Pap smear to test for cervical cancer and STDs. In the final weeks of your pregnancy, your provider will do a cervical check to see if your cervix is opening, an indication that you are close to going into labor.
Pregnancy testing is fraught with a lot of anxiety. First, you may be nervous about the actual test procedure itself and any pain and discomfort you may experience. Next, you may dread the waiting period until you get results. And last but not least, you may be very nervous about what the results will show and what that will mean for you.
The best way to cope with test anxiety is first to gather as much information as you can. Ask specific questions about exactly how the test is performed, how long it takes, and what exactly it will feel like. It's your body and you're entitled to ask these questions, no matter how nervous or silly they may sound to you.
Be sure to follow your health-care provider's instructions before and after the test. If you are told to go home and put your feet up, be sure to do so. Your health-care provider is an expert about your test, and his or her instructions are important.