In 1969, when my mom was pregnant with me, prenatal sonograms and blood-screening tests hadn't yet been invented, and amnios were only offered to women over 35 whose pregnancies were considered high risk. So until I came out, all my mom knew about my health was that I had a good, strong heartbeat and an irritating habit of kicking her in the ribs. Imagine that kind of innocence! Imagine getting through pregnancy without the screening tests or the anatomy scans—with hope, rather than science, as your guide. Sounds pretty good, actually.
Five months ago, when my doctor confirmed that I was expecting, her first words on the matter were "Will you be getting CVS or amnio?"
What? No congratulations? "Uh, I hadn't thought about it yet," I answered. I could already tell that this pregnancy was going to be even more closely monitored than my first one, which had occurred at age 34. Now, instead of "Don't worry," the message was "Go ahead, worry." And so I did.
But the chromosomal tests that could help assure me of my baby's good health—amniocentesis and chorionic villus sampling (CVS)—were almost as stressful to contemplate as the possibility that something could be wrong with my baby: The chances that I would miscarry as a result of these procedures were about 1 in 400 and 1 in 200, respectively. I couldn't decide which unthinkable occurrence would make me hate myself more: getting an unnecessary test and miscarrying, or not getting one and finding out that my child-to-be—and by extension my husband, Ted; my son, Finn; and myself, I thought more selfishly—would live a compromised life. My solution was to take a 100 percent safe, noninvasive test called the Ultra Screen at 11 weeks. (It combines a nuchal-translucency scan with blood-test results to give you a personalized risk factor for Down syndrome, trisomy 18, and trisomy 13.) The day after the scan, the sonogram specialist called to tell me that my fetus's nuchal-translucency measurement looked beautiful, and the blood looked "pretty good," so my overall risk of an abnormality was much lower than average for my age.
I was thrilled. For about three hours. Then I started to wonder why my blood work had only merited what sounded like a C+ grade. I called my genetic counselor (women of "advanced maternal age" like me get one at no extra charge!), who explained that my blood contained high levels of a chemical called free beta hCG, and that this was sometimes a marker for chromosomal disorders. "Well, your levels are 95 percent higher than average," she said. "Most likely, this is just a normal variance. We can't say for sure, though."
My thoughts raced. What if that hormone was trying to tell me something and I ignored it? I signed up for CVS. It was a riskier choice than amnio, involving the insertion of a catheter through the cervix to collect cells from the placenta, but I could get it almost a month earlier than amnio. If truly bad news awaited me, I wanted to hear it soon.
I felt resigned to my very un-zen thirst for data—until the day before my appointment, when I couldn't work, couldn't sit still, couldn't even eat. Maybe I wasn't supposed to get this test. It does carry a higher risk of miscarriage than amnio, after all.
