Decisions

You know, many things about becoming a parent are decisions that grown ups make.  Can we afford it? Are we prepared to not be the center of the universe?  What will we do without the second guest bedroom?  Will we do immunizations?  Should I get out of bed and get my wife the ding dong she is craving? (the answer to that one has been a resounding no...)

The biggest and most difficult decision thus far has been about doing an amniocentesis.   As a woman of "advanced maternal age" the risk of downs syndrome is elevated.  The risk is 1/65 going into the baby making process.  That's a pretty significant risk, but not big enough to not try.  There are multiple tests you can do to get some reassurance that your little baby is on track.  The first is an ultrasound at about 12 weeks that measures the space behind the spine.  If that measures large or there are nasal bone issues those are strong indicators that downs syndrome may be present and more testing should be done to know for sure.

They also do blood tests of the mommy at 12 weeks and then again at 13 weeks to see if there are indicators in the blood that indicate an elevated risk for Downs, Spina Bifeda and other issues. 

Our ultrasound and initial blood work came back with good results.  I was feeling confident that we were right on target.  Then, our second round of blood tests came back and the results were even better.  They reduced our odds of having a baby with Downs Syndrome to 1/610.   The other risks went to 1/9000 and 1/6000 !  Woah, those are some great numbers.

Since those numbers are so reassuring, why am I on the fence about doing an amnio?  I should be happy to cancel the appointment and move on - right?  An amnio can provide reassurance that your baby doesn't show genetic mutations of the chromosomes (they are checking for) but doesn't provide any reassurance that the baby is "perfect" as there are many many things that we humans can face that aren't chromosomal in nature.  Doing the amnio would give us a definite answer about Downs Syndrome.  We would know what to prepare for or simply to finally relax and enjoy the ride. 

The amnio also does not occur without some risk to the pregnancy.  There is a 1/200 shot in an amnio causing a miscarriage.  This is generally speaking, and the farther along you are the better the odds, but those are the standard numbers that are thrown out for your decision making benefit.
 

Jason has been fabulous through my hemming and hawing about should we or shouldn't we.  He has simply expressed his concern over the risks and asked what we would do if we knew about an issues our baby might have. 

There was a day that I would have said, if the baby isn't healthy we could consider ending the pregnancy.  This was before I lived with it for 17 short weeks.  We are at the point where we are invested in and bonded to the little munchkin holding Circ du Solei tryouts in my womb.  We both agree that what is coming our way is coming our way.  CAVEAT:  should it be discovered that our person has some terrible, ailment that would result in a horrific and painful situation then I reserve the right to make a decision that is based on humanity and medical advice. 

Still on the fence, I called the advisor at the Eastside Maternal Fetal Medicine clinic and told her of my indecision.  She reassured me and said that many women in my shoes (older with superb initial test results) feel unsure about doing the amnio, because from the beginning we're told it is a must.  She offered up a secret third option that has caused me to breathe again.

We'll be doing the 20 week "big" ultrasound next week.  (two weeks early) which will give the doctor the ability to see any physical issues that may be present (lack of bones... or something) and if that ultrasound shows excellent baby progress and good physical indicators they will again drop the odds of downs to an even lower number.  We can decide right there and then to have or not to have an amnio.  The beautiful thing is that we'll be making that decision with the benefit of additional (non-invasive) information. 

I feel a big sense of "fweew" going on. 

I read an article today about a side effect of all this testing.  "Limbo Bonding" or some such thing.  The premise is basically that some moms emotionally wait to 'fall in love' with their baby until after certain milestones are met, to guard themselves from the appointment's of a miscarriage or terminated pregnancy.  I understand that concept.  The first 3 months I was super excited, but didn't want to buy anything or prepare in anyway just in case the pregnancy went away.  I could sense the wary nature in which I approached life those first 3 months and the elation I felt at getting through the 12th week.    I can't imagine living like that through the whole first half of the pregnancy.   I am wary no more... heck I'm packing for a San Jose work trip and the maternity tops are coming.  woo woo.  Trust me, I'm in love.