This question is a rather personal one to me, and I am writing this article from a personal view, showing that being a midwife and a mother sometimes has no boundaries.
I was expecting my third child at the age of 31 – some may think an ideal age; young enough, healthy, fairly good lifestyle, non-smoker, had an occasional drink but more of a non-drinker, to be truthful. I had already had two healthy, uneventful pregnancies and normal vaginal births – would a third be any different? Surely it would be easier, I would think!
As a midwife I would be talking to pregnant women about the routine antenatal bloods that would be required throughout the pregnancy, and also informing them of a blood screening test known at that time as the ‘Tripe Test’, screening mainly for Down syndrome, Neural Tube Defects and other chromosomal abnormalities that may occur. It wasn’t a diagnostic test, but a screening to see if one was in an increased risk group of women to have one of these conditions as stated above, based on factors such as age, single or more pregnancies, and correct gestational age at time of test, mainly before 16 weeks. It was a statistical result being based on a group of 250; the result being between one and 250 being at increased risk, and anything over one in 250 considered not at increased risk. This test in itself was not 100 per cent accurate, but it was an indicator for further diagnostic testing if so required. I opted to have this test done along with my routine antenatal tests, not thinking I would ever come to be in the increased group based on the things I already thought to make me low risk.
But that Monday morning, it did happen. I went in to work as normal only to find a message informing me to contact my colleague in the Antenatal clinic, which I proceeded to do.
There it was, in black and white, my result: 1:61 for Down syndrome – I was in the increased risk group of women. So after the result had sunk in, I was then offered an appointment for an Amniocentesis. This a 100 per cent accurate diagnostic test, an invasive procedure where they take some of the amniotic fluid and send it away for genetic analysis. After discussion with my husband, in a whirlwind of numbness I agreed to have it done within a few days. With this procedure there is a small one to two percent chance that it could trigger an amniotic leakage, resulting in an evitable termination of pregnancy.
Well, nothing was going to be straightforward for me on this occasion. During the scanning phase of this procedure, it was found I had a very rare occurrence that the lining of my membranes were not completely closed together as they should be at this stage of my pregnancy, at 17-18 weeks, which would increase my risk of amniotic leakage to 4 percent. So, after discussion with my husband again, I opted not to go through with the Amniocentesis. We opted to have a full anomaly scan two weeks later to look for any significant markers for Down syndrome. At the end of the day, it was still only a scan, and within the limitations of this we continued through the rest of the pregnancy until I had a normal vaginal birth at Term + 10, resulting in a healthy baby girl!
Looking back afterwards, it threw up different questions - would I have done anything differently? Would I have had the test or not? Did I really want to have an Amniocentesis done? What would I do with the information if it confirmed that my baby had a condition such as Down syndrome?
These are all personal questions where we all have our own choice and decisions to make, even which may be differing between partners. In hindsight, maybe we could have discussed these before planning a baby or in early pregnancy, but when the excitement of having a new pregnancy and looking forward to meeting this new little person is overwhelming, sometimes the decisions we may have to face can seem very remote to how we are feeling.
The main point is not to scare but to show that you need to be informed of all things along this life-changing journey together, so you can make the right choice for you and your baby.