Amniocentesis

Since I am 35 years old, I was given an appointment with a genetic counselor, in order to discuss the increased risks for complications and genetic problem that come with an advanced maternal age.

I’ve never thought of myself as someone of advanced age, I mean I didn’t think I was a spring chicken, but still…

Unfortunately, as soon as you hit 35 years old, you are suddenly in the “at risk” category in the pregnancy world, and while your chances of having a perfectly healthy baby are still high, the chances of complications increase as well, especially birth defects involving chromosomes, with the most common being Down syndrome.

To be honest with you, when the genetic counselor started listing the increased chances that come with age, for a minute I wished I had planned for this baby five years before, and cursed myself for waiting so long. But the counselor reassured me, saying that most mom go on to have a healthy baby. But looking at how the chances increase dramatically every few years didn’t make me feel that good:

• At 25 years old the chances for a woman to have a child with Down syndrome are 1 in 1,250.
• At 30, 1 in 1,000.
• At 35, 1 in 400.
• At 40, 1 in 100.
• At 45, 1 in 30.
• At 49, 1 in 10.

So what are my options? I asked.  How can I find out if my baby is going to be ok?

It turns out there are a few different tests that can screen for chromosomal birth defects. The first one is given relatively early in the pregnancy, at around 12 weeks. It’s a blood test that will show the likelihood that your baby will have Down syndrome, but it won’t be 100% accurate. It will only give you a general idea of your chances, but in the end any result is still possible.

This screening test is more of a first step to let you know how high your chances are, so that you can take further steps if you want to. Many women decide that this is enough information: if the test shows them at a higher risk level, they will use this knowledge to be better prepared in case of a birth defect.

Other mothers decide to take the next step, which is further and more precise testings that will give them accurate results. The two tests in this category are the CVS (chorionic villus sampling) and the Amniocentesis.

I personally prefer the Amnio over the CVS, because if you compare the two, CVS comes with a higher risk of miscarriage and is more invasive than the Amnio. In fact, the CVS takes a sample of the placenta while the Amnio takes a sample of the amniotic fluid from the uterus.

So why is the CVS test even given? The only reason I can see is that you can take the CVS test before than the Amnio (10 to 12 weeks for the CVS versus the 16 to 20 weeks for the Amnio) so I guess if you are in such a hurry there is an earlier option that comes with a slightly increased risk.

But, because the Amniocentesis is performed on a more developed fetus, it gives more comprehensive results, and, for example, can diagnose spina bifida, while CVS can’t.

So after a little research, I knew I was going to go with the Amnio.

Making that decision wasn’t the hard part, preparing for the test was. See, I have never been a big fan of needles, and the idea of getting one stuck in my belly was not appealing at all.

Nonetheless, I tried to keep calm until the day of the test, and I fooled myself into thinking that I wasn’t really worried about it. But, like I said, I was fooling myself.

When the doctor came in, I was pretty much shaking, not visibly, but definitely shaking. Fortunately, he tried to calm me down by jocking around and questioning me about any good restaurants in my neighborhood.

I tried answering him as best as I could, but never for a moment I forgot what we were there to do. All I could think about was how painful that needle poking through my skin was going to be.  

One thing that kept me somewhat calm was the fact that I knew this doctor to be an expert in his field, and a mentor to many OBs, mine included, so that knowledge was the only calming light that afternoon.

Yes, I was worried about the pain of the needle, but I was more worried about any complications from the procedure, and the possibility of miscarriage. So I kept telling myself that even if the needle would hurt me, this doctor was going to make sure that the baby was going to be safe.

I had read that the first step in the procedure was a 15-20 minutes long sonogram to determine the position of the baby and to decide on a safe spot where to insert the needle. My doctor took about 3 minutes to find a good spot, which cheated me out of 17 more minutes of avoiding the needle.

Then he started poking down with a finger on the “safe spot”. At this point I stopped looking at the screen and closed my eyes. But I made sure to remind my boyfriend to keep his eyes on the screen to make sure the needle didn’t touch the baby.

After the fourth poke or so, the doctor raised his finger for a longer pause, and I knew the needle was going to be next. I held my breath and waited. And waited. And waited.

And then I felt the needle go in.

And it wasn’t half as painful as I thought it was going to be. It almost wasn’t painful at all. It was weird, but not painful.

I made sure I didn’t move until I knew for sure the needle was out. And once the doctor took it out, I started shaking, this time visibly. But it was shaking due to nerves more than anything else. The procedure hadn’t been painful at all, really.

My boyfriend went on to reassure me that the needle had been inserted nowhere near the baby.

The doctor then told me that I could go out and have dinner if I wanted to, meaning there was no reason to be too worried about complications, and the only thing he specified to avoid for the day was sex.

I already knew that I was going to take as much precautions as I could, so not only I didn’t go out to dinner that night, but I went home and sat on the couch, took the next day off work, and got off the couch only to use the bathroom and to go to sleep at night. I basically didn’t do anything but watch TV for about 24 hours.

Luckily, I had no complications, no leaking, no bleeding, no nothing. And about a week later we got the results, which told us that the baby was fine, and that she was a girl!

And that was a very happy day.