When you're pregnant with multiples, you will be offered or prescribed certain screenings and tests for you and your babies. Even though you're having multiples, you do have the right to choose the type of information you do or do not want to receive and what screenings and tests you want to have performed. Thinking about this early in the pregnancy and communicating your wishes to your care provider can help make the testing process go more smoothly and help you avoid unnecessary stress and worry. It can also help you choose the type of care provider you want to work with over the next 8-9 months.
An Example of an Optional Prenatal Screening
An example of screenings that you may want to think about are the ones that look for potential birth defects such as Spina-Bifida and Down Syndrome. Usually, these screenings are done in the first and second trimester. If, through the screening - usually by blood and then by ultrasound - there is an increased chance of a deformity, a test called Amniocentesis may be recommended. It should be noted that fertility treatments such as IVF can manipulate the results of certain preliminary screenings and increase the chance of a false-positive. If you've had IVF treatments, it is even more important for you and your doctor to discuss the reliability of the initial screening and to weigh that against having an Amniocentesis performed. Here is one study that found this conclusion.
Amniocentesis is when a needle is inserted through the mother's abdomen and into the uterus so the doctor can withdraw a sample of amniotic fluid to examine fetal cells. Performing Amniocentesis does increase your risk of miscarriage (albeit low - in this one study it was less than 1%)
Probably the more important impact of these screenings and tests is the emotional and health toll it can take you, the mother. Being informed that one or both of your children has a higher chance of being born with a genetic birth defect can, understandably, lead to increased anxiety levels and hard choices. Opting into these tests may also delay your awareness and connection to your pregnancy. Barbara Katz Rothman interviewed women who consented and refused amniocentesis in her book The Tentative Pregnancy. She found that taking the test delayed the mother's awareness of fetal movement until after getting the results; indicating a form of psychological self-protection.
However, not knowing can also have a negative impact on your pregnancy, especially if you have a family history of birth defects or are over the age of 35 - when genetic issues are more prevalent (although still low). You may be worried from the very beginning about your children and so screenings and, if necessary, Amniocentesis may be the only way you can enjoy and bond with your children during pregnancy.
The Bottom Line
Whatever your decision, it is important for you (and your partner) to make it early and to communicate your wishes to your care provider so you all can have a conversation about how the decision may affect your pregnancy and your children.
If you're not sure what you should do, here are some questions to ask yourself: What will you do if early screenings show an elevated possibility of a problem? Will you take a subsequent action? Will it help you feel prepared and give you the opportunity to be more educated on the situation or will it throw you into a state of paralysis? Will it leave you feeling empowered or defeated? Will it cause more or less worry and anxiety than before you get the results?
You can also try to think about a time in your past where you received news that a negative result might occur if you follow through with a certain decision. What was your reaction? How did you feel?
Spend some time with these questions and memories. This is one of those decisions that has to be your own. Everyone takes news like this differently and reacts differently. Do what is going to be best for you and allow you to have the most positive pregnancy possible.
Information for this blog was taken from:
Luke, B. & Eberlein, T. (2011). When You're Expecting Twins, Triplets, or Quads: Proven Guidelines fora Healthy Multiple Pregnancy: 3rd Edition. Harper. New York, NY.
Nobel, E. & Sorger, L. (2003). Having Twins and More: A Parent's Guide to Multiple Pregnancy, Birth and Early Childhood: 3rd Edition. Houghton Mifflin Company. Boston, MA.
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