- Is the size of a small lemon or large lime. With a twist! Yeah, we’re done with the bean and nut comparisons and have moved onto fruit. Next stop, small household appliances!
- Is officially a fetus, and is downright human-baby looking with non-webbed fingers and toes, although s/he needs a lot more cooking and fattening up.
- Is moving and kicking and dancing and even hiccuping, although you won’t be able to feel the acrobatics for a few more weeks (sometime between weeks 16 and 20).
- Please, it’s just all more of the same. The pregnancy books are all yapping about how much better and less sick/exhausted/crabby we should be feeling by now, and I spent a very productive morning hurling several particularly annoying tomes at the wall.
Okay, this week’s entry will cover several things that I am in no way qualified to cover. But considering this is the Internet, I’d like to see anyone try and stop me.
We already sort-of covered some of the typical first-trimester tests, or at least the ones tied to your family’s genetic history. Now it’s time to start thinking about all the other ones. If you’re over 35, your doctor may be a little more pushy about genetic testing. Conversely, if you’re under 35, your doctor may just assume you’re not interested in them. No matter what your age, the tests are entirely optional, so it’s obviously best for everybody to educate their own little selves about the available tests and decide which ones (if any) they’d like to pursue.
With Noah, the only test I was offered (and likewise accepted) was the triple-screen or multiple marker test, which is a simple blood test performed between weeks 16 and 18 that screens for neural tube defects, Down syndrome (trisomy 21) and Trisomy 18. I’m not sure what we would have done if we’d gotten a positive result — usually further testing like an ultrasound and an amniocentesis is next. Our results were negative, however, and I was able to stick with my plan of only accepting the tests that offered absolutely no risk to the fetus (even though I knew these tests also had higher rates of false positives, bah!).
Today, though you have more options! Easier and more accurate options. Even more options than I had, back when I wrote the original version of this article.
(HELLO FROM THE FUTURE. SPOILER ALERT I HAD A BABY. THEN I HAD ANOTHER ONE. THEN I WENT BACK IN TIME TO UPDATE THIS WEEK’S ENTRY BECAUSE IT WAS HELLA OLD.)
For my second—and third!—pregnancy, I opted for the nuchal translucency ultrasound. It was considered a “newer” test at the time, and a big step up from many of the “old” procedures like chorionic villus sampling (CVS) that carried a risk of miscarriage (1-2%). It is still offered today, though getting rapidly lapped by the newer options I’ll touch on in a bit. You get an ultrasound at any point after you hit week 11 and before week 14. Your OB measures the clear space at the fold in the back of your baby’s neck. Babies with chromosomal abnormalities tend to have extra fluid in this area during the first trimester, so the ultrasound (sometimes combined with a finger-prick blood test for mama) could actually give you a decent head’s up on potential problems.
While the nuchal scan scored points for being safe and non-invasive, it definitely lost points in the accuracy department. False positives and negatives were very possible and quite common, so it was NOT considered an actual diagnostic tool. If something didn’t look right, you had to move on to the more invasive and risky CVS if you wanted an accurate (99%) answer.
Now there are new DNA-based blood tests available that check your baby’s chromosomes for trisomies 21, 18 and 13. You can get a simple blood draw done (as early as week 10) and generally get the results back in about a week. These tests (with brand names including Harmony, Panorama, Verifi, and several others) are a HUGE leap forward in the accuracy department: about 99.9% accurate for detection of an abnormality, and an incredibly low rate of false positives, at least compared to the “old” tests.
Again, these tests are completely optional, but most insurance companies will still cover them. (My nuchal scans were covered, and were resoundingly and accurately negative.)
Back when I originally wrote this, I included the following as a bit of “here’s my general line of thinking in regards to the optional tests:
If I am going to have a child with disabilities, I’d like to know as soon as possible so we can prepare ourselves for it. I tentatively believe I’m one of those “I’ll have this baby no matter what” people, but I also admit to being rather spoiled and blase about the whole thing, because I don’t have any reason to believe my child would even be disabled. I’m only 30, have no family history, my first kid turned out all right, etc. Ah, hubris.
(Trust me on this, though: about 10 minutes before my appointment I will fuh-REAK the eff out over the test and panicpanicpanic because THERE IS SOMETHING WRONG WITH MAH BABY I KNOW IT.)
You might have some mitigating factors that make the whole genetic testing topic more of a minefield for you, and if that’s the case, it’s best to read as much information about the various tests as you can, and have several talks with your partner about your options and the potential outcomes. We (thankfully) have many, many choices available to us — and it’s funny how I actually value those choices even more after having a baby, because it honestly never occurred to me that those choices are extremely relevant to WANTED pregnancies as well.
Oh Yeah, THIS: I have zits all up in my hairline. I suppose that’s significantly better than getting them right on my nose, or something, but MAN, this is annoying.
New This Time Around: (whispers) The puking has stopped. Last time I puked straight through week 14, and still couldn’t really eat anything until week 16. I’m still not loving food and food smells, but oh, dear God, I think the puking has stopped.