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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Jun 03
    2009

    Considered AMA and genetic testing

    Archived User

    Hi - I am pregnant for the first time at age 38.  Of course, I'm considered of "advanced maternal age" and high risk.  My doctor has referred me to a genetic counselor, in conjunction with my regular ob/gyn.  I have an initial consultation set up but I'm really not sure if I need this or not - I'm not convinced that the screening/tests conducted are going to do anything but worry me.  I guess my question is, are these test really necessary, given my age?  No one in my family or my husband's has a history of genetic problems.  The only risk factor I have is my age.  Any suggestions?

    Thanks!

    Henci Goer

    Regardless of your genetic background, age is an issue, at least for Down's syndrome. However, the rule is that you should only have a test if the information will help you make a decision. If there are no circumstances under which you would end a pregnancy, you may wish to refuse genetic testing. In such a case, getting a positive result will, as the Dutch term it, "spoil the pregnancy." If there are conditions that would lead you to end the pregnancy, then you have to consider how likely one of those conditions is and weigh that against the accuracy of the test you are considering, the potential harms of the test and how likely they are to occur, what further tests or procedures would be recommended if the one you are considering is positive, and the accuracy and potential harms of those. 

    -- Henci

    P.S. You didn't ask my advice on this, but I have to tell you that some obs treat all older first-time mothers as high-risk, which you most certainly are not if you are in good health. Misplaced belief in the benefits and safety of high-tech management and cesareans can also lead to your ending up with procedures, drugs, restrictions, and surgery that you don't really need. I recommend finding out more about the attitude of the obs in the practice regarding first births in older women and toward pregnancy and childbirth in general. To find out more about what constitutes optimal care for a healthy woman, I recommend About Normal Birth on the Lamaze website and subscribing to Lamaze's weekly pregnancy newsletter. I also recommend "Having a Baby? Ten Questions to Ask" from the Coalition for Improving Maternity Services website.


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