After the + sign: A mother’s guide to prenatal testing

Becoming a mother

Everything changes the moment a mother sees that first positive sign or test result. Sure, thoughts of potential names, baby gear to be acquired and your little one’s future come to mind, but the immediate priority becomes your baby’s health.

To make sure he or she is both healthy and thriving, the order of the day — well, roughly nine months, actually — is testing, testing and more testing!

Read on to learn about common prenatal tests and what moms have to say about them.

These are basic summaries only, and this list is not exhaustive! Please check with your obstetrician, midwife, or other prenatal care professional for complete information.

First trimester blood test/pap smear/STI/STD test. Other than a pregnancy test to confirm your pregnancy, pap and blood tests are usually up first to rule out any infections. Verifying your blood type is also key. If you’re RH negative, your blood type is likely at odds with your baby’s, and you’ll need to be mindful of any potential “crossover” of your and your baby’s blood. If this occurs, your body will produce antibodies and for any subsequent pregnancies, there’s a risk that these antibodies will attack your child’s blood. To prevent this, you’ll need the Rhogam shot around 28 weeks.

I’m RH-negative and, to be honest, knowing the potential impact my blood type could have on my babies made me pretty nervous initially. However, my doctors explained everything clearly, and I felt a great sense of relief after the Rhogam shot.

First trimester screen/nuchal translucency (NT) test. This screen, which is usually performed somewhere between weeks 11 and 14, combines information from an ultrasound and bloodwork. The NT test is carried out via ultrasound, wherein the amount of fluid at the base of baby’s neck is measured. An increased amount can indicate an extra chromosome and presence of a genetic disorder. Blood tests, which account for the second part of the screen, can indicate higher risk potential for Down Syndrome and Trisomy 18.

Triple screen/quad screen. These are blood tests that indicate chromosomal abnormalities, genetic defects and congenital heart defects. These tests are given between weeks 14 and 22. If results are abnormal, follow-up testing may be recommended. This could include specialized blood tests or amniocentesis (the extraction of amniotic fluid).

Glucose screening/glucose tolerance tests. The glucose screening test checks for gestational diabetes and is given generally between the 24th and 28th week of pregnancy. You’ll drink a super sugary drink within a specified amount of time and an hour later, your blood will be taken and eventually screened. “It was really—for lack of a better word—gross,” said Camp Hill mom Lesley Ramsey. “I really don’t mind having my blood taken, but drinking the super sugary concoction as quick as possible was nauseating.”

If results indicate high(er) levels of glucose, you’ll take the glucose tolerance test, which requires fasting, gulping another delicious drink and having blood drawn three or four times. If it is determined that you have gestational diabetes, changes to your diet and exercises will be recommended.

Fetal non-stress test. Once you’ve passed the 28-week mark, if you’ve noticed a decrease in baby’s movement, you’re high risk, you’re overdue or there are other concerns, you’ll likely undergo a fetal non-stress test. Baby’s heart rate and your contractions will be measured via two bands around your stomach/abdomen. The test is intended to discern how baby reacts to his or her own movement and, based on the results, whether there are signs of fetal distress.

Group B streptococcus test. As you near the homestretch of your pregnancy (specifically, between the 35th and 37th week), you’ll need to take the Group B streptococcus screening test. GBS is a common bacterial infection that is present in a large percentage of healthy women’s vaginas/rectums. For the test, you’ll be swabbed (or self-collect) in both areas. A positive result will require antibiotics during labor since GBS can cause an infection in your newborn.

Routine ultrasounds and exams. Your tummy and baby will be checked periodically to determine baby’s size, heart rate, position and development. Your blood pressure will be checked, too. Due to repeated high blood pressure readings during an appointment at the tail end of my first and my second pregnancy, I ended up having two emergency C-sections. It may sound naïve, but I never knew just how significant blood pressure during pregnancy was until I had babies in my arms a bit earlier than expected.

But it’s all about balance.

“With my first pregnancy, considering all the prenatal tests and their possible outcomes was pretty overwhelming and anxiety-inducing, which is not the optimal mindset for having a stress-free, positive pregnancy,” said Amy Storm. “Choosing different tests and fewer ultrasounds during my second pregnancy has led to a still-informed yet more relaxed prenatal experience.”

And don’t disregard the possibility of less common tests. “For the second child, I remember very vividly one specific test which the doctor did kind of as an aside when he heard we have cats. He tested for toxoplasmosis,” recalled Mechanicsburg mom Nicole Schaefer. “It came back inconclusive and could have meant terrible things for the pregnancy. We went through rounds of tests and months of worry, only to finally use a special lab for testing and find out there was never anything wrong in the first place. It was terribly stressful. My advice to expectant mothers is to ask about each and every test before it is given. Ask about how the test works, how accurate it is, what would happen if certain results were returned, etc.”

Ultimately, most prenatal testing should be determined by both the parents-to-be and their doctors. “My advice to expectant parents would be to do what they think is best and not to feel pressured by other people’s opinions,” said mom Erin Griffiths. “Almost everyone’s pregnancy story is different. Make yours your own, too.”


 Laura Boycourt is a freelance writer based in Camp Hill.

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