Wednesday, June 9, 2010

My First Real OB Appointment

I had my first real OB appointment today. I haven’t officially graduated from my RE’s office, as they’ll continue to see me for the next few weeks, but they said to book an appointment and start going to my regular OB. I had seen this doctor once before, in November for an annual exam, but now that I’m an official prego, I got to see him in a completely different way!

It was pretty cool – I first had an ultrasound to “confirm” the pregnancy. So funny. I had to tell the tech that I’m a fertility patient – I know I’m pregnant, I don’t need you to confirm it, but I’m happy to do another ultrasound. Then she spent a bunch of time explaining a vaginal ultrasound… Finally she interrupted herself and said, “You’ve had these before, right?” Yes, I’ve had my share. I got to see the little one, and it’s measuring a little small (7 wk1d and I’m at 7wk5d), but the heartbeat was going strong – it’s at 158 beats per minute! The doctor said that the size was still completely normal, so I’m choosing not to worry about the size. And then the tech turned on the sound – I got to hear the heartbeat for the first time! What a beautiful sound! I started tearing up when I heard that fabulous beat – it’s like my baby made its first sound. Oh I’m tearing up again just thinking about it. Gotta love the pregnancy hormones…

After the ultrasound, I went in to talk to a nurse, got a grab bag full of goodies, and then talked with the doctor today. No exam or blood work, he said we’ll do all that in four weeks. But we just talked about my concerns. He was really nice. He brought up that considering I’m a fertility patient, he knows I’ll be a little anxious, and that’s ok. If I ever feel nervous, all I have to do is call his nurse, and she’ll get me in for an ultrasound. The plan is for me to go in every four weeks, but not have an ultrasound until 20 weeks, and then another around 35 weeks. That is, unless I feel nervous. I may have to be an annoyingly nervous patient… I don’t know, we’ll see! But I loved how supportive he was about my anxiety – have to love that!

And then we started talking about tests. There are all kinds of screens and tests they can do to see if there is anything wrong with my baby. A lot of my friends have been doing the CVS – where they can tell definitively if there is anything wrong. Most of the tests, particularly the CVS, have some sort of risk. But the bigger thing is: would we do anything with the information? I’ve talked with a friend of mine that just had this done, and this is her third baby, and she was quite willing to terminate the pregnancy if the baby had Downs, for example. I have to respect her opinion, I guess, but there is no freaking way that I would terminate this pregnancy – no matter what!

So my initial reaction is to not do any of the tests – I don’t know that I care to know the results. Sure, I would love to know the sex of the baby, which CVS allows you to find out around 12 weeks, but that’s about it. Maybe it would be good to know the baby had Downs or something to learn about it, and prepare for taking care of a Downs baby, but it wouldn’t change how I feel about this baby – and I can figure it out when it’s born, right? Why would I need to find out early?

The Hubs is out of town, so I wrote up a big email explaining all the tests, the risks, and included links to information about the tests. And then I said that I don’t know if the tests are worth it if we wouldn’t terminate. He asked what I thought, and I told him that I wouldn’t terminate, no matter what, but I wanted to know his opinion. So then he got kind of pissy and said it didn’t matter what his opinion was, because I already made up my mind. Then I dropped the conversation, because you know what? I have already made up my mind – not necessarily about having the tests, but about any potential termination – I won’t do it. And for this kind of thing, I’m going to call the shots – I’ve been through so much to have this baby – there’s no way I’m walking away now.

I know this is a sensitive topic, but I’m very interested to hear people’s opinions. What would you do? Are you guys going to have screening tests, or have you? And why?

16 comments:

  1. That has always been a tough one. I've been through phases where I thought I'd never do any testing because obviously I wouldn't want to terminate but I go back and forth. Depending on risks I may have some early testing done. I would never decide to terminate but my husband is a different story so it would really be something that we'd have to work through together. Maybe the extra time with the knowledge (if it was anything other than "normal") would be good for us to work through before birth.

    Good luck with your decision!

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  2. So funny how the OB was explaining everything to you. Isn't it crazy that some people (fertiles) go into their first OB appointment and don't know ANYTHING!

    I'm not sure what I'd do with the testing. It would be cool to know the sex though! I guess I'll have to see, if I ever get to that point!

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  3. I recently had a similar post when I was debating doing the NT scan. For me, it did come down to what I would do with the information. If my child has Down's I wouldn't terminate, so why find out? The flip side though, there are other abnormalities that are life threatening to the baby you can find out about, and to me, I thought it would be better to find out sooner than later. I changed my mind on that last point because someone who's baby DID have one of the life threatening abnormalities didn't find out until after the child was stillborn, and she had had an NT scan.

    It is a really personal decision though. I know I would be too stressed out if I did know, and because I wouldn't terminate, I decided not to stress myself out. I know I will have less time to prepare for life with a Down's child, but I could handle that better than I could handle knowing ahead of time!

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  4. I *think* we're passing on the 12 week test as well for the very same reasons you've mentioned. I pointedly asked our OB what would really be the advantage of knowing so soon, aside for greater length of time to prepare yourself (or, more precisely for me, greater length of time to FREAK OUT) and she said, "Well, this gives you the opportunity to terminate if you choose." N and I looked at each other with raised eyebrows and a look of "Yeah, right." when she said that. While I support each persons choice to do whatever they feel is best for their family, I'm personally just not comfortable with terminating. I guess when you've worked so hard to get where you are, the thought seems totally unfathomable. (Again, just speaking for myself!)

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  5. While we wouldn't terminate, we are doing the NT scan. I think one of the reasons is that we really want another glimpse and my OB isn't as accommodating or understanding about IF patients as yours! But, I'm all about being prepared. And, while I know the tests aren't infallible, I also feel like I'd like to have a better sense of what to expect.

    We will only do the CVS if there is ambiguity in the NT scan.

    Oh, and YAY for a good appointment and a sneak preview!

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  6. I'm pretty sure that I wouldn't terminate, unless there was a fatal condition that would cause the baby harm and suffering. But as far as the testing, I absolutely would get it. I would want to know every little thing about the little one in my belly. It would mean knowing if something was wrong for a long time before the birth, but I think it would help me prepare for what was coming. I have been OCD about infertility too, so its really just a personality thing for me :)

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  7. I wish you the best with your decision making on the additional tests - I know it is not an easy one to make. My OBs office did not offer the NT Scan (if it had, I would have gone forward with it) so I went forward with the Quad Screen. I knew that unless it was completely life threatening, that all we would do is educate ourselves more on the possibility of some situations. For me, it was the thought of knowing and being able to mentally prepare (even though the quad screen only gives odds and is not like an amnio which is more definitive.) I know you will make the right decision for you and your DH!!

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  8. We're doing the NT scan and will have an amnio if there is ambiguity. We're decided more on the preparation side of things since we wouldn't terminate.

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  9. We did testing when I was pregnant with the twins. For us, I think the positives for screening wasn't necessarily the termination aspect, but rather it was an opportunity for us to be prepared -- both mentally and in the physical senese -- should an issue have been there.

    I am a planner. I wanted to know whatever I could before the babies arrrived.

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  10. So happy to hear all is going well with you and the baby. I know the feeling you get when you hear that heartbeating.. it was the first time I cried.. it just made it all real to me!! I still love hearing it when I go for my visits! About the tests, I did do the NT scan at around 12 weeks just to check all looks good and then I had the option to do blood tests but my doctor was happy with what she saw on the scan so we didn't push for it either. We were not recommended any of the other tests as my doctor said the scan looked good and my age is still low (i am 29). I don't think I could have done any other tests if I knew that they could have posed any health risk to the baby though.

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  11. I don't know, because I'm not there yet, but one of the worst things about infertility for me is not knowing. I feel like I'm in a constant state of unknown and worry. Therefore, I *think* I'd get every test under the sun...but that's just me...and who knows what I'd actually do if I'm ever pregnant.
    Anyway, congrats on graduating to an OB!

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  12. Hmm, I don't know. I think that if you aren't going to terminate the pregnancy under any circumstances, then why risk the tests? I wouldn't.

    For me, I don't know what I would do. 12 weeks still seems like an unreachable goal...

    Finally, congratulations on your first OB trip! Sounds like things went well, and I agree that you should just listen to your OB's concerns and not try to google yourself into a frenzy about a bit of natural variation. :)

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  13. I didn't do anything except the normal morphology scans when I was up the duff with DD. Unknown to me, they still looked for Down's and I say my risk factor on a report after the ultrasound. So that was a bit weird. But yeah, I wouldn't have terminated. And I agree with Leslie. Why take those risks? take care

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  14. so glad to hear you had a good first OB appointment! One thing my RE said to me last appointment was that the risk of miscarrying with a CVS was greater than the risk of something being wrong. I still haven't fully researched this, but that might be something to consider. The later amnio test apparently has a much lower risk of miscarriage (although it's later and harder, perhaps, to make a decision to terminate then.)

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  15. I'm absolutely supportive of not doing the tests. Especially since, as I understand it, often all they can tell you is that your baby is a certain percentage chance of having certain things. Then you have to spend the rest of your pregnancy worrying about it. You might as well just wait and find out one way or the other. And if you're not going to terminate, then really, there's no point! And I'm glad to hear you had a good appointment and have a nice doctor!

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