Is AFP testing right for me?

Just recently, my husband and I came around to that time again – AFP testing. A test we avoided during the first pregnancy, the old issues were revisited at 18 weeks. Should we or should we not have the alpha-fetoprotein (AFP) test?

This is a simple blood test that can give insight into the health of the unborn baby. Once blood is drawn, the protein is measured and this is then compared to a standard range for the current length of pregnancy. A low level of AFP could be an indicator that the unborn fetus has Down’s syndrome, and a high level could indicate a neural tube disorder such as spina bifida or anencephaly.

But are the results accurate? Dating of pregnancy could influence the results, as could the presence of twins. Of the one in thirty women who have a high level of AFP in their blood, the vast majority has a normal healthy baby. And it can happen that a woman who receives a normal result on this screening test can still have a child with a genetic abnormality.

To decide whether or not we would have this test, we had to look beyond the results. If my results suggested a problem with the baby, would I move to a riskier test such as amniocentesis? This test uses a long needle to extract amniotic fluid surrounding the fetus, and that fluid contains genetic material. An analysis of this genetic material will reveal with accuracy whether there is a genetic defect with the fetus. But, 1 to 2 % of women who have an amniocentesis will spontaneously abort the fetus, and that number varies depending on the skill level of the doctor or technician performing the procedure.

Then, if the amniocentesis showed a genetic abnormality, would I ever be able to consider the choices that would be offered? I knew in my heart that the answer was a strong ‘No’. After feeling the baby since 14 weeks, and my husband could feel movement at 18 weeks, there was a strong attachment, a clear bond that was solid. I firmly decided that amniocentesis was not an option. Any such procedure was far too invasive into the baby’s secure world.

That decided I once again had to assess my own personality. If I opted for the test and the results were questionable, would I stress and obsess and worry and pace trails in the floors until the baby was born? Knowing myself, I was certain that any news that was not positive would be on my mind constantly – even with the knowledge that chances are the baby is 100% fine. The fetus undoubtedly feels this level of stress and worry on the part of the mother-to-be, even though the effects of chronic stress are unclear.

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