More Math

I will be 40 when Boogie is born, so we need to do genetic testing. We decided on the quad screen and nuchal translucency instead of going directly to an amniocentesis, because of the chance of miscarriage. The quad screen is a blood test, and nuchal translucency a special ultrasound. In an amniocentesis, a needle is inserted into the placenta to get some of the amniotic fluid surrounding the fetus. There is a 1:340 chance of miscarriage if the amnio is performed at UCSF (the nationwide probability is 1:200, so all of us older mothers in the Bay Area are lucky). The difference is what the amnio is certain because you get cells from the baby, while the quad screen only gives you probabilities.

With my first trimester blood test, I screened negative for Down's and for Trisomy 18. Trisomy 18 is a different chromosomal disorder, where there are three copies of chromosome 18. Probability for Trisomy 18 was 1:11,000. So great. Probability for Down's was 1:220, somewhat better than the probability based on my age alone - 1:80.

We got lots of pictures of Boogie at the nuchal translucency ultrasound. And, the back of his neck measured 2.2 - 2.3 mm, which was in the desired range of 1-3 mm.

I have to wait until my second trimester blood test for an updated probability for Down's. Then we can make a final decision on the amnio. I do like certainty, so the amnio remains very appealing to me.

Boogie Baby Rocks On

We had our first regular OB/GYN appointment on Friday, Dr. Nick Rubashkin at St. Luke's. 11 weeks, 5 days. "Dr. Nick" was recommended by several folks on the Bernal Parents yahoo group (thank you), and immediately demonstrated the great bedside manner he had been recommended for. It seems they usually start the first OB/GYN appointment with a sit down discussion on care options, etc. I steered the conversation to my fears of missed miscarriage, given my experience last year. He proposed we change the appointment order to have the ultrasound first. Wonderful.

Ultrasound on the belly this time. And, there was boogie baby! Bouncing about and doing back stretches. Ben said he saw seven fingers moving around on one hand - evolutionary advantage for our little pianist or plate spinner?! I'm so relieved and happy.

Boogie measured somewhere around 12 weeks, very close to my pregnancy based on IVF date. My due date is mid-January.

After the ultrasound, we got back to care options. Dr. Rubashkin discussed the centering pregnancy program at St. Luke's. This is a program run by mid-wives where monthly check-ups are with a group of women due in the same month as I am. It incorporates additional prenatal training. I assume it's a way to keep costs down, and provide broader care, both of which I'm all for.

I'm conflicted about this. I always imagined I would be an earth mama, but having gone through a very medical/interventional process to get pregnant, I'm not comfortable moving away from the intervention. In fact, I had originally planned to go to Laurie Green at Pacific Women's partially because I had assumed that I would have a difficult pregnancy and likely requiring a C-section. I feel I have some variant of Münchausen syndrome, where it's not because of desire for attention but because I want someone checking every minute for a baby heartbeat.

My mother-in-law feels it's important I get happy and positive about my pregnancy instead of being anxious. And, she's right. I think my fear is coming from the fact that I told myself so many times during my last pregnancy that my family doesn't miscarry (not sure why I started framing my outcome based on what happened with my and Ben's moms). By the time that I got to my 13th week appointment, miscarrying was not a possibility I was considering. So I'm fearful of being surprised again, if I start wholeheartedly believing all will be well.

So the next few weeks will be interesting. My next appointment is five weeks away, after my genetic tests are completed (we'll do the integrated screen including NT ultrasound then decide on amniocentesis). Hopefully I can wrestle my anxiety to the ground and just enjoy boogie baby and my growing belly. And yes, the belly is growing...