Knock Me Up

Babies in the waiting room, women with bellies stretching against pleasantly pliant fabric, smiling nurses and aides in floral print scrubs. I felt like an intruder. Where is my solemn waiting room? Here, at the Columbia-Presbyterian Maternal Fetal Medicine group, pamphlets with cute baby faces prevail. At the fertility offices, intruders with babies were quietly whisked away to back rooms. But now I am pregnant. No need to be shy or protective. Here they act as if all will be well. The inverse of the thinking I’ve become accustomed to: all is treacherous; all is uncertain; all is risky.

I like my new doctor, but I’m suspicious of her lack of scrutiny. No ultrasound today? No, and I find out I might only have two or three during the entire pregnancy. But I’ve had three in 9 weeks! The fuzzy black and white images have reassured me, the fluttering heartbeat, so fragile and real.

Dr. L. asks me what I want to do about screening. No, she asks me if I want to screen. Of course, I say. What do you want to do, she asks? My god, I have to make a decision. Isn’t someone going to do this for me? She presents the options clearly, offering up an NT (nuchal translucency), a CVS and amnio. I’ll take all three, I think. She explains my options and only advises on the NT for now. It is the least invasive and the one we can perform next week.

I jump on a Monday appointment. The NT (or nuchal fold scan) can help assess the risk of Down syndrome, and hopefully some other chromosomal abnormalities. I think of that little neck in last weeks scan — amazed that it had even formed so early. It was more like a curve that connected the torso and head, that huge head.

Here’s a description of the test from www.babycenter.com:
“The NT test uses ultrasound to measure the clear (translucent) space in the tissue at the back of your developing baby’s neck. Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this clear space to be larger than average.”

Okay, seems simple enough. Non-invasive. No risk. Dr. L. says if the results look good, I may decide not to do further screening. If it looks so-so, I can do the amnio. If it looks poor, we go for the CVS. The CVS presents a higher risk of miscarriage, but if we think there is a problem it is better to find out sooner rather than later. This all seems like a bit of a crap shoot. I know I will want the amnio no matter what, but she is right to point out the NT may ease my mind for a few more weeks.

I ask her if she ever advises against an amnio. She says never.