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Please note: It is beyond the scope of this site to be able to give you all the information you need to know about all the tests that you are offered during pregnancy (please note I said "offered"--no one can force you to take these tests). I have, however, searched out some good links to information and resources, which you'll find at the end of this document.
Prenatal tests are tests that are done during pregnancy to detect problems that could effect the pregnancy or the baby. The tests fall into four basic categories:
A woman may have tests to detect problems with her body or problems with the baby. Screening tests differ from diagnostic tests in that screening tests are used to determine a relative risk for the condition in question. Screening tests are used to flag individuals who need further testing, by a diagnostic test, to confirm the presence or absence of the condition.
For example, many women are offered a blood test early in pregnancy to detect neural tube defects in the baby. This is the Maternal Alpha-Fetoprotein test--a screening test. It cannot tell you for sure that your baby has a defect, only that you need further testing. If the test came back positive, the test would be repeated to make sure it wasn't a mistake ("false positive"). If the test still is positive, you would be referred for a follow-up test, usually an ultrasound examination, that would be able to confirm if there was a problem. Please note, however, that both of these tests, like all other screening and diagnostic tests, can also come back negative when a problem really exists ("false negative").
Common screening tests include:
Diagnostic tests may include:
Well, the test can be wrong. For instance, even when they look at a baby's genes through amniocentesis they can still get the baby's sex wrong. Now that's pretty hard to mess up, but this is an imperfect and evolving science. So you can see how more confusion can occur with something that isn't as cut-and-dried.
Unfavorable test results can open you up to pressure to consent to treatment that you don't feel is in your family's best interest. If you don't believe in abortion or you don't feel you need to prepare yourself ahead of time for a disabled infant, why have the test? Obstetrics is a branch of medicine under a lot of pressure to "produce" a "perfect infant" every time. The thing is, we're dealing with living organisms, not tissue cultures, and sometimes things go awry. Let your priorities guide you as you make your decisions.
The tests themselves may carry some risks. For instance, amniocentesis and CVS have a 1-3% risk of causing a miscarriage. One couple in my class was in an age bracket where doctors usually recommend an amnio to rule out birth defects. After careful consideration, they turned the test down. They felt, since this might be their last chance to have a baby, that they couldn't accept the risk of the procedure. Their baby would be precious to them no matter what.
Some tests are of questionable value. Most women end up getting tested for anemia at about 28 weeks, but this timing often corresponds with a temporary but natural low red blood cell count that corrects itself in 2-3 weeks. Most women also get tested for gestational diabetes at this time, but gestational diabetes doesn't carry the risks that pre-existing diabetes does, and the test is done too late to be a useful screening for pre-existing diabetes. Furthermore, the worry and special care many women with gestational diabetes go through hasn't been shown to improve the health of the mothers or the babies!
Your personality affects your choice. Only you can make the decision. It's that simple. Ask yourself this question, "Will I actually do something with the information we get from this test?" If the answer is "no", you would probably choose to decline the test. The educated choice you make is the best one.
You may decide that in your situation some tests would be a waste of resources. In most cases, healthy moms will have healthy babies. Even with the tests some families are surprised during pregnancy or delivery. Every one worries about whether their baby will be all right, and it's such an intricate process that it's a wonder things don't go wrong more often. Again, it's your decision. Follow your heart.
Chances are, the results will come back OK. You'll be relieved. If it's not OK, you'll need support and information as you continue making decisions about your care. Think hard about your priorities and do what you feel is right for your family.
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