Opting out of testing?

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Starryblue702's picture
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Opting out of testing?

Hey girls, I'm going to post about this is November as well, but I wanted to get as much feedback as possible. I'm considering opting out of any additional bloodwork testing for the remainder of my pregnancy. I think all that's left is the alpha/feta test (where they test for downs and spina bifida) and then the blood glucose test for gestational diabetes. I would have opted out of the first test also, where they test for HIV and all of that, if I would have thought about it... but I'm just now starting to do more research on it and I'm finding that more and more women are opting out of these tests that are optional anyway, but docs make them out to be like they're mandatory. My issues are, with the 1st test... I'm married and I'm 100% sure that DH and I are completely faithful, not to mention I've had that test with DD and everything was fine (like I knew it would be)... with the alpha one, there's no way that I would terminate this pregnancy (or any other) under any circumstances, so it wouldn't matter what the results might say, so what's the point. Plus, a lot of times they come back with a false positive (which it did with my DD!), and baby ends up being just fine! Same thing with the GD one... I've had three healthy babies and pregnancies, and don't have a history of diabetes anywhere in my family. When I took the test with DD the first one came back positive, so I had to go for the four hour one, which was not only inconvenient but very painful, as they draw blood from both arms twice! And as I figured, everything came back just fine! I just think it's a lot of hoop jumping for nothing, and even though I love my OB and their office, it's just a way to get more money out of you. I'm all for it if you have a history of one of these problems, or if I were a high risk pregnancy... but I just don't see the point. I'm not wanting this to be a debate, I just wanted to say that I'm thinking about it, and wanted to see if there were any other ladies on here that are planning on doing the same thing or have opted out in the past?[/

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Yeah, I'm kind of in the same line of thinking as you. I opted out of the HIV test for the same reasons as you. I don't know anything about the alpha-feto protein whatever it is, but we did choose not to do the nuchal fold scan or the quad screen or anything like that. I just personally see no reason to do those tests.

I am debating the GD screen. I myself have never had GD but there is a family history of diabetes and GD. But I have heard that the screen & testing is not always very accurate. Honestly I don't remember much about them, will have to read up on that stuff soon.

Other things.... I will choose to do the GBS test, but I also do a GBS prevention protocol starting around 32 weeks, so the likelihood of me being positive is small.

We don't do prophylactic eye ointment, no reason to. Still debating the Vitamin K shot, although I did it with my 2 previous kids. We'll see how the birth goes, that will likely help me make my decision.

And then there's the usual birth interventions that happen in hospital births that we choose not to do - continuous fetal monitoring, IV, pitocin upon delivery of the baby.

We prefer a pretty hands-off approach to prenatal care. If there's a reason for testing or whatever, that's fine, but some things have become routine when they don't really need to be, IMO.

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Nicole, I was thinking the same thing about the delivery. I really don't want an IV, but I know that I'll want an epi, and I keep reading that you have to have at least one liter of fluid in you via IV before they'll allow you to get the epi. I'm going to talk to my OB about that, but I really don't want an IV at all. I don't mind the fetal monitoring, but I've never heard about pitocin after delivery? Is that to get the placenta to come out faster?

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"Panonim" wrote:

We don't do prophylactic eye ointment, no reason to. Still debating the Vitamin K shot, although I did it with my 2 previous kids. We'll see how the birth goes, that will likely help me make my decision.

Can you explain these to me? I remember DS getting them but didn't know why. When DH asked about it I just said "I don't know, guess they need it for something"

On the OB testing...last time I opted out of the NT scan but this time I was eager to have an u/s to see the baby. My OB doesn't push any testing and I had to ask for the NT Scan myself. As far as the GD test, I definitely want that. I didn't have it last time but diabetes is prevalent in my family so I just want to be sure.

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I've seen the eye ointment on babies on TV before, but I don't think any of my babies ever had it. As far as the vitamin K shot, I'm assuming that's something they give to baby in the hospital?

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I had GD with my daughter so the diabetes testing was a must for me. As for the blood tests with down syndrome and spina bifida I could understand opting out of that. For me it doesn't matter one way or the other. This baby is coming. And given the fact that 90 some percent of the "positives" on the AFP are false positives I really don't want to sit and worry about something that given the odds really isn't going to happen.

As for the delivery I don't mind the fetal monitoring because I enjoy hearing the baby's heartbeat and such. It gives me peace of mind knowing baby is safe in there and tolerating the labor. I've never really given a second thought to the eye ointment and Vitamin K shot. To me it's just something they did. But kinda scary that as as parent I didn't even think to question "why are you doing this to my child?"

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Newborn infants routinely receive a vitamin K shot after birth in order to prevent (or slow) a rare problem of bleeding into the brain weeks after birth. Vitamin K promotes blood clotting. The fetus has low levels of vitamin K as well as other factors needed in clotting.

Found that info about the Vitamin K shot.

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"Starryblue702" wrote:

Nicole, I was thinking the same thing about the delivery. I really don't want an IV, but I know that I'll want an epi, and I keep reading that you have to have at least one liter of fluid in you via IV before they'll allow you to get the epi. I'm going to talk to my OB about that, but I really don't want an IV at all. I don't mind the fetal monitoring, but I've never heard about pitocin after delivery? Is that to get the placenta to come out faster?

Yep, that's right. I *think* it's routine in hospital vaginal births, but maybe not everywhere. They stick a shot of pitocin into your IV (so you might not even know it's happening) as soon as the baby comes out, to speed up the delivery of the placenta. (My DD was born in a hospital, and the nurse was kind enough to tell me that she would be putting the pitocin into my IV as soon as the baby's shoulders were born - otherwise I never would have known about it) Again, it's one of those things that's not really needed in most cases. Most women will have no problem delivering their placenta naturally, but hospitals tend to like to speed the process up.

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"Jenn0113" wrote:

Can you explain these to me? I remember DS getting them but didn't know why. When DH asked about it I just said "I don't know, guess they need it for something"

On the OB testing...last time I opted out of the NT scan but this time I was eager to have an u/s to see the baby. My OB doesn't push any testing and I had to ask for the NT Scan myself. As far as the GD test, I definitely want that. I didn't have it last time but diabetes is prevalent in my family so I just want to be sure.

The prophylactic eye ointment is routine for newborns to prevent blindness in case the mom has an STD infection. I *think* it's gonorrhea, but maybe it's syphilis also? They administer it routinely because they don't know who has an STD and who doesn't. But I know that I don't have any STDs, nor am I at risk for any, so it's unnecessary, IMO. You definitely have the right to refuse, but you might have to sign a waiver.

The Vitamin K - as you can see from the previous info, it's a clotting factor given routinely to newborns. Babies are born with low levels of Vitamin K, and I believe they naturally increase after the first week of life. I have heard, not sure how accurate this is, that this is why Jewish circumcisions are performed at 8 days old - because those babies will bleed and they need their clotting factors! If I had a baby who had some trauma or bruising from birth, or who was going to be circed, I would definitely do the Vit K shot. (Both my babies were bruised at birth, that's why we did it). If not, I might skip it. The problem is that there is a possibility of a link between the Vit K shot and childhood leukemia. :confused: I don't think it's been confirmed, but it was a possible link.

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I did the HIV testing because of my job.

I don't do any baby screening tests or bloodwork. I am keeping the baby no matter what. A test won't change that.

I will do the GD test. Depending on the population, 3-10% of mothers develop it. As many as half of women have no risk factors for it. I think its a good idea for all women. It's completely harmless. Untreated GD can be dangerous.

I also don't want pitocin. I do all my care with midwifes so the topic has never even come up.

Luke got the eye ointment. i wiped it off though after an hour. Again, its harmless, but a safe protocol. If it saves some babies from blindness and has no side effects I don't have a problem with it. I KNOW my child is not at risk, but a midwife/OB does not know that and they have the highest malpractice rate of any other area of medicine. I would want to be very careful too. You can sue your OB/midwife until your child reaches the age of 18. crazy!

Luke was circ'ed on day 2, he got the vitamin K shot.

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We aren't doing any genetic testing, unless our ultrasound shows something serious. We would talk about further testing then, but we wouldn't terminate anyway so I don't know if it's even worth doing anything. We declined all the blood work in the beginning...I just wanted to enjoy my pregnancy and not worry. Plus the HUGE rate of false positives really turned me off the idea of testing.

I did get the HIV test because it was lumped in with all the usual maternal health tests that I got right away. As for the vitamin K and eye stuff when baby is here...I dunno. I will check with my midwife to see if it is routine up here too, and ask about the risks...then we will decide. I think we will probably do it anyway to be safe.

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I did the nuchal scan, but mainly because I wanted the ultrasound. I have opted out of the bloodwork for spina bifida and cystic fibrosis and I will probably opt out of any other tests that I can. I was under the impression that the blood glucose test would be required, but if I can opt out, I will. That one scares me because I have cut most grains and sugar out of my diet to regulate my blood sugar and hormones, and I am a little scared of what drinking a big sugary beverage will do to me!

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I agree about all the tests. We had alot of health issues with our first and the ob talked about an aminocentsis and I flat out told him I would not be doing such a test. So many of them have to many false positive in addition I would not be terminating so rather just wait until delivery to know.

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I'm all for the testing it helps me to prepare or to get the best care if something should be off. As far as HIV test I am 99.99% positive DH has been faithful but I'd hate to be wrong and pass HIV to the baby and to not get treated myself. Plus there are others ways to contract HIV. And we may not know it.

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I went for it and was a little surprised how many times they pointed out the box to check if I wasn't willing to allow the blood samples to be used for research. If I'm having the blood drawn it seems to ridiculously selfish to say no to research! Anyway, yes, I went for the HIV test because that only makes sense to check occasionally, I had to get my blood type checked because that office needed it on record even though I already knew my type, and I went for the genetic screening just to have the info. I got back a 1 in 44,000 chance of Down's syndrome but was told they cannot analyze for the other abnormalities when it's multiples.

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Haha I just thought about the whole blood type thing. This is my 4th pregnancy with the same doctors office and everytime they've typed my blood. Does it change ever? I didnt think it did. Please someone correct me if i'm wrong. I'm sure its just standard prenatal blood work and they just group a bunch of stuff together.

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*Nov Lurker*

"Starryblue702" wrote:

I've seen the eye ointment on babies on TV before, but I don't think any of my babies ever had it. As far as the vitamin K shot, I'm assuming that's something they give to baby in the hospital?

As far as VitK shot, that was given because back in the 70s so many women were formula feeding instead of BFing and there wasn't substantial vitamin K in formual. From things I have read, if your diet is already rich in VitK and you are BFing and you continue to get enough VitK, your baby should be fine.

If you opt out, be sure that you monitor your baby closely for bruising and petechiae.

Hope this helps!

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"PAmom2boys" wrote:

Haha I just thought about the whole blood type thing. This is my 4th pregnancy with the same doctors office and everytime they've typed my blood. Does it change ever? I didnt think it did. Please someone correct me if i'm wrong. I'm sure its just standard prenatal blood work and they just group a bunch of stuff together.

I think it's pretty standard and no, your blood type doesn't change. I know they determined my blood type with the first round of bloodwork that they did at my initial visit. That is also when they did the HIV test. They didn't even ask me if I wanted it. They just told me that they needed me to have bloodwork done and they gave a brief list of things they would check for, HIV being one of them. I am assuming that's when they also check for beta levels to make sure your pregnancy is progressing as expected, so who's gonna say no to that? That's the only time I have had to have blood taken except for the finger prick with my nuchal scan.

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I just let them do all the tests (unless they would hurt my baby). I'd rather be safe then sorry and its not that invasive to me to have a little blood drawn or a swab taken.

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I was told that the HIV testing was mandatory along with the eye ointment after birth. I think that is just for my state though (NC).

I will be having all of the testing done that is offered. IMO knowledge is a good thing and I will take all the info I can get. I also am a little scared of GD because of the complications it can cause. For me, I feel like I could control it well if I knew I had it so its better to know to make sure I am giving the baby exactly what he/she needs!

I don't see any harm in the vitamin K shot.. besides just the prick on the baby. I would rather have a shot for the peace of mind than to risk something, although rare, from happening.

My nurse told me that they give pitocin after birth to help the uterus contract and shrink down. Honestly, at that point I didn't care because I had my handsome baby boy with me and everything was fine. Breastfeeding also helps with uterine contractions.

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If you don't want your baby to have the Vitamin K shot I believe they can give it orally instead. I think it takes two doses and I read you may need to discuss this with your doctor ahead of time so they can have the oral doses on hand.

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I don't even remember being asked if I wanted the HIV test but I do think I saw it on the blood test form - didn't know it was optional . We opted out of the screening blood tests and I don't think we get a NT scan unless the blood tests show high risk. The reason we opted out was (like others) the huge rate of false positives and a very poor experience my friend had. She had the blood tests (one at 12 wks and one at 20) and they showed increased risk (not sure what exactly). She then traveled to a larger town 4 hours away (nearest possible) to get the detailed ultrasound. That showed some sort of "soft marker" (again don't know the details). She opted out of the amnio for fears of miscarriage and not wanting to travel to said town again - she would keep the baby anyways. She then had to go on another 18 weeks worrying if something was wrong with the baby. She (and her husband) told me it was the single most miserable time of their lives. The baby was perfectly fine.

I would only go with all the up front testing if I was prepared to go all the way and do the amnio to find out for sure. And since I am not willing to do that I declined the upfront tests. I still get the usual anatomy scan at 19 weeks where they take a very detailed look at baby and measure everything. My doctor told me they can see down to the level of the retina in the eye!! So they will see anything structural such as holes in the heart etc.

Had I not seen my friend go through this I likely would have agreed to the tests. But it's very difficult to keep the concept of "odds" in mind (90% false positive) when dealing with something as emotional as the well being of your child.

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"Panonim" wrote:

The prophylactic eye ointment is routine for newborns to prevent blindness in case the mom has an STD infection. I *think* it's gonorrhea, but maybe it's syphilis also? They administer it routinely because they don't know who has an STD and who doesn't. But I know that I don't have any STDs, nor am I at risk for any, so it's unnecessary, IMO. You definitely have the right to refuse, but you might have to sign a waiver.

The Vitamin K - as you can see from the previous info, it's a clotting factor given routinely to newborns. Babies are born with low levels of Vitamin K, and I believe they naturally increase after the first week of life. I have heard, not sure how accurate this is, that this is why Jewish circumcisions are performed at 8 days old - because those babies will bleed and they need their clotting factors! If I had a baby who had some trauma or bruising from birth, or who was going to be circed, I would definitely do the Vit K shot. (Both my babies were bruised at birth, that's why we did it). If not, I might skip it. The problem is that there is a possibility of a link between the Vit K shot and childhood leukemia. :confused: I don't think it's been confirmed, but it was a possible link.

Hmmm, I'm going to google the ointment. I remember getting DS handed to me and I was kissing his face before I realized he had that on him.

I definitely want my LO to have the Vitamin K shot if this is what its for. 1. We have a blood clotting disorder in my family that I need to be tested for and I need my DS tested for. So anything to help that would be great. And if this LO is a boy he will be cird'd so he will need it.

Thanks for all the great info!

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"gaidinsgirl" wrote:

I just let them do all the tests (unless they would hurt my baby). I'd rather be safe then sorry and its not that invasive to me to have a little blood drawn or a swab taken.

I agree that it's not invasive... but to me if you're in a committed relationship (and not to put TMI out there about DH and I lol, but we've only been with each other and our first spouses!) so the initial blood test for HIV is silly to me. Obviously if you're sexually active or used to be with anyone other than the father, or you suspect that the father has "stepped out" on you, then it's a smart idea to just do the test. Better to be safe than sorry. As for the spina bifida/downs blood test and the GD test, again I don't mind doing them... but both tests came back positive with DD when in fact she was perfectly fine and I DIDN'T have GD (after sitting through the VERY invasive four hour test!)! For me it just caused a lot of unnecessary worry and heartache (and the doctor's office actually got money off of my pain!)... and I don't want to have to go through that again.

You all have a lot of valid points though! I will definitely opt out of the eye ointment if my hospital routinely puts it on baby, although like I said before I've never had it on any of my children, and they were all born at the same hospital (Trystan will also be delivered here), so I don't think it's something that they do. Maybe they check mom's blood tests, as I always give them a copy of my medical records at registration, and if she's negative for STD's then they don't bother. I don't think I'll opt out of the vitamin K shot though, as this baby is a boy and he will be getting circumcized. I didn't know about it before, so obviously all of my other babies got the shot, and they're just fine!

Anyone else know if hospitals force you to have an IV if you plan on having an epi? I read online on a couple of different websites that they require you to have at least 1 liter of fluid in you before you can have one. Plus, I really don't like the fact that they might give you pitocin at any point in your labor unless you need it, like being induced. I've heard that it makes contractions quite unbearable. I really have never had a "normal labor," as with DS#1 I had horrible back labor, which was excrutiating. With DS#2 I was induced (but had an epi) and the contractions were horrible, and with DD I was also induced (also had an epi)... but with #2 and 3 I duked it out with the pain as long as I could until I got the drugs. I'm really wondering what contractions feel like without back labor or pit?! I've also read that they can put the initial needle in your hand and just tape it down but not plug you up to any fluids... basically it's there just incase you need it, but until you do you don't have to be tied down to an IV?

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"Starryblue702" wrote:

I agree that it's not invasive... but to me if you're in a committed relationship (and not to put TMI out there about DH and I lol, but we've only been with each other and our first spouses!) so the initial blood test for HIV is silly to me. Obviously if you're sexually active or used to be with anyone other than the father, or you suspect that the father has "stepped out" on you, then it's a smart idea to just do the test. Better to be safe than sorry.

But, you don't only get HIV from sex. I mean, the chances are rare and all, but I can see why its important to check.

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"Starryblue702" wrote:

Anyone else know if hospitals force you to have an IV if you plan on having an epi?

I think you are almost guaranteed to have an IV if you get an epi. I have never heard of anyone having an epi without an IV. And I believe it's the fully hooked up IV, not just the hep lock. Heck, I think even moms who DON'T want the epi still have to fight tooth and nail to not have the IV.

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"Panonim" wrote:

I think you are almost guaranteed to have an IV if you get an epi. I have never heard of anyone having an epi without an IV. And I believe it's the fully hooked up IV, not just the hep lock. Heck, I think even moms who DON'T want the epi still have to fight tooth and nail to not have the IV.

This. That is one thing that I heard a lot about when I was doing a birth plan for DS's birth. You had to really be vocal about NO IV when you were going natural (no epi) and even then it was usually a fight.

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I had 20 minutes of monitoring with the machine initially but after that, I never had anything attached to me during my labour.

However, as far as I know, once you commit to an epi, you are more committed to an IV and monitoring.

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I'm fine with monitering... even if I wasn't getting an epi I wouldn't have a problem with them attaching a fetal moniter. It makes me feel better hearing baby's HB during labor anyway. I'm gonna talk to my OB on my next appt and see what she has to say about the IV situation. I know the hospital's website states that an IV is optional...

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So I just got off the phone with my OB office and they said that I could opt out of the alpha/feta test but not the GD one. I don't understand how they can force me to take a test that I don't want to take??

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"Starryblue702" wrote:

So I just got off the phone with my OB office and they said that I could opt out of the alpha/feta test but not the GD one. I don't understand how they can force me to take a test that I don't want to take??

I have heard that before from other people. They can't make you do the screening, but they can refuse you as a patient if you don't. They don't want the risks associated with undiagnosed GD. It can be really dangerous for the baby.

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I guess I can understand that, it's just frustrating...

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I understand the frustration. I hate it when people try to tell me I HAVE to do something I don't want to do. I guess it's a liability issue even if you are choosing to not do the test.

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Don't blame you at all for wanting out!

Personally I opted out of all the genetic testing. With DS they had us so upset and worked up going to the Perinatologist from week 7 until week 30 because of those test. I did not even enjoy being pregnant because all we heard was he "might" have downs, or another genetic disease and that his heart was abnormal. They even sent us to a genetic counselor and told us we may have to terminate. IT WAS HORRIBLE. And guess what? he was born 100% normal and healthy! They had me spend the majority of my pregnancy worrying and stressing because of the false positive.

With this pregnancy....nothing but bliss Smile I even told the ultrasound tech that if she sees something to keep it to herself! This is a much better pregnancy! Good luck!

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They do two tests for GD on base. A fasting level blood sugar at your first appt and then the regular 2 hour later. If you test high on the fasting you get put on 4 times a day finger pricks with a home monitor until you deliver. I've heard you if you refuse the GD test they do the same thing. If you really don't want the normal GD test and can handle doing your own finger pricks and monitoring for a few you days you could maybe ask your ob if they would consider something like that.

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"fireflies11" wrote:

Don't blame you at all for wanting out!

Personally I opted out of all the genetic testing. With DS they had us so upset and worked up going to the Perinatologist from week 7 until week 30 because of those test. I did not even enjoy being pregnant because all we heard was he "might" have downs, or another genetic disease and that his heart was abnormal. They even sent us to a genetic counselor and told us we may have to terminate. IT WAS HORRIBLE. And guess what? he was born 100% normal and healthy! They had me spend the majority of my pregnancy worrying and stressing because of the false positive.

With this pregnancy....nothing but bliss Smile I even told the ultrasound tech that if she sees something to keep it to herself! This is a much better pregnancy! Good luck!

That's terrible! I only had to go through it for about a week with DD because the test came back wrong on account of their screw up... they had the wrong due date for me! It was a nightmare, and for what??!! I was so upset! You should be able to sue or something for emotional distress... that's ridiculous what you went through! Well, at least I can opt out of the one test...