During your pregnancy you will be offered a number of prenatal tests for birth defects.

These tests include:

• Screening tests: First trimester screening (FTS) & Expanded AFP screening (XAFP)
• Diagnostic procedures: Amniocentesis and chorionic villus sampling (CVS).
  

All of these tests are optional, and are offered to all pregnant women regardless of their age.

For some pregnant women, none of these testing options feels like the right choice. You may choose to have no screening tests and no diagnostic procedures for birth defects if you wish.

As you think about your options for testing for birth defects, some important questions that you may want to consider and discuss with your prenatal provider include:

"If I had a prenatal test for birth defects, what would I do with the results of the test?"

Before having any test for birth defects, it is useful to think about how you would react to the results. For example, most women (up to 95%) who have a prenatal screening test receive "screen negative" results and are told that the chance for a problem is low enough that further testing may not be necessary.

However, a small number of women (about 5%) will have a "screen positive" test result, and are told that their baby has a higher than average chance of having a birth defect. Women with screen positive test results are offered further testing. This requires making more decisions, such as whether or not to have a diagnostic procedure like amniocentesis or CVS. Having a screen positive result and being told "Your baby may have a birth defect, but further tests are needed to know for certain" can leave some women feeling very anxious and distressed.

If you feel that you definitely do NOT want to have a diagnostic procedure under any circumstances, you may prefer to have no screening tests for birth defects.

"Would knowing my baby has a chromosome abnormality or other birth defect affect my decision to continue my pregnancy to term?"

Some birth defects can be treated after birth, but others are not curable. For example, chromosome abnormalities are lifelong and many are associated with mental retardation and physical defects. When serious birth defects are found prenatally, parents are usually told that they have a few options:

1) They may choose to continue the pregnancy, knowing their baby will have special needs or may not live a normal lifespan.

2) They may choose to end the pregnancy with a termination of pregnancy.

3) They may choose to continue the pregnancy and place the baby for adoption after birth.

For some women, learning that their baby has been diagnosed with a birth defect before birth is so upsetting, that it seems to ruin their enjoyment of the rest of their pregnancy. Rather than making them feel more prepared to welcome their baby, it simply makes them more anxious and distressed.

If, for personal, religious, or any other reasons you feel that learning that your baby has a birth defect would have no affect on your plans to continue your pregnancy and that it would not make you feel more well-prepared for your baby's birth, you may not want any prenatal testing for birth defects.

"If I choose to have no testing and no diagnostic procedures for birth defects, what should I keep in mind?"

Most babies are healthy, and it is likely that your baby does not have any birth defects. However, keep in mind that if you choose to decline all prenatal testing for birth defects, you will still learn about any birth defect that your baby has after the baby is born. Some birth defects are apparent at the time of birth, while others may take longer to recognize.

Occasionally, knowing that a baby has a birth defect during pregnancy helps the prenatal providers (doctors, nurse practitioners, nurse midwives) manage a pregnant woman's labor and delivery more effectively. This is something to discuss with your prenatal provider.

"What do I do now that I have made my decision to have no testing and no diagnostic procedures for birth defects during my pregnancy?"

Talk with your doctor, nurse practitioner, or nurse midwife as soon as you have made your decision.

Remember, making the choice about having a prenatal test for birth defects is entirely yours.

Back to: Prenatal Testing for Birth Defects: A Guide to Helping you Decide.