August 18, 2005
permalink The amnio

I had my amnio two weeks ago today. Got very stressed out the day before, but other than that I think the hardest part was all the ruminating and agonising that went into the decision about whether or not to have it.

Well... what can I say?

Phew. My friend asked me yesterday if I was relieved that the test showed no signs of Down syndrome or the other couple of major chromosomal abnormalities that are checked for using the FISH test. Yes, I am relieved. But it's as much because I did not have a miscarriage and lose a healthy baby as it is about not having a baby with Down syndrome.

The guy we had for the amnio was just exactly the sort of person you would have wanted for it. Calm. Softly spoken. Very professional. Very reassuring. Many, many years experience and a wealth of knowledge he was willing to share with us. Gentle sense of humour. There was no guarantees about who we would get so it was major luck to get this lovely man.

Usually a sonographer does the initial ultrasound where you get to have a good look at the baby, then hands over to the specialist doctor who does the actual (relatively fast) amnio procedure. The day we were there they were short on sonographers, so we got the knowledgeable doctor for the lot.

They used a 3D ultrasound, much spiffier than the one used at our usual hospital's ultrasound place. This pleased my geeky husband greatly. He adored the superior technology.

The doctor went through each part of the baby, explaining things to us, and said he was actually able to rule out many of the major abnormalities caued by diabetes, even at this 16 week stage. I didn't want to get my hopes up but couldn't help feeling reassured and incredibly pleased by this.

He found no markers for Down syndrome and said he didn't expect our baby would have it. When I talked to him about the fact that I'd had a dodgy looking first trimester blood screening, he said they take it with a grain of salt. So after this I really thought perhaps we shouldn't go through with the amnio after all. But was so glad the doctor didn't ask us what we wanted to do. He calmly moved onto the next step (which really was what I wanted him to do, we had come this far).

In terms of the amnio procedure he said his practice risk rate was 1 miscarriage in every 350 amnios. This was reassuring too given the quoted rate of 1:200. It was also closer to my estimated risk from the nuchal scan alone 1:397 which made me feel better about my decision to proceed.

The actual taking out of the amniotic fluid part of the visit was over with pretty quickly. First a local anaesthetic. I had said to my partner earlier in the day that I would throttle the person doing this if they said "you should be used to needles by now" before injecting me. And he said it! When will they stop saying this to diabetics?! Having a needle stuck into your abdomen before an amnio is completely different to a subcutaneous jab from your trusty insulin pen. Arg. Anyhow, luckily the guy was fabulous on all other fronts, and I was lying in a rather vulnerable position at that point, so no throttlilng occured :-)

When the actual amnio needle went in it was not the most pleasant experience in the world. Pressure. Twice. In it goes. eeerk. A couple of minutes. But then it's done. Phew! Relief! Apparently it had been as simple and straightforward an amnio as was possible and we would have to be very unlucky to lose a baby afterwards. My placenta was posterior meaning he did not have to go through it to do the procedure. There was no bruising of the uterus lining afterwards. Those were the things he mentioned.

I was told to take it easy for a day afterwards, although it was not necessary to lie down. My partner took the rest of the day and the next day off work and I did a lot of lying down. I had a fair bit of cramping that day (still mild I guess) and the next day a bit too. Didn't feel quite right for a couple of days. My ob told me when she rang with the "all clear so far" results to take it easy for a week as that is usually the time when a miscarriage will occur after amnio if it's going to occur. Still, I had to run around after my toddler, and probably pushed myself on a number of occasions.

Boy did I feel a sense of relief when I visited my ob a week later and she just about hugged me when I walked in. We did an ultrasound and listened to bub's heartbeat. All was well.

I am due to go back to the same place for my morphology screen at 20 weeks. Hope I get the same guy.

PS When I left the building where I'd had the amnio I was confronted with four placard-carrying anti-abortionists. Talk about confronting. I had to sit there near them while my partner walked to get the car and come back and get me. Felt very wierd.

I tried to engage with one of them, asking him about his placard. But he just stared ahead. Who did they think I was? The devil or something? I have no idea whether the place where they did terminations was the same place I'd had my ultrasound done. But I doubted it. There were many offices inside.

In some ways it was even refreshing, good, no neither of these are the words to describe it, but something, to see the protesters there. So much prenatal testing is timed to give women enough time to have a termination should they find something badly wrong and wish to terminate. But this is rarely spoken about or acknowledged to patients in my experience.

This pregnancy, just for my own knowledge, I had asked all sorts of questions of the genetic counsellor I had seen for my nuchal scan about terminations at various stages of pregnancy. I thought the decision to have a termination would be extremely painful for any woman no matter what the situation.

What I found was this: In the state where I lived terminations were legally carried out up to 20 weeks. Up to 14 weeks a surgical termination was carried out. After that, termination involved something akin to being induced and going through the birth process. After 20 weeks in some ethical circumstances, with proper documentation and representation, a later termination could be done. There was apparently one operator who came from interstate one day a week I think to perform them up to 24 weeks.

All quite awful for the people involved I imagine no matter what stage you were at. But so many complex factors would go into such a decision, I would hesitate to judge anyone else's actions.

When I said I imagined it would be easier for someone to have a termination before 14 weeks, the genetic counsellor said, you know, it had surprised her too, but she had never met anyone who had had one earlier that felt any better about it than anyone having one later.

Posted by M.A. at August 18, 2005 07:00 AM


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