Screening tests and birth defects
"We did the triple screen, which yielded funny results, so we worried about heart defects until week 18, when an ultrasound showed that everything was fine."
— Megan Keim, Vancouver, Wash., mother of Patrick, 11 months
Screening tests can be a double-edged sword: They often help put a woman's mind at ease if they show that her fetus is at low risk for having a disorder; on the flip side, they can cause unnecessary anxiety if they show an elevated risk. But it's important to keep this point in mind: A positive screening test doesn't mean that a child actually has a disorder. "Screening tests don't give a definitive answer," says clinical geneticist Karen Filkins, M.D., a retired OB-GYN in Marco Island, Fla., and a member of The Teratology Society. "Rather, they usually assess the risk—such as a 1-in-10 or 1-in-100 risk—of a fetus having a disorder."
If a woman's screening test is positive, she can then choose to undergo others, such as an ultrasound, or move on to a definitive diagnostic test, such as chorionic villus sampling or amniocentesis. While some women might be hesitant to do so because they feel that even if a disorder was detected they would not terminate a pregnancy, Filkins points out that termination is not the only possible outcome: "A woman might choose to continue the pregnancy and find support early on so that she's prepared to care for that child when it's born," she says. Still, it's important to keep the risk in perspective: "Most times the results of a diagnostic test will be perfectly normal, even if a screening is positive."
Reality check: "A full 97 percent of babies are born without a major defect," Filkins says.
Getting it all done
"During my second trimester, I started worrying about all the little details: registering for my shower, furnishing the nursery, making sure I had all the gear I needed before the baby came."
— Stacy Whitman
Sometime during pregnancy, many, if not most, women get struck with an almost irresistible urge to feather their nests. "There's a natural desire to get things ready for the baby," says Jennifer Shu, M.D., a pediatrician in Atlanta and a co-author of Heading Home With Your Newborn: From Birth to Reality (American Academy of Pediatrics). "Women are so excited that they want everything to be exactly the way they imagine it. They want it to be perfect."
Yet perfection is a mirage, as any seasoned mom will tell you. "I don't think it's possible to get everything done—there's always something else," Shu says. "Women should rest easy in knowing that they can't get it all done perfectly because there's no such thing. Just do what you can."
That said, you do need a few basics on hand when you bring your newborn home: an infant car seat, a safe place for the baby to sleep, diapering and feeding supplies and a basic layette. Convenience items, such as a baby bathtub and changing table, aren't crucial.
"You could just as easily change the baby on a bed, in the crib or on the floor and bathe him in the sink, as long as you're careful about it," Shu says. She also points out that you won't need certain items until the baby is older—a highchair and jogging stroller, for example.
Reality check: "Remember that your baby's health is what's important—not how pretty the nursery looks or whether everything matches," Shu says.