Conference moira::parenting_v3

    Lori,
    
    I haven't had an amnio myself (didn't with my first, and am only 3
    months along with the second) but a good friend of mine had one and her
    only comment about the whole procedure was the sound the needle
    "popping" through the layers of flesh and cartilage (between ribs if they
    have to go in from the side I guess) got her. She said she wished she
    had a walkman on!! Don't know if she was blowing it out of proportion
    either but Chris seems to have a high threshold (her second was
    delivered in her bedroom because the contractions weren't bad enough
    yet for her to go to the hospital and she would rather be at home then
    pacing in the hospital)
    
    Good luck with the up-coming event!! Congratulations! Are you starting
    your leave this week or are you already out? 
    
    Andrea                          

    I have not started my leave yet.  Believe it or not, I'm going to work
    right up until the day I go in to be induced or until June 27th, which
    ever comes first.
    
    Lori B.

    My amniocentesis was done at 16 weeks, so I don't have any experience
    with amnio late in pregnancy. As for the procedure itself, it wasn't 
    nearly as difficult as I'd expected.
    
    I was pretty nervous about having it done. It turned out to be less
    painful than a blood test. I felt a slight prickly sensation as the 
    needle went in, and felt muscles contract, but that was it. The
    hardest part was psychological - I felt squeamish thinking about
    the needle, couldn't look at it, closed my eyes and tried to 
    think of other things.
    
    I was advised to take it easy after the procedure, which I did.
    I never experienced any cramping or other problems.
    
    Pam
    

    Hi Lori,
    
    I was wondering about you. I thought you might be out by now. I
    have no amnio experience....I just didn't know your phone number,
    and you are leaving the same day that I am (transferring to the
    PTO office). Make sure you have someone put a message in letting
    us know if it's a boy or a girl, and how you are. I'll be reading
    this notesfile down in PA to!
    
    Dottie

    Hi Dottie,
    
    Thanks for thinking of me.  I'm still here!  If you need to reach me,
    I'm on DTN 251-1221 (call anytime, I'm always here!).  So far from all
    the ultrasounds I've had (I think it's 8 or 9 now!) we're pretty
    positive it's a boy.  My sister also works here at DEC so I've asked
    her to access all the notes files that I'm active in and put in a birth
    announcement for me.
    
    I'm glad to hear that you've found a new job, congratulations.  I don't
    know if I'll be coming back to DEC after the baby is born or not
    because I really need to find permanent work, but I may until I do find
    something.  I'll definately keep in touch though.
    
    Good luck in the PTO office.
    
    Lori B.
    announcem

    Lori,
    
    Like .3 I had an amnio at 16/17 weeks.  It was not too bad,
    a bit unpleasant but not painful.  I too felt a bit skeamish
    at the time and couldn't watch it being done, also it seemed 
    to take quite a long time to draw the fluid off - about 5
    minutes I think, when you need to keep still ( I found that
    quite hard!!).
    
    The worst part for me, was worrying about it beforehand, as
    we were not completely convinced we should be doing it.
    
    Afterwards I had some leaking of fluid and had to stay in
    bed for five days, but no cramps or pain of any sort.
    
    Hope it goes well, try not to worry, that's the worst bit!
    
    Good luck,
    Sarah

    Lori,
    
    Like many others I had one at 20 weeks.  My husband reallly
    got into it...I chose to stare at the wall or close my eyes
    as well (great opportunity to refresh my relaxation techniques
    before labor!).  The anticipation before AND afterwards, waiting
    for results was tough.  I had one or two very mild cramps, but
    I took their advice seriously.  Put my feet up and drank lots
    of liquids.
    
    My sister-in-law just called last night and she's having some
    scary complications.  Her Amnio was yesterday and she felt
    some sharper cramping.  So, I'm sure it depends on many factors.
    If you cramp and it is frightening and you find yourself thinking
    about it more than once or twice -- ease your mind and call the
    doc.  I'm sure you wouldn't need any additional concerns on 
    your mind.
    
    Best of luck -- I love that walkman idea!!!!
    
    Julia
         

    I too had an amnio done at 16 weeks.  I'm having twins, and they
    both occupy their own sacs, so I had to have both done sepparately.
    
    It was more uncomfortable than painful.  The first baby took awhile
    to get the fluid flowing because my uterus contracted so it took
    the Dr. some proding and needle moving to finally get the job done.
    I experienced no cramping with this one.
    
    The second baby took longer to determine the best entry point, but
    once the needle was placed, the fluid came out immediately.  I felt
    some fairly mild cramping during this proceedure, but was told that
    it was very normal.  The cramping did not last long after the whole
    thing was over.  I too took my Dr. advice and pampered myself for
    the rest of the day.  Took it easy.
    
    We were told by our genetic counselor that the results would be
    available anywhere from 10 days to 2 weeks.  Not long ago, last
    year in fact, the results wer'nt available until at least 4 to 5
    weeks!  2 weeks later the results were in.
    
    Hope this helps.  With todays advanced technology (ultrasounds etc.)
    the occurance of any problems from the proceedure are becoming fairly
    rare.
    
    Good luck.
    
    Cynthia
    
    

    Thanks everyone who have entered notes here.  I'm still a little
    apprehensive, but I think that's normal.  I have a doctors appt.
    tomorrow, so I'll ask her more when I see her (I talked to the nurse on
    Tuesday, not the doctor).  I was told though that the results would be
    back that afternoon because of the fact that I'm due in 3 weeks, they
    rush it along.
    
    I would still like to hear from anyone that has had the amnio done this
    far along in the pregnancy though.
    
    Thanks again,
    Lori B.

    I had one done at sixteen weeks, but that isn't what you need to know. 
    A friend of mine had one done during her eighth month for the same
    reason of determining how mature the baby's lungs were.  She was on
    medication for premature labor and they wanted to take her off it to
    allow the baby to be born.  From what she said it was pretty much the
    same as having one done earlier on.  Only difference was it is harder
    to find a place to insert the needle because the baby is so much larger
    obviously, and there is less amniotic fluid to access.  So like one of
    the previous notes said, you may have the needle inserted higher up
    than an earlier pregnancy,  or they may have a bit more trouble finding
    a place to insert it so it may take longer.  I know she mentioned them
    poking at the baby to try to get him to move over so they could do it
    :-). 
    
    Try not to worry.  It's hard when it's you but, they do these types of
    procedures all the time.  And the best of luck with your upcoming
    delivery!
    

    RE .8 and .9...
    
    Just to clairfy the time it takes for results....
    
    The length of time depends on what results are desired....
    
    For lung development, they check the level of lycocytes (sp?) in the
    amniotic fluid.  This test generally only takes a couple of days to get
    the results back.  If there are other complications, the mother can 
    be given steriods that will trigger faster lung development, thus
    giving a better chance of survival on a premie (38 weeks is premature, 
    but not a small premie).
    
    For genetic counseling, the results take a couple of weeks because
    cells from sample need to be cultured before they can be analyzed. 
    
    But, if quick results are required for genetic counseling, the Dr.
    may ask to do a "PUBS" (sorry, I don't know what the letters stand
    for).  This procedure is usually done in conjunction with the amnio.
    But here, they actually take blood out of the umbilical cord.  Genetic
    results are returned within a few days after the procedure.
    
    When my wife had a PUBS/Amnio about a year ago, the chances of 
    complications/miscarriage/early delivery were about 1/2 of 1%, and
    the pubs was more along the lines of 1% risk.
    
    Good luck!  The waiting is the hardest part!
    
    jeff
    

    I had it done when I was in my 37th week.  A c-section was planned and
    sue to some medical complications, the doctor wanted to insure (like
    yours) that the lung development was far enough along.  While I was
    very scared, I found the procedure to be very easy. I don't remember
    any pain or cramping.  The doctor did it while having an ultrasound
    (perhaps this is normal procedure--at the time I assumed so).  This
    made me feel better since one of my fears was that the doctor would
    stick the baby.  I remember that the needle was very long and that was
    frightening but again the procedure was fine for me.  My doctor also
    looked at the fluid and gave me an indication just by looking at the
    fluid that the lung development was probably good. The lab results came 
    back that same afternoon and I had the c-section the next morning.  
    All went well.   Best of luck to you.
    							Louise
    

I had one done in the 41st week.

It wasn't too bad; luckily it was unplanned and was preformed about 5
minutes after the doc decided it had to be done, so I didn't have time to
stress out about it.

I was given a local anesthetic first (novocaine I think).  That was just a
light prick, like any shot.  The actual amnio didn't hurt (didn't feel a
thing), but what was, um, uncomfortable was this:  because the baby is so
large at this point, the doc had to push him up toward my ribs to make sure
his head was not in the path of the needle.  He did this by pushing down
very hard on my lower abdomen.  It only lasted a second, though.

My test was done strictly to determine lung development.  The test results
were back in 4 hours.

In the meantime, though, the amnio started contractions (I guess somewhat
common).

Good luck, it's no big deal compared to the overall picture of what's
happening!


Marty

    I'm so glad to see that you are getting the type of response you were
    looking for. It must be aggravating to read through all of the "I had
    mine done at 16 weeks" when you specifically asked for amnios done
    later in the pregnancy.

    It looks like there are some success stories out there!! I hope that you
    can now relax and let the doctor do what has to be done.

    Best of luck on the rest of the pregnancy and the delivery. From what I
    have heard, once you see your baby for the first time, you don't even
    remember pain and agony.

    I have been very fortunate, as I am expecting my first baby in October
    and have not had any complications at all! 29 weeks and counting!

    Regards,
    Norma

    Like you, I had gestational diabetes (to the point that I had to give
    myself insulin injections), and my doctor wanted to perform an amnio in
    the 38th week of pregnancy to determine lung maturity.  After an
    exhaustive ultrasound examination, the (very experienced) doctor told
    me that he could not risk doing it because he could not find a spot
    where he could extract the fluid without going through the placenta --
    there were literally no pockets of fluid that were easy to get to!
    
    I was scheduled for a C-Section a few days later (because the baby was
    breech AND I had had several previous abdominal surgeries).  I asked if
    my doctor would go ahead as planned, and he said they would have to
    consult and decide.  When I reached my doctor he said that they both
    felt confident that it would be safe to go ahead as planned.
    
    The baby's lungs were NOT ready -- and although he weighed in at 7 lbs.
    9 ozs., he was 36 weeks old, and not 38.  Everything DID work out, but
    my husband and I are sure that if we were faced with this situation
    again that we would never allow the C-section to go ahead as scheduled
    without knowing the condition of his lungs.  In other words, we would
    have waited until I went into labor on my own.
    
    I'm sharing this with you only because I'm sure your anxious about the
    test itself, but you may want to consider how you'll want to proceed if
    they CAN'T do the test.
    
    My guy will be two on Wednesday of next week (July 18th) which is also
    my birthday -- maybe your guy will make his debut on the same day! 
    Best of luck to you and husband on this wonderful countdown ahead!
    
    Dale (who tried calling you yesterday)
    
    

    Gale,
    
    Thank you for sharing that with me.  I have ultra-sound and non-stress
    tests done twice a week.  As a matter of fact, I had one done this
    morning.  They showed me several large pockets of fluid, so I'm sure
    everything will go o.k.  I talked to the doctor regarding induction
    following the amnio and he said that as long as the lungs were mature
    (and he said he didn't see why they shouldn't be) they would definately
    induce the latter part of next week.  He did an internal and I was not
    dialated or effaced at all so he said that it may take a couple of
    inductions to get me to go into labor.  We'll see what happens.  I'm a
    little nervous, but not so much about the amnio procedure itself, I'm
    nervous about everything that's happening right now.
    
    Lori B.
    
    P.S.  I'll call you because I would like to talk more about this
    privately.

    Well, I had my Amnio done on Tuesday.  There was no pain as far as the
    insertion of the needle was concerned (and I didn't hear any popping
    either), but I did cramp up a bit and felt a bit light headed
    afterwards.  I called the hospital yesterday for the results and
    unfortunately, the lungs are still immature, so they're going to have
    to "re-tap" me next week.  Also, they say the baby is around 7 lbs. 11
    ozs. now.  I guess I'm going to have a large baby to say the least. :-( 
    I'm not looking forward to the delivery!!!
    
    Lori B.

    Hang in there, Lori.  My daughter's sitter is a very tiny woman
    and she gave birth to a 9lb. 10oz. boy and said "Piece o'Cake".
    I'm sure you'll do fine.
    
    - Kathryn
    

    Development of the lungs can be increased by you taking steroids.  Did
    you and your doctor discuss that as a means to insure that the next
    amnio is your last??
    
    jeff
    

    re: .19
    
    No, we haven't discussed steroids yet.  I don't really want to take
    them as I've heard terrible things about them.  The doctor said that
    the lungs could develop in just a couple of days, so we'll just wait
    and see.  I'm due in 13 days anyway, and I have a feeling that I'm
    going to go into labor before then (I've had severe contractions and
    haven't been feeling right in general).
    
    Lori B.

    Well, it's me again.  Just thought I'd add an adendum.  Like I said in
    the last reply, I've been having severe contractions and haven't been
    feeling right, well at approximately 1:15 this afternoon, I lost my
    mucus plug.  I wasn't sure right away what it was and just thought I
    was having a bad discharge.  I called the doctor and explained what it
    looked like and she said, "Yep, that's your mucus plug".  I thought for
    sure there would be blood, but there wasn't, just a yellowy colored
    phlegmy looking substance.  She told me to carry on at work (as long as
    I wasn't doing anything strenuous and absolutely no climbing stairs or
    lifting).  She also said it could be up to three weeks before I
    actually go into labor.  She said I was probably feeling a little
    scared because of the amnio results and I told her I was.  She said
    that I shouldn't worry because when there's a positive reading it's
    definately positive, but when the results come back as mine did,
    there's a 40% chance that it could be a false negative and that the
    lungs could very well be o.k. and if I were to go into labor tonight or
    within the next couple of days, I shouldn't worry, everything will be
    o.k.  I have an appointment to see her tomorrow anyway, so we'll see
    how things go.
    
    Lori B.

    I have amnio scheduled in 2 weeks and that will put me at about 14
    weeks of pregnancy.  Has anyone else had amnio this early? The last
    time I was pregnant I had it at 16 weeks.
    
    Anne

    I had my at 14 weeks also.  14 weeks is now the earliest that they can
    do all of the tests (chromosome, nural tube defects).  I was told that
    they can do them as early as 12 weeks but that test does not include
    the test for nural tube defects.  I opted for the 14 weeks so that I
    could have all of the tests completed at the same time.
    
    Congratulations and Good Luck,
    Debbie

    14 weeks was when I decided not to have the amnio when I was
    pregnant with David in '89.  
    
    I think the lab people prefer that you take it as early as you can
    in the "window" so that if the test fails for some reason, you can
    take another.
    
    --bonnie

    Help!!  I have to make up my mind on amnio or not within a week. 
    I'm worried sick and haven't been able to sleep thinking about the pros
    and cons.
    
    I suffered 4 yrs of infertility, including 2 failed IVF attempts among
    many disappointments, before conceiving on my own in October.  We were
    ecstatic, as you can imagine!  But now we must face reality, which is
    that I just turned 36, and they say the risk of the child having Downs
    is 1 in 200.  According to the doctors, the risk of miscarriage from
    the amnio procedure is about 1 in 300 to 400, so they think it's a
    pretty good risk.
    
    I know the decision can only rest with me, but I'm really torn between
    the tremendous fear of losing this hard-fought baby  and the dread of
    having a Downs child.  I know that as a personal decison, I would not
    keep the pregnancy if the test shows Downs (no opinions on this,
    please), but would be devastated if the amnio itself triggers a 
    miscarriage of a normal baby.  I fear also how long it would take for 
    me to conceive again.
    
    Has anyone reading this had the alpha fetoprotein blood test done? 
    What is your opinion on having that done first and then basing my decison
    of amnio or not on these reults?  I'm in my 13th week (fetus' 11th wk)
    so I gotta tell them ASAP what I'm going to do...
    
    It's really amazing, don't you think, that even in this day and age,
    they haven't developed a more sophisticated screening test for birth
    defects that would not harm the fetus.  It's tragic that for people
    like me who can least afford to lose the baby are the ones who must
    bear unacceptable risk.
    
    Any words of advice, opinion, knowledge, etc. would be greatly
    appreciated.  But please hurry, as I've wasted so much time agonizing
    over what to do, I haven't even had to courage to read PARENTING til
    tonight.
    
    Thanks so much.
    
    -Stella

    First of all, does AFP detect Down Syndrome?  I thought it was
    only for things like spina bifida.
    
    The AFP test has a very high false positive rate -- something like
    25% of the tests come back indicating a potential problem that
    then requires an amniocentesis to resolve.  Only a very small
    percentage of those positive results actually indicates a problem,
    though, and three-quarters of the time you get a clean bill of
    health. 
    
    So in your circumnances I would think it would be worth having the
    blood test first, if it does detect that problem, since that would
    increase the likelihood that you wouldn't need the amniocentesis. 
    
    --bonnie

    Really, the place to start when considering whether you want to go
    ahead with any of these tests is what are you going to do with the
    information once you have it?
    
    Basically it boils down to a question of wanting to terminate the
    pregnancy if it is a Downs baby.  If you don't want to terminate, then
    the only other question is do you want to know about the problem ahead of
    schedule "to be prepared" ?  I'm not sure how much being prepared
    really would help.  It might be better to talk to some Downs parents
    to get a better idea of whether you could cope in the unlikely event
    rather than just have an amnio.
    
    If you don't really need to know "to be prepared", and you cannot
    terminate then why bother with the tests.  The doctors seem to want
    to put a great deal of undu pressure on parents to go through this,
    quoting age as being the motivating factor.  It shouldn't be.  It
    should be YOUR wishes, and the doctors sure don't counsel you on
    this.
    
    My wife and I went through this twice, with pregnancies at age 34 and
    37 ... The one at 34, the procedure was recommended but only if we
    wanted to.  The second, it was a different matter.  We went for so
    called genetic screening, where a family tree was done, and we went
    back several generations, and sideways several generations.  The
    counsellor indicated that the only risk was age alone, and that some
    of the risk numbers often bandied about due to "age" did not take into
    account other genetics.  Anyway, the elaborate multi-page chart was
    then passed to the doctor, who looked only at the first page, which
    contained only the details of my wife and the pregnancy dates.  He
    read her age, and said 36 nearly 37, OK, when do we book your amnio.
    He made NO reference to the screening done before asking that.  We
    booked a tentative date ... went home and talked about it.  
    
    We decided that the risk of miscarriage quoted from the procedure at 
    1 in 200 matched the numbers of the risk of Downs.  The risk of Downs at 
    this stage was sufficiently low and the comparative risk of miscarriage
    sufficiently high that we had our doubts.  We talked about what we'd
    do with a Downs baby and decided that we wouldn't be happy about
    termination.  So, we told the Dr. to take a hike.  Spoke to our own GP,
    who agreed with our logic.  In the end all the fuss was for nothing
    because we had a beautiful healthy daughter.
    
    Please don't get the idea that I'm against the procedure because I am
    anti-abortion ... I just did not see Downs as sufficient grounds for
    it in our own circumstances.
    
    A difficult decision ... but make sure you're deciding the right thing
    and not the other red herrings that get thrown up in the smoke screen
    of modern medicine.  Once you can make the fundamental decisions, then
    the rest becomes much easier.
    
    Good luck ...
    
    Stuart

Stella, I'll throw in my two cents because I kind of know what you're
going through.  I was pregnant in 1989 and was 36.  I elected to have
CVS (Chorionic Villus Sampling, may have spelled it a little wrong)
because I also felt I would terminate a pregnancy had it shown that
I was carrying a Down's child.  I chose CVS over amnio because it can
be done much earlier and the preliminary results are available in 
about 2 days.  The risk, however, is about 1 in 100 of miscarriage.

I did end up miscarrying that baby.

I am now 37, two days past my due date, and I chose NOT to have either
CVS or amnio this time.  I can't put it in words, but my perspective
changed.  Yes, I'm terribly terribly frightened that this baby will be
a Down's child and that I will not be able to cope.  Sure, I won't know
until I get there, but it scares the hell out of me.  On the other hand,
I did make a choice.

This probably doesn't really help, but it's what I did.

Liz

    Just as a few extra thoughts ...
    
    We looked at the risk of Downs, and we thought about all the hundred
    and one other things that can result in a physically or mentally
    handicapped child, or other undetectable problems.  We came to the
    conclusion that there were enough other potentially "how will we
    cope" problems with similar enough probabilities that Downs didn't
    seem so scary after all.
    
    Most Downs children that we have come across haven't been so frightful.
    I think maybe the worst part is thinking you haven't made something
    perfect, and that others will usually instantly see it, and also
    knowing that the child's life will be significantly shortened is a
    painful thought.  I get the impression the problem may be more a
    matter of coping with ourselves rather than coping with a Downs child.
    
    Stuart

    Re: To amnio or not  .25
    
    Thank you all for the kind advice thru Notes & E-mail.  I have made up
    my mind to have it done, to take the risk, as I know I wouldn't be able
    to stand not knowing for another 6 months.  I sure hope it's the right
    decision.  Will have it done this wk or next.  Will report on results.
    
    Thanks again for your hel
    
    -Stella
    

    re: .30
    
    Good luck, Stella.  We'll all be pulling for you.
    
    hugs,
    --bonnie

    
    Stella,
    I've had 2 amneo's--one when I was pregnant with Hannah (at age 33),
    and now again, at age 37.  I didn't think much about miscarrying when I
    had the 1st amneo--it just wasn't a fear at that time.
    
    However, having had 2 miscarriages inbetween Hannah and this
    pregnancy--you bet I thought about it.  I decided however that the risk
    was worth the information--and so I went ahead with the amneo.  Of
    course, everything is fine and I'm glad I did it.
    
    I well understand your concern about miscarrying--but don't drive
    yourself nuts worrying.  The entire amneo is very quick and relatively
    painless.  I asked my doctor how many women have miscarried after
    amneo's that he's done--and the answer is 0!  And he does at least 1 or
    2 (if not more) a week.  Perhaps it would put your mind at ease if you
    asked the doctor doing your amneo how many woman have miscarried as a
    result of his/her amneo.  I'm sure you'll be surprised (and relieved)
    at the low numbers.
    
    Good luck.  I'm sure everything will go perfectly fine.  And
    congratulations!
    
    Bonnie
    
    

    Re:  .25
    Hey, everybody!  I did it!  Survived the amnio and the results came
    back normal!!
    
    Thank you all for your kind support.  It really went a long way in
    terms of setting my mind more at ease beforee going ahead with the
    fearful procedure.  Making up my mind and then waiting for that fateful
    day was definitely the worst part, altho the needle going in itself was
    pretty painful.  Luckily it was brief.
    
    Good luck to those of you thinking of having it done.
    
    And thanks again!
    
    -Stella 

    I'm expecting my first in August and asked the Dr. to have an amnio
    performed as my mother died in childbirth with me (cause unknown) and I
    subsequently don't know my medical background (all signs are normal to
    this point).
    
    The question I have is - do you need to take any more time off work
    than just the day of the amnio (scheduled for Feb 11th).  Certainly if
    you have cramping or bleeding.  I just want to let the boss know...
    I'd ask the Dr. but notes is easier.
    
    Thanks - Kath

    re: .34
    
    I had an amnio in the morning and was back to work that afternoon.
    
    Lori B.

    No need to take off any more time.  Even when we had some minor
    complications during my last amnio I went back to work that afternoon.
    
    I don't have time to re-read what's in here, but the procedure was
    pretty simple .... get changed, ultra-sound goop all over your belly,
    they locate the baby, then clean off part of your belly, dump betadine
    all over it, inject xylocaine (MAN does that _STING_!) to numb up your
    belly, wait a few minutes, then insert the needle.  The only thing I
    felt from the amnio needle was pressure, and I watched the ultra-sound
    screen as they inserted it.  Once it's in the fluid, they screw on the
    syringe part to the needle, pull out the fluid, unscrew the syringe,
    pull out the needle, wipe you off and check for any 'leaks' or
    problems.  Then you're done.  In my last one there was some blood
    leaking into the fluid, so we decided we'd do the C.section the next
    day instead of when it was scheduled (5 days later).  I had 2 amnios
    for the 1st preg., and this 1 for my 2nd ... all 3 were done the same.
    
    Definitely the worst part is the shot of xylocaine.  The next worst
    part was the last time when I caught sight of the needle (It's pretty
    long to fit through all that belly!)
    

    I hope the Doctor explains EXACTLY why he wants to do an amnio ...
    What is he looking for medically ?  The usual purpose of the amnio
    is detection of Downs Syndrome and other neural tube defects (like
    Spina Bifida), from which the parents to be would decide whether
    they want to terminalte the pregnancy.  I have never heard of other
    uses for the amnio such as you described.  It sounds to me like the
    amnio has become a fashionable procedure with poor justification in
    many cases ... and thus a way to earn money and avoid malpractice
    suits.
    
    If I were a woman and faced with this procedure, I'm quite sure that
    I'd tell the Doctor to take a hike, unless there was something very
    specific in my family history that I definitely wanted to avoid.
    
    Stuart
    
    Stuart

    re: .37
    
    Are you referring to .34?   If so, I read it to say that the noter
    *requested* the amnio because she is unsure of her medical 
    background (whatever that means).   So, don't know how that would
    qualify as a "dr trying to avoid potential malpractice suit".
    
    carol

    reply to .37
    
    Stuart, *I* asked the Dr. to perform the amnio - he never approached me
    with the suggestion.  Re-read my note if you must, but I don't know my
    medical background or if any genetic diseases run in my family
    history.  I would like to anticipate any problems AND I want 
    to know if I am carrying a Down
    syndrome's child.  I know Down more often happens to children who are born
    to women over 35 but I know of someone who had Down's whose mother was
    only 28.  
    
    Just thought I'd clarify.  I have great trust in this Dr. and feel he
    would have talked me out of it otherwise.  In this generation, we are
    extremely fortunate to have the technology that can help us and I
    intend to take advantage of it.
    
    

I misread .34 the same way Stuart did -- thanks for clarifying.  That
makes a lot more sense.

There is a popular misconception that because Down Syndrome is more
common in older women, that younger women don't have to worry about 
it, so if you are worried about it, then taking steps to find out
is sensible.  

--bonnie

    	I have put several replies in regarding the age of mother's and 
    Down Syndrome.  
    	I was only 29 when Shayne was born with DS and in the past year, of 
    10 babies born in our city with Down Syndrome, only 1 mother was over
    the age of 30.  I do believe someone brought it to our attention, that
    since more mother's are younger the occurence of DS is higher.......
    
    FWIW

    Stuart,
    
    Another reason for amnio (which was why I had all 3 of mine), is to be
    able to determine how developed the baby's lungs are to determine when
    the baby should be delivered in a planned early delivery.  If the lungs
    are not developed enough for the baby to breathe on their on,
    complications can be severe.  
    
    Perhaps I've missed something, but an amnio does _not_ seem like a
    dangerous procedure to me.  A bit uncomfortable, but for the comfort of
    being able to gain more information about the well-being of your baby,
    it's well worth it.  I suppose - like anything - if someone incompetent
    does it, there could be problems.  I think it's **GREAT** that they can
    provide us with more information to help us make better decisions.
    
    

>    Perhaps I've missed something, but an amnio does _not_ seem like a
>    dangerous procedure to me.  A bit uncomfortable, but for the comfort of

I've heard figures suggesting a miscarriage rate of anywhere from 0.5% to 2%
in consequence of amniocentesis.  These are average rates, of course; some
doctors presumably have better rates, and therefore, to make up the average,
some doctors must do worse.

	-Neil

We were quoted similar miscarriage rates.  My wife was 38 with our last child
and the rates quoted for Downs at that age was very similar.  The ob wanted
to do an amnio.  When asked why ... "to provide you with info in case of
Downs or other similar defects".  Medical reasons to assist in the pregnancy
"none really".  So our concern was "why do it".  Sure, it's not a terribly
risky procedure, but it did have some risk, and we were more concerned about
not losing the child (which at 38 was more important to us than the risk of
Downs) and when younger it would have mattered even more.

So, what it boiled down to was what was more important to us.  If there were
non-invasive procedures, with a lower risk, then the story would be different.
I've become a great supporter as I grow older of "If it ain't broke, don't
fix it", and invasive procedures fit this category.

I do react quite strongly to the medical profession using procedues when I
question the benefits.  If mortality rates were to show significant declines
because of these procedures, I'd be quite happy, but there is no strong
evidence that amnio has done anything to help.

Stuart

    
    Stuart,
    As stated earlier, amneo does have many benefits.  First, if a couple 
    would abort a downs, spina-bifida, or tay-sachs fetus, then the benefit
    to the amneo would be in knowing whether or not to abort.
    
    Secondly, amneo is frequently used for women scheduled to have early
    c-sections.  The doctor needs to make sure the baby's lungs are fully
    developed before performing the surgery.  A neighbor of mine was 
    scheduled for a c-section just a week before her due date.  Sure
    enough, an amneo was performed and as it turned out, the lungs weren't
    fully developed.  Hence, the procedure was postponed for a week.
    
    As far as questions regarding amneo's are concerned--I've had 2 of them
    (4 actually--since my doctor had to go in 3 times with the 2nd amneo in
    order to get fluid).  My doctor has NEVER done an amneo that resulted
    in a miscarriage--so it's important to find out your doctor's track
    record.  In my case, I didn't consider the amneo to be any risk at
    all---and I'm prone to miscarriage.
    
    My 1st amneo was a breeze--I felt fine afterwords and don't remember
    any pain at all.  My 2nd amneo (the one where my doctor had to go in
    3 times) was a bit of a drag--but I don't remember the needle itself
    being painful at all.  What I do remember is having some cramping for 
    about 24 hours afterword--but my doctor had to go thru membrane in
    order to get fluid--so that might have something to do with it.
    
    Honestly, I don't remember any kind of "numbing" procedure
    beforehand--and the needle wasn't a big deal.
    
    Bonnie
    
    PS
    Most physicians WON'T perform an amneo as a routine procedure unless
    there is a medical reason for it (ie: early c-section).  If a woman is
    over 35, the procedure is suggested and if the woman declines the
    procedure, she may have to sign some kind of waiver releasing the
    doctor from liability should she have a downs, etc. baby.  I know that
    with my 1st child, I had to argue with my doctor to get him to do an
    amneo (he was concerned that my insurance wouldn't pay for it since I
    was only 33)--but this time, he suggested it (I'm now over 35).
    
    Also, the doctor's fee for performing an amneo is not that much--maybe
    $200-300 depending where you live.  The bulk of the cost lies in the
    hospital fees.  My doctor offered to waive his fee with my 1st amneo
    (when he wasn't sure if the insurance company would pay for it)--but
    couldn't waive the hospital fees (for ultrasound, lab work, etc.).  As
    I recall, the cost, excluding doctors fees, would have been around
    $800--which we were more than willing to pay.  As it turned out, our
    insurance covered the procedure without a blink--so the issue was moot
    anyway.
    
    Bonnie
    
    

    re: .44
    
    A neighbor of mine was feeling very similar to you on this issue,
    basically, why do it?
    
    Anyway she decided to do it because she found out that if detected
    early, spina bifida can be dealt with at birth.  I'm not sure of
    exactly what is done, something about dealing with the problem very
    early is better for the child.  Anyway, a pediatrician can be alerted
    to the problem and ready to handle it right after the baby's born.
    
    That information swayed my neighber to have an amnio.
    
    Diana

    Seems I'm digging myself into a deeper hole here with every attempt
    to clarify my thoughts ...
    
    Amnio does definitely have its uses ...  If, for example, we had
    family histories of problems detectable by amnio which altered the
    risks above the risks of the amnio ... If my wife had been older ...
    (there are a number of other more personal ifs too) ... our attitude
    to the amnio would have been a little different ...  The idea of
    a Downs baby wasn't that terrifying to us, and most of the other
    problems detectable ususally show in family histories.  If the chances
    of a Downs baby had been higher, we'd have probably thought
    differently.
    
    The last two of our children were in fact taken 1-2 weeks early by
    C/S, the first about 1 week over, by C/S.  There was never a question
    about lung formation even suggested when planning the early C/S.  It
    was considered important that my wife not go into labour because of
    the shape of her pelvic opening (and our kids big heads!).
    
    The use of the procedure seems just a little too routine for comfort
    is all I'm trying to say.  It would seem that my comments about fees
    were a little off base, but I'd stand by my comment about the procedure
    being used to avoid malpractice suits ...  the mention of the release
    being evidence of that.  After all, it sure isn't the Doctors fault!
    
    Like so many procedures, there are "fashions".  Routine tonsilectomies
    are rare now; the number of C-Sections in some areas is starting to
    drop after reaching record numbers for a number of reasons.  A lot of
    Doctors seem to be recommending amios to women before the woman has
    really had a chance to think about what she'd do with the results if
    she had them.
    
    It's a tough call ... we spent several nights agonizing over deciding
    what we'd do in case of a defect was detected based on the risks.  It's
    an individual call too.  I'm not telling anyone DON'T what ever you
    do, submit to amnio, but I am saying don't let anyone tell you to have one
    blindly; know the risks; know what you'll do with the results if you do
    have one.
    
    Now, I HOPE I've finally expressed what I've been trying to say more
    clearly and not be misconstrued as MD bashing, or as having a definite
    stand on the abortion issue.  We question many, many seemingly low
    risk medical tests, but this one does seem to escape the same scrutiny.
    
    Stuart

    re .46
    
    Other than Downs, the other detectable defects, we were told during our
    genetic counselling, definitely tend to be hereditary.  The incidence
    of these genetic defects occuring spontaneously is very small.
    
    Downs, on the other hand, has a much lower hereditary component, and
    spontaneous occrance accounted for the majority of cases.
    
    We had no family history of problems other than far-sightedness, and
    even that was rare.  So, for us our only real concern was Downs.
    (Believe it or not, even hereditary allergies is 99% a non-issue for
    us ... lucky eh ?)
    
    If we'd had a family history of problems, then our approach would have
    been very different.
    
    Stuart
    
    ps  re my own .44
    
>question the benefits.  If mortality rates were to show significant declines
>because of these procedures, I'd be quite happy, but there is no strong
>evidence that amnio has done anything to help.

    Please don't read this to mean amnio is useless ... What I'm trying to
    say is that if an amnio did improve mortality rates, then I'd be far
    happier with it as a more routine type test.

At least some genetic diseases can be detected by a simple blood test of
one or both parents.  Since my wife and I are both at risk for Tay-Sachs,
one of us had a blood test before we were married.

    I had an amnio about three weeks ago (at about 16 weeks). Unlike
    some other noters, I did not have any local anesthetic. I didn't
    find the needle to be that painful. I did have some cramping for
    24 hours afterwards, but I took it easy as suggested and that helped.
    
    The doctor doing the procedure explained that the needle is only
    in for a few seconds. They find the place they want to insert it
    using ultrasound, then insert it, immediately following it with a
    tiny "straw" through which the fluid will be drawn. As soon as the
    straw is inserted (which I felt as sort of a pop), they withdraw the
    needle, and leave the straw in for the 30 seconds or so it takes to 
    get enough amniotic fluid. This minimizes the chance of the baby
    coming in contact with the needle. If the baby touches the straw, 
    no harm done, they say. In fact, they said they've had cases where
    the baby grabs the straw with its hand for a few seconds! Wonder
    what that feels like!? 
    
    Lucy
    

 
    Back to work after 5 months off with Mackenzie and getting caught up on
    notes ;-)

    .50 brought a smile to my face and warm memories (as I am still
    breastfeeding, my let down started  too ;-)

    I had my amnio at 16 weeks and refused to look at the size of the
    needle. Friends had warned me that I would get too scared if I saw its
    size so I just kept my eyes on the ultrasound screen. This was great -
    it was the first time I got to see my baby on the little screen. I saw
    her moving around, could even count her toes too. They found a pocket
    of fluid  away  from this active baby , I felt a pinch, (I don't
    remember any unpleasantness ) and then could see the needle on the
    screen. We ended up laughing alot (although it probably wasn't funny)
    cause out of no where this tiny hand appears on the screen *swatting*
    at the needle. They had to bend and manipulate the needle in me to keep
    it away from the baby (this I do remember as painful). The doctor was
    joking about my childs activity level (most babies pull back from
    anything inserted into the womb) and I had visions of giving birth to a
    little terror. Everything went fine and my doctor was successful at not
    touching the baby (although she kept swatting the entire few
    minutes....

    She is just as active outside the womb as inside!! She was 6 months old
    yesterday and trying still to touch and grab everything in her sight.
    She is also constantly babbling and singing and screeching but *rarely*
    cries. She is the joy of my life.

    One last thing...waiting for results was the hardest part. The test was
    easy.

    Take care!

    Dena

    .51
    
    Great story - that must have been a riot, seeing that tiny hand
    reaching out. I believe they use a small blunt tube (not a hollow
    needle) to withdraw the fluid, so even if she had gotten hold of it, it
    wouldn't have hurt her. It might have hurt you, though! 
    
    I say this so others who read this won't worry (as I did, about
    everything...) 
    
    Lucy

    
    Hi! I know .50 had no painkillers. For how many other of you
    was that true. I just found out my doctor doesn't use any
    either on the grounds that it doesn't hurt any more  than
    the painkiller needle would.?
    
    I know you said not to worry but it is hard..
    
    Suz

    I've seen my wife get several amnios.  She was nervous, and it's
    not painless, but it's not very painful.  The doctors are right--if
    they stuck a needle in you so you wouldn't feel them sticking another
    needle in you, there'd be no gain.
    
    The hard part is waiting for the results...
    
    		-John Bishop

I had no anesthetic.  It hurt some, but not as bad as labor; it was definitely
shorter than labor.

    
    Well it is over. AND like most of you said it wasn't painful.
    (I didn't have any painkillers) It felt like any other shot
    - a short prick and then another when he pulled it out.
    I really didn't feel anything much while it was in.
    
    The whole procedure which was mostly sonogram, was all of
    20 minutes all told. The needle part was short 25 seconds?
    
    So far (this is next day) I have had no problems, no cramps
    etc...
    
    For those of you who are going to go thru it I will repeat
    what all the others have said - Try not to worry......
    (I know easier said than done!)
    
    Good luck
    
    

    I decided to check this note out after having an amnio this week 
    because of a low AFP count and the somewhat surprising reactions of
    my and my husband's family members (I won't get into that but it
    strange to me that there was quite a broad spectrum of opinions in
    each family).
    
    Anyway, our decision to have the amnio done has not been covered but
    to me was important. The normal risk of having a child with Down's 
    for a woman in my age group (30) is 1/720. Because of the AFP results
    my risk increased to 1/160. The risk of miscarriage, as stated earlier,
    was something like 1/300 to 1/500. Our decision to have the amnio was
    based on the need to plan for a handicapped child. Things like would I
    go back to work, full time, part time, any special day care
    requirements, learning programs, etc. and you get the idea.
    
    The Dr. who did the amnio for me specialized in genetics and birth
    defects. For him, screening tests like the AFP help to locate more
    women at risk. As stated earlier a majority of the Down's babies are
    born to women under the age of 35. The AFP screening test can detect
    50-60% of Down's.
    
    As an aside, when we were receiving our counseling, the nurse asked if
    we wanted to know the sex. When we said no, she warned us to tell the
    OB's office. She said they will put that in our file but it could slip.
    This made me believe we were in the minority about not wanting to know
    the sex. So I'm just curious if anyone else felt as we did even though
    it was 100%-98.5% accurate and under your OB's nose.
    
    Jan

    For our first child, we asked to be told.  After he was born,
    my wife expressed feeling that she'd missed something, so for
    our second we asked not to be told.  In retrospect, I'm glad
    we didn't know--it added to the excitement and suspense of 
    the birth.  I also liked partaking of tradition to the extent
    of the doctor's saying "It's a girl", rather than "Here he is".
    
    Your mileage may vary, of course.
    
    		-John Bishop

    We never expressed a preference either way. In our case the results
    came to the nurse after my visit with the doctor.  What the nurse said
    to me was if I wanted her to tell me the results.  My response was, if
    it's good news go ahead and tell me, if it's abnormal I'd like to speak
    to the doctor.  So the nurse goes ahead and blurts out,"it's a male and
    it's healthy!".  I was reduced to tears of joy, the same kind of joy
    you feel when you give birth and the doctor announces "it's a boy".  I
    literally ran to the closest phone, in the hall just outside his
    office, to call my husband at work to tell him he's having a son!
    
    For us it was a kind of bonding, we knew it was a HE, and HE was
    healthy and that HIS name was AJ!  For me it was better, since I had to
    have general anesthesia for delivery, at least at they put me under I
    knew what I was having at least.  
    
    The delivery was funny, according to my husband.  The doctor looked at
    my husband a little worried, as AJ was being delivered and asked him
    "what did I say the baby's sex was?", my husband replied it's a boy,
    and the OB seemed relieved, he was afraid there had been a mistake.
    
    The other good thing was that because he was born so close after
    Christmas, it gave people the opportunity, like my wonderfully generous
    mother inlaw, to go buy little boy-blue outfits.  By the time I got
    home from the hospital he had a rack full of boy outfits, thanks to a
    doting grandma who had bought all these things in her Christmas
    shopping travels!  Let's face it, a week after Christmas you'd be lucky
    to find anything for a baby!
    
    Lyn 

    
    
    I too was glad to know.  I had my first, a boy, last Sept and after 15
    years of marriage we were ready.  Since there are all girls in my 
    family and this is my parents first and maybe only grandchild (and they
    are in their 80's) I wanted to tell them.  When I heard it was a boy
    I was elated and immediately called everyone.  My dad was elated to
    have a boy in the family and my folks were able to know in case
    anything happened to them before the birth.
     
    
    It also made us feel like we were bonding more after since we were
    able to talk to him by name before he was born.
    In addition, as an older first time mom, I did not know if I might need
    a c-section if there were complications or need pain killers that might
    dull the senses and miss out so I wanted to know ahead of time.
    
    I am glad i did and would again
    
    Michelle
    As for the amnio, that went well.  I was told by a friend of mine to 
    plan a day off after to rest so I did work from home with my feet up
    and all went well.