Health Advice for Women Before Your Doctor Visit
For many first-time moms, pregnancy is already filled with the 'what-ifs' and late night Google searches about every scary complication out there looking for advice for women. So, why would physicians choose to add to the concern with unnecessary screens and tests—ones that cost a lot of money and pose more of a threat than foregoing them altogether?
Despite the medical advice from a majority of doctors in this country, pregnancy screens are not required and should be carefully considered before agreed upon. For instance, the AFP, or alpha-fetoprotein, screen is used to detect neural tube defects, placental complications, Down's syndrome and defects in the fetus.
This screen is a simple blood test generally done between 16 and 18 weeks of pregnancy. The American College of Obstetricians and Gynecologists stated that they believe the test should be offered to all pregnant women, but many women believe it to be mandatory. It’s not. Neither is what they call the 'first trimester' screen, which also looks for possible genetic defects. Most other concerns, if there are any, will show up in a routine ultrasound.
On a personal note, before deciding to give birth using a midwife outside of a hospital, I went to an OBGYN in my first and second trimesters. Because of some mildly irregular results from my AFP screen, she strongly suggested my husband and I see a genetics counselor. In the matter of five minutes of our appointment, we went from pure excitement to complete distress. Aside from being a compassion-less, cold woman, this medically trained doctor was using a scare tactic that is part of the 'standard of care' in hospitals. She claimed it was 'normal' to do genetics testing in this case, but nothing felt standard or normal. We left and found the wonderful birth center where I gave birth to our healthy baby boy. It was an emotionally draining experience that was pointless and now I realize—completely avoidable.
My advice for women is before agreeing to any tests, consider what you would do with the information. Would you terminate if the results show a possible issue? If there is a cause for concern, are you willing to do a follow-up test like an amniocentesis—knowing that roughly one in 300 can cause miscarriage?
Photo by Michelle Burrus
Keep in mind that false positives are common and there are varying reasons for an 'abnormal' result, if you do the screen. Many screens claim to have only a five percent false positive rate, when in reality, research shows the inaccuracies (or false positives) can be as high as 80%. In a world where we demand pregnancy tests to be 99.9% accurate, why are we okay with a test that has the potential to be so inaccurate and cause unnecessary stress?
If you decide to pass on the test, prepare for some serious hesitation from across the exam room. You can expect an initial look of surprise (read: judgment) followed by a cautionary recommendation to reconsider. Also, the doctor is required to have you sign a waiver indicating that you opted out of the screen against their advice.
It makes me wonder why these tests are considered a hospital 'standard of care' in the first place for a healthy life for mom and baby. Are these non-diagnosing screens available for our safety or are they there to scare us into having another, more invasive, more expensive test? The controversy lies where you’ll find all the other medical paradoxes—insurance companies and money.
Think about why you are doing the screen(s) and most importantly, what you would do with the results. If there is no question in your mind—or your partner’s mind—that you will have your baby no matter what, then skip the blood work and the unnecessary stress and trust something far more reliable for having a healthy baby — your body.
Denise Day is a writer and owns a public relations company called Orchid PR.
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