I am now halfway into my 14th week of pregnancy.  This week, my doctor’s office called to inform me of my visit to “Maternal and Fetal Medicine Clinic (MAFMC)” at the local teaching hospital.

Visits to the MAFMC are reserved for women who are 35 and over and pregnant; women who have a history of stillbirth or miscarriage; or those who have children with genetically inherited diseases.  I am not happy to say that I fit into all of the above categories.

My appointment at the clinic is March 30th.  At that time, they will offer genetic counseling to my husband and I (I’m not too worried about this as the genetic issues my older children have were inherited from their father’s side), and perform a level 2 ultrasound. During the ultrasound, they will be looking for birth defects, and also physical markers for Down’s Syndrome.

Since I am 39, I am well aware of my risks and that worries me.  My sister-in-law and brother discovered recently that the child they were expecting had Down’s.  She is my age.

Another factor that concerns me is that my husband travels frequently.  I am hoping that he will be home for this visit and able to attend with me.  I am sure I’ll want the emotional support on that day.

The exciting news is that I shall be 19 weeks pregnant at the time of this visit.  I am praying that all is well with our baby, and I am also hoping that we might be able to find out the gender of our baby during this visit.  I’ve found that not all of my children were willing to share that secret with us during the ultrasound visit! This does happen occasionally.

I finally found a brand of pre-natal vitamins that I can tolerate! The doctor I have was kind enough to give out samples so I could try the different kinds without purchasing a whole lot of vitamins.

Have you ever been scheduled for a “high risk pregnancy appointment”?

The baby shower is so much more than a gift giving session?it?s an event to mark the passage of a couple into parenthood, and to celebrate the birth of a child. Baby showers are important events requiring special care to plan in the best of circumstances. When the mother-to-be lives out of state and is on bedrest, this can complicate the plan, but it need not be a show stopper.

When I got remarried, I moved 800 miles away from my family, who mostly reside within a 50 mile radius of each other. Family friends live about 1 ? hours away in another state, but for the most part, everyone is centrally located.

When we announced the great news that we were expecting, my sisters began planning me a shower as it had been 9 years since the birth of my last child! It was assumed that I would make the 450 mile trip north to attend my baby shower where everyone lived, as it was the most logical plan. Apparently, life doesn?t follow logic.

I was put on modified bedrest during the last few months of my pregnancy. With my husband away with the Army for training, and four other children to care for, life was challenging enough. When I mentioned the baby shower plans to my doctor, he nixed them. That was too far of a drive to do alone and even if I could have someone help me out by driving, it wasn?t advisable.

My sisters were disappointed, but not deterred, and began planning the ?new? baby shower?without my knowledge. Recently, I saw an article about a family who gathered together and actually had a virtual shower for a woman in their family who had moved far away because of her husband?s military service. Both the woman and her family had webcams and they could watch her open up her gifts. That is an awesome idea, but sadly, my family is not technologically equipped.

Instead, most mailed the gifts to my home at my sisters? request. Others, who could make the trip, drove the gifts to a place where friend?s of my husband lived. He would be traveling that way after his military training, and could pick up the gifts before heading back to our house a few days before our child was due to arrive.

On my end, all I knew was that the baby shower had been canceled. I was deeply saddened and disappointed, but I tried to concentrate on the positive things like the fact that my child was healthy, that my pregnancy would soon be over, and that my family cared enough to suggest a shower.

On the day my husband was to arrive home, my mother-in-law stopped by to clean the house for me. I have to admit, my husband doesn?t care if the house is clean or not, so this was a shocker. Even more shocking was the fact that she arrived with a large amount of food from a local caterer. About an hour or so later, my husband arrived home with a car load of gifts and a few minutes after that, the neighbors arrived with gifts in tow.

We had a great time opening gifts and calling the different relatives on the phone to share the excitement with them?the low-tech version of the webcam experience. Although it wasn?t quite what it could have been had all of my loved ones been present with me while I was opening the gifts, it certainly was a very good option given the circumstances.

All ultrasound systems help in determining the following:

~ Determining the age of the baby
~ Analyzing development of the baby
~ Evaluating multiple pregnancies
~ Detecting structural problem with uterus
~ Detecting placental abnormalities
~ Detecting abnormal bleeding
~ Determining ectopic pregnancy
~ Detecting ovarian tumor/fibroids
~ Locating the placenta

But aside from the usual trans-vaginal ultrasounds (done early in the pregnancy to determine if there is a baby growing inside you) and pelvic ultrasounds (performed during the second and third trimester), there are three other specialized ultrasounds you may choose to have or that may be prescribed for you to get in the course of your pregnancy:

The 4D ultrasound
The latest in ultrasound technology, this type allows live action images of the unborn child. For 20-40 minutes, you can watch your baby smile and turn in living color. Usually, you also get a video or printed shots. Keepsake clinics where these can be gotten (aside from hospitals) are generally strictly-monitored, with this ultrasound having to be medically ordered/required (usually tied up with a congenital anomaly scan) and performed by a licensed sonologist. Usually performed between the 20th-27th week.

the congenital anomaly scan/screening
This is a very detailed scan where special attention is given on the fetus’ body parts. It can also detect possible congenital anomalies with varying detection percentages like Spina Bifida (90%), Anencephaly (99%), Hydrocephalus (60%), Congenital heart disease (60%), Exomphalos /gastroschisis (90%), Major kidney problems (85%), Major limb abnormalities (90%), Diaphragmatic Hernia (65%), Cleft lip and palate (80%) and Down Syndrome (50%). It is also performed between the 20th-27th week of pregnancy.

biophysical profile (BPP)
A BPP is usually performed in the last trimester of a pregnancy, often ordered for women with high-risk pregnancies. This test measures the health of the fetus by measuring the baby’s heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around the baby.

High-risk pregnancies or strong illness histories could prompt your OB to order the above, whether you like it or not. But parents also have a choice to request for a 4D ultrasound or congenital anomaly scan. However, it will be good to note of the controversies surrounding these two.

Some from the medical field believe that a 4D ultrasound usually has “non-medical indications”, after all, having a keepsake usually overwhelms the true purpose of the ultrasound for the expectant parents. Obstetricians are also divided when it comes to congenital anomaly scans since it does not really offer guarantees, something that was detected now could still mend itself in due time or something could not be detected at all.

Such scans purport to forewarn about possible medical problems a baby might have so parents can deal with it accordingly, like having a heart doctor ready for a baby detected to have a heart anomaly. But it also raises the issue of depression among parents during a time when ignorance could may very well be bliss (e.g. in minor cases as a cleft palate which wouldn’t require URGENT surgery or intervention, but would nonetheless burst the expectant parents’ happy bubble). And in case there is a major anomaly detected, like Down’s Syndrome, will the parents abort the baby? Can they still enjoy the pregnancy knowing they are to expect a child with disabilities? Will they have anyone to support them?

Thus, it is very important for parents to talk about the negative possibilities and their implications first before getting such tests.

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Life Issues
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