Early test for Down Syndrome first trimester

[Ariadne]

It sounds like infants will still have immediate access to all the NICU bells and whistles which is ideal. I would prefer all laboring women also have access to the highest standards of intensive care on site should they need it, but that is pretty unrealistic (every hospital that does deliveries can't support that). At the very least if they are going to be doing high risk deliveries they need dedicated specialists and a high risk unit. For healthy moms, this place seems perfectly reasonable to me. When you think about it, most low risk women in Canada don't deliver in hospitals with the highest available acuity units. Many are choosing midwives or GPs even rather than OBs. I know if I were to give birth and was low risk, my preference would be a midwife, so I can't say I think it's necessary for low risk women to all have access to high risk perinatologists and neonatologists.

Thanks for your considered response. I think I agree with you that this doesn't seem to add up the way it should. There was a woman that had a miscarriage in the hospital waiting room a few months ago and she wasn't very happy about it. I think that this new facility is intended to help all pregnant women, but it sounds like the hospital omits dealing with complications in high risk moms. If this facility is addressing only low risk moms, then as you point out it's doubling up services that are already available through midwives and home births. I hope that some of the people that resigned can still make a difference because it seems like the people planning the hospital are not looking at the big picture. If a mom needed special care she would have to be transported by ambulance to the next hospital, which seems to defeat the purpose of a birthing hospital and could lead to delays that may worsen a patient's condition. If fact, it seems like they're trying to rebuild the Salvation Army type Grace Hospital that was shut down years ago because it didn't have all the specialized care. Round and round the politicians go.

 

[tracy]

Thanks for your considered response. I think I agree with you that this doesn't seem to add up the way it should. There was a woman that had a miscarriage in the hospital waiting room a few months ago and she wasn't very happy about it. I think that this new facility is intended to help all pregnant women, but it sounds like the hospital omits dealing with complications in high risk moms. If this facility is addressing only low risk moms, then as you point out it's doubling up services that are already available through midwives and home births. I hope that some of the people that resigned can still make a difference because it seems like the people planning the hospital are not looking at the big picture. If a mom needed special care she would have to be transported by ambulance to the next hospital, which seems to defeat the purpose of a birthing hospital and could lead to delays that may worsen a patient's condition. If fact, it seems like they're trying to rebuild the Salvation Army type Grace Hospital that was shut down years ago because it didn't have all the specialized care. Round and round the politicians go.

I remember that woman's story. It's one reason many hospitals have pregnant women bypass emergency rooms completely if their complaint relates to their pregnancy. Nurses and docs on other floors often don't understand the emotional consequences. You wouldn't believe some of the things I've been told nurses and docs have said to women who have experienced perinatal losses. One hospital I was in put those women on the postpartum floor because of it.

Unfortunately I don't think there are enough midwives to be able to look after the moms who would use them and a lot of women still wouldn't use them or have a homebirth so I don't know about the idea of services being duplicated...

As far as safety, it doesn't seem unsafe to me for low risk women but there isn't enough information for me to say it's unsafe for high risk women or not. They aren't being specific about what isn't offered. I used to work L&D at BC Women's in Vancouver which is one of the busiest hospitals in the country and is the high risk referal hospital for the region. I did have one case where we had to transfer a mom out for a service we couldn't provide. No hospital can offer everything.

 

[Kreskin]

When my wife delivered our GP and his partner (another GP) were there. There were also at least 3 nurses. I lost track because I was busy counting aimlessly for the supposed benefit of my wife. Are there usually that many staff around?

 

[tracy]

When my wife delivered our GP and his partner (another GP) were there. There were also at least 3 nurses. I lost track because I was busy counting aimlessly for the supposed benefit of my wife. Are there usually that many staff around?

The minimum for low risk deliveries is one person solely responsible for the mother and one person solely responsible for the baby. In real life, we usually had two nurses (one for mom, one for baby) plus the doc or midwife. A second doc (not a GP) or a respiratory therapist or NICU nurse usually attend if the delivery is high risk. Different hospitals have different protocols.

 

[Ariadne]

If anyone is interested, there's a book called "Expecting Adam" that's very good. It's a true story about a woman and her husband who are studying at Harvard and find out they are pregnant with a DS baby. Everyone thinks they should abort. Although it's not in the book, the woman, Martha Beck, basically went on to develop a vitamin/nutrient protocol to help DS people and is a very successful writer who works for Oprah.

I was at the bookstore this afternoon and this book: The Memory Keeper's Daughter was in the new release section. It's about twins, one with DS that is given away at birth. I didn't pick it up but it looks relevant.

 

[fuzzylogix]

The reality is that the cost of testing every pregnant female to find one or two Down's syndrome children is an exorbitant cost.

The reality is that many of the individuals who are told they have a Down's syndrome choose to carry on and still have the child.

The reality is that the risk of loss of amniocentesis is around 1% and therefore for all the amniocenteses that will be done as a result of the testing, there will be loss of normal babies.

The reality is that the government could take all that money used for testing and put it into a slush fund and end up giving each family that has a Down's child, a million bucks to be able to take care of their child.

No abortions.
Loving children.
No loss of normal babies.
Economic sense.

 

[Zzarchov]

I fail to see whats wrong about aborting a child which would be born with Down Syndrome.

The child doesn't exist yet, it isn't concious or sentient yet in the first trimester.

You can say "But if he was born he'd want to live", damn skippy. I'd want to live if I was born with Down Syndrome too. Of course if my older sibling had been born with Down Syndrome then I wouldn't be Alive (and I very much liked being born). That is why you can't actually consider this a valid form of logic, its based purely on an emotional response which could just as easily be flipped. Every time you take a birth control pill you can really consider yourself having a mini-abortion of if you wish, that doesn't mean you are in actuallity.

If you are planning to have a child (and please let it be planned) then are you going to have a child, it would be most logical to think of it as "The one child I am going to give life to, would he/she prefer to have down syndrome or not?"

 

[talloola]

Exactly how "early" in the pregnancy can this test be done.

 

[Kreskin]

The NT is approximate 11-14 weeks by gestation. The fetus is actually 9-12 weeks by development because pregnancy is measured using the start of the last menstrual period as day 1, when in reality the conception occurs approximately two weeks later.

 

[talloola]

I wonder how many parents would opt for abortion at this time, which is why I wanted to know how
early they can be told the results of such a test.
And, then of course they would have to have the second more detailed test, to be quite sure, or could
they decide at that point to abort.
And, my concluding point is - are people judged harshly for making such a decision.
I don't know where I stand on this matter, as I haven't had to face a situation such as this, and I
wouldn't want to judge anyone, who thought they couldn't cope with such a birth defect, as, I suppose
some of the downs kids are much more seriously effected than others.
Any comments?

 

[Kreskin]

I wonder how many parents would opt for abortion at this time, which is why I wanted to know how
early they can be told the results of such a test.
And, then of course they would have to have the second more detailed test, to be quite sure, or could
they decide at that point to abort.
And, my concluding point is - are people judged harshly for making such a decision.
I don't know where I stand on this matter, as I haven't had to face a situation such as this, and I
wouldn't want to judge anyone, who thought they couldn't cope with such a birth defect, as, I suppose
some of the downs kids are much more seriously effected than others.
Any comments?

You hit the nail on the head. This could be one of the most complex and emotional decisions one could ever face. With so many different considerations to make, and with each situation unique, it's really impossible to say what's right or wrong for someone else.

 

[talloola]

You hit the nail on the head. This could be one of the most complex and emotional decisions one could ever face. With so many different considerations to make, and with each situation unique, it's really impossible to say what's right or wrong for someone else

Yes, that's right. I tried to put myself in that position, and I think I could opt for abortion if I could
know very early, but there is a point where I would change my mind. Maybe someday they will be
able to detect these problems, as soon as one knows they are pregnant, and if that was possible then
I would have no problem with my decision.

If one could abort in the first four weeks, it doesn't seem any different to me, than using birth control
which also aborts "sperm" and/or "egg", just because they haven't joined together yet, they are still
alive. It is all "emotional" and once the pregnancy has reached 8 -12 wks or so, I couldn't do it, "maybe",
but I haven't had to face the situation, so I still really don't know.