Heartbreak and Confusion
The first time I got pregnant, I had the haughty self-assurance that my baby would be healthy, beautiful, and above average in every way. I was shocked and devastated when I lost her early in the pregnancy. A year later, when I got pregnant again, I knew that I could lose that one, too, but I didn't think I would. Then one night in week 12, I had another sudden miscarriage.
Six weeks later, my ob-gyn called and said she had good news. My fetal tissue sample tested positive for Trisomy 21, or Down syndrome. Intellectually, I understood why she considered this good news. It meant we had a reason for my second miscarriage, unlike the first one, which remains a mystery. Emotionally, my reaction was more complicated.
Loss -- and Gain
After two losses in a row, I felt rage at being picked on. Some people told me I was lucky -- my body saved me the heartache of having to choose whether to terminate a pregnancy. But I had already loved this second baby and missed her acutely. Then a few months later, unexpectedly, I found myself pregnant yet again.
A healthy 34-year-old woman has about a 1/2 percent chance of carrying a Down syndrome baby, but since I'd already lost two pregnancies -- one definitely to Down syndrome -- my risk was assessed at one percent. Normally, such a low chance wouldn't scare me, but my earlier experiences had left me leery of the odds.
Testing the Limits
To help ease my worry, my doctor suggested a Level II ultrasound to look for signs of chromosomal defects. This is a noninvasive, high-resolution ultrasound done in the 11th week that looks for thickening of the skin behind the fetal neck -- called the nuchal fold -- which sometimes but not always points to Down syndrome. When the technician said everything appeared normal, my husband and I both cried.
The second test was the standard blood screening. The news this time wasn't so rosy: My AFP levels were elevated. This could indicate Down syndrome. The doctor suggested genetic counseling and an amniocentesis.
Amnio -- or No?
By this time I was nearly 17 weeks pregnant and beginning to let myself believe that I'd one day meet the child inside of me. As I lay beside my husband one night, I put my hand across my belly. "Please be okay," I told my baby. Then I felt funny little flutters, like a fish darting far below the surface of the water. Had I really felt her move, or did I just want to feel her so badly that I had convinced myself she was moving? Who knows, but those flutters were enough to let me know that I wouldn't risk losing her.
After all, amniocentesis triggers miscarriage in about 1 in 200 women. And I didn't care if my child had Down syndrome or three legs or gills. I loved that baby. I loved her like I'd loved each one of my pregnancies, and the thought of losing her for any reason was unbearable. So I declined amniocentesis. That doesn't mean I'd make the same choice if faced with it in another pregnancy. Nor does it mean I think my choice is right for every woman. But making choices that are right for your family is the essence of parenting.
At 18 weeks, an anatomy scan showed no outward signs of Down syndrome. I rarely thought about it after that. I merely concentrated on getting my baby into the world so that I could begin loving her on this earth like I already loved her deep inside of me.
Heather Swain's daughter was born without complications and is a healthy 1-year-old. Luscious Lemon (Downtown Press) is Swain's novel dealing with pregnancy loss.
Originally published in American Baby magazine, September 2005.