no thank you doctor

The T.M.I. Pregnancy is the headline of Patricia Volk’s Opinionator column in the New  York Times.

“Pregnancy is treated like a nine-month illness cured by childbirth,” she says.  There is a great amount of information garnered from prenatal testing.  Once upon a time in Canada, tests were only offered only to women over 35, and indicated Down syndrome and neural tube conditions, such as Spina Bifida.  Even then the tests were not reliable without more invasive procedures like amniocentesis to give a definitive diagnosis.

Times have changed.  All women are now offered the testing. There is a ‘non-invasive’ test for Down syndrome.  The list of things that can be detected prenatally is growing.  Suddenly, this is not just a Down syndrome or Spina Bifida issue anymore.

As Volk points out, all this information about pregnancies is staggering.  “What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.”

Because my son has Down syndrome, I’ve thought a lot about prenatal testing.   I appreciate that Volk steers away from the negative language of what we are testing for.  She simply asks us:  why do we need all this information about a woman’s pregnancy?

That brings me to this:  as women, we also have the choice to decline the prenatal tests.  I know some physicians get very agitated if you say, no thank you, I don’t want any of these tests, including the maternal blood screen.  Other doctors go ahead and order the blood tests without explaining what they are actually for – without the patient’s expressed consent.

I believe that you have a choice to say to your physician:  I would like to continue to enjoy my pregnancy, for the baby I’ve conceived is the baby I’m going to give birth to.  Testing won’t affect the outcome of my pregnancy, so please respect my choice.  It is my body, and my choice.

Of course, informed choice means that we understand all of our options.  So if you are the type of person who needs information for peace of mind, or who might have a baby who requires treatment in-utero or immediately after birth, or whose pregnancy outcome may be altered by testing results, it is certainly your choice to have the tests.

But the other choice is to politely and firmly say, “no thank you doctor.  I don’t want the tests.  Not even the blood test.”  Then do as I did:  enjoy your pregnancy in oblivion as women have done for centuries, and be at peace with what will be, will be.

If your baby happens to pop out and has a disability like mine, then your lovely, uneventful pregnancy has put you in a place of strength to face all of your new challenges.  You have loved your baby, as a baby first, for the past nine months.  A little bit of Down syndrome isn’t going to stop you from keep on loving that baby.

If your baby isn’t healthy, yes, your life will be different than you had planned.  But I can promise you this:  with love, patience and faith, you will find your way.



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