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Old 11-03-2017, 08:52 PM
 
Location: Silicon Valley
2,744 posts, read 1,207,954 times
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My wife and I have had a debate. Ultimately she is the decision maker on this and has let me know it, but the conversation has left me very indifferent to having children. We'd be older, call it (37-43), and as the age rises, risks increase. So here's the equation:

If we get pregnant, and the baby has a deficiency detected, my wife wants to abort the baby and try again.

Originally I'd been open to another child. She'd like one, but she wants to make sure it's a good one. The analytics involved have truly cooled me off to the idea. I mean, of course we all would like a healthy baby that has the full advantages of our gene pool and none of the disadvantages. I think I'm more in for a child of any stripes and find the idea of aborting until the right alignment is found impossibly horrid.

I'm not an anti-abortion person. I'd support her, but I can't help but feeling like...nah, maybe we can do something else instead. A lot of the excitement just got amazingly doused to where I'm not even sure i want to try. I work late during peak cycle times. I know I'll have to talk to her, and I will but wanted to get some thoughts.

Anyway, I'm sure we're not the only couple that's talked about this. What decisions have you guys come up with?
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Old 11-04-2017, 10:47 PM
 
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My husband and I began trying to conceive when I was 35, and succeeded right before my 36th birthday. We knew there were slightly higher risks associated with "advanced maternal age," as it is so diplomatically called when the mother is 35 or older, so we had a similar discussion. It would have taken a very extreme situation for us to consider abortion. I desperately wanted a child and loved my baby from the moment I saw two pink lines, so I have a hard time fathoming the mindset of a woman who would abort a less-than-perfect baby.

I'm sure your wife has done her research, but it sounds like her cavalier "we'll just abort and try again" is glossing over a lot of other factors. She's at an increased risk for fertility problems, so it could take quite some time for her to get pregnant. The earliest screening for chromosomal abnormalities can be done around 10 weeks, but the test carries its own risk of miscarriage and isn't foolproof. There's also some evidence that abnormalities detected that early will correct themselves. How long into the pregnancy is she willing to wait to be sure? What if something shows up at 22 weeks when she's felt the baby kick and seen its face? Then if she does abort, it could be months before she ovulates again- by which time she is of course older, meaning more potential difficulty conceiving and even higher risk for complications.

I can definitely understand your hesitation. Even ignoring my own philosophical difficulties with abortion, I would have a very hard time being excited about trying to conceive with a partner who took such a view of creating a child.

Last edited by AlaskaAma; 11-04-2017 at 11:21 PM..
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Old 11-04-2017, 11:37 PM
 
Location: Middle America
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There are a number of potential abnormalities that can't be detected by genetic screening panels...the screenings since at 12 weeks test for a panel of chromosomal abnormalities/genetic disorders, and they don't give you definitive diagnostics, anyway... they inform you of elevated potential risk factors. There are many disorders and congenital abnormalities that aren't chromosomal in origin, so a clean screening isn't insurance against birth defects, either. Genetic testing also won't prep you for issues that can arise with birth trauma, cord issues, placental abruptions, etc. There is a lot that can happen that can't be predicted. While it's good to be aware of risk, know that you'll never really mitigate it.

I got pregnant with our son at 38 (a year after we married, on my 37th birthday). I got pregnant with our daughter at 39, had her at 40. So I've been through genetic testing twice due to advanced maternal age.

My husband and I (he's five years older) had already decided that trying for kids meant handling any health and developmental issues that came up. I had been a special ed teacher for many years, and have more experience with an array of developmental disorders than most. So it's definitely something we talked about.

For the record, we have two typically developing children with no chromosomal abnormalities, birth defects that there is any evidence of, or developmental issues.
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Old 11-04-2017, 11:43 PM
 
Location: Middle America
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Also, cell-free DNA testing at the end of the first trimester actually does not increase risk of miscarriage. It is a maternal blood test and is noninvasive to the fetus. Other more invasive tests, such as amniocentesis and chorionic vilius sampling, do come with heightened risk of miscarriage, which is why they are no longer recommended unless cell-free DNA testing shows potential chromosomal flags.
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Old 11-05-2017, 04:34 AM
 
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Quote:
Originally Posted by TabulaRasa View Post
Also, cell-free DNA testing at the end of the first trimester actually does not increase risk of miscarriage. It is a maternal blood test and is noninvasive to the fetus. Other more invasive tests, such as amniocentesis and chorionic vilius sampling, do come with heightened risk of miscarriage, which is why they are no longer recommended unless cell-free DNA testing shows potential chromosomal flags.
Amniocentesis is what I was thinking of. I didn't realize (or had forgotten) that there was a non-invasive option that early in pregnancy. I chose to forego any screening myself, since I knew it would have no bearing on our decision to keep the baby.
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Old 11-05-2017, 11:16 AM
 
Location: Middle America
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We did it to be well-informed as earlyinas possible of potential medical needs and resource needs, should there have been any problems, not because it had any bearing on termination decisions.
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Old 11-05-2017, 11:22 AM
 
Location: Middle America
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Quote:
Originally Posted by AlaskaAma View Post
Amniocentesis is what I was thinking of. I didn't realize (or had forgotten) that there was a non-invasive option that early in pregnancy.
NIPT is a fairly recent offering. It has its limitations, but the tradeoff is relative safety compared to the more invasive screenings. It's most highly effective for detecting trisomy 18 and trisomy 21 genetic markers.
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Old 11-05-2017, 02:31 PM
 
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I can empathize with your view, OP.

When it comes to reproducing, yes you can test for some potential genetic anomalies. But as others mentioned, not everything will be detected.

You may want to ask your wife whether she would okay with having a baby that passed prenatal genetic screening, but still ended up with a child that had some disability down the road? Physical, mental, behavioral, etc.

Of course we all try to mitigate risk, and who wants a child with a "deficiency"? However, there is only so much about having/raising a child that is in your control. The rest is a huge leap of faith, and doing the best you can with the cards you are dealt. I feel like anyone who wants to be a parent needs to accept this and love the child for who they are, regardless of their genetic makeup, personality, etc.

Best wishes with whatever you and your wife decide.
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Old 11-05-2017, 07:59 PM
 
5,496 posts, read 3,352,872 times
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Quote:
Originally Posted by English Ivy View Post
Of course we all try to mitigate risk, and who wants a child with a "deficiency"? However, there is only so much about having/raising a child that is in your control. The rest is a huge leap of faith, and doing the best you can with the cards you are dealt. I feel like anyone who wants to be a parent needs to accept this and love the child for who they are, regardless of their genetic makeup, personality, etc.
This is beautifully said.
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Old 11-05-2017, 08:25 PM
 
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While I have never made a decision to "terminate for medical reasons", I know women who have made those decisions and for them it was by far the most awful horrible and heart breaking decision that they ever had to make. It is not cavalier for the women I know by any means. I obviously don't know everyone that had to do this but it was horrible for the ones I know. Terminating a wanted child is very different from just terminating an oops baby in my opinion.

There's a whole spectrum of genetic/ other issues that may be detected prenatally. Some of them are common like Down's and can have a fairly normal life and others less so. Some are incompatible with life even. Some of them are fatal and the children suffer a lot for the short time that they are here. I dare say that only parents who are having to make these decisions can imagine what they are feeling like.

To PP that suggested early detected chromosomes abnormalities self correct. That is very very incorrect. Mistakes in testing may be made and correctly tested a 2nd time but who we are at a cellular level doesn't just change.

OP - I suggest you and your wife sit down and really have a very honest discussion about where each of you are coming from.
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