Genetic Counseling and Testing Can Help Abate Worries

Beneath all the discussion about childbirth after the prime childbearing years lurks an almost unspeakable fear: the fear of delivering a baby with a birth defect. All pregnant women must deal with this fear until the day of delivery. But for women thirty-five and over, the steep increase in incidences of birth defect cannot be ignored. "If you were going on a cross-country trip, you'd go in for a good tune up," says high-risk pregnancy specialist Dr. Steve Calvin. The same kind of planning and preparation can prevent unnecessary accidents for all moms-to-be, and especially for moms facing the added risks of delivering their babies later in life.

As women grow older, they may need to visit the doctor more often, stay in the hospital before the birth of the baby, and need special tests. According to a book by the American College of Obstetricians and Gynecologists, questions to ask yourself before actively attempting to become pregnant should include:

• Do I or a member of my family have a disorder that could be inherited?

• Do I need to gain or lose weight?

• Should I make any changes in my lifestyle?

• Could any medications I'm taking cause problems during my pregnancy?

Can I continue my exercise program?

• Does my work expose me to things that could be harmful during my pregnancy?

Do I need to be vaccinated for any infectious diseases before trying to get pregnant?

The book also recommends considering genetic counseling for couples who are worried about having a baby with an inherited birth defect. Counseling can provide a realistic outlook about individual risk and information about options, and it may calm unwarranted fears. Genetic counseling is strongly advised for couples with an increased risk of having a child with a birth defect, including:

• Mothers thirty-five years or older when the baby is due.

• Family or personal history of birth defects, genetic diseases or certain medical disorders.

• Having a previous child with a birth defect or genetic disease.

• Certain ethnic backgrounds: African-& American, Mediterranean, Asian, French Canadian or Jewish descent.

• Three or more consecutive miscarriages.

Some genetic tests are offered to all pregnant women. Others are offered only when your medical history, family history or physical exam indicate they're warranted. The tests can't locate all the problems, nor are they 100 percent accurate. Sometimes results indicate a defect when none is present or that a fetus is free of defects when that isn't the case.