Prenatal testing

Testing 1, 2, 3

Not every prenatal test that your health-care provider suggests is necessary. We review the five you definitely need and give you the real deal on those you don’t.

By Judith A. Lothian, RN, PhD, LCCE, FACCE, and Charlotte De Vries

Adapted from The Offical Lamaze Guide: Giving Birth with Confidence

These days, it can seem like your doctor has another round of prenatal testing every time you go in for an exam. OB/GYNs and midwives used to check only a few vital statistics throughout a woman’s pregnancy, but during the past 20 years, the extent of prenatal testing has increased dramatically. Yet not everyone in the medical community agrees that all of these extra tests are of value. Instead of being vigilant about picking up on problems, many health-care providers (doctors far more than midwives) over-test because they fear liability and simply expect trouble.

Many of these newer tests were created to diagnose problems in high-risk pregnancies. But with the increased medicalization of pregnancy, they have become routine for healthy women with no known risks. This does not mean that every test is right for everyone, however, or that they are risk-free themselves. There may be a problem that prenatal testing doesn’t show, or a problem may not exist even if the test suggests it does. Results that are unclear or even misleading can plague your peace of mind and decrease your confidence. The barrage of tests can also make you feel like your health-care provider knows everything there is to know about your pregnancy, which is not the case.

This list details the prenatal testing that is considered essential by everyone, as well as other tests that you’re likely to encounter during the next few months. You have the right to ask about and understand why each test is being recommended, the particulars of how a test will be done, all the risks associated with a test and if there are less risky approaches to diagnosing a problem or concern. Your health-care provider should let you know that you have a right to refuse a test, and he should welcome your questions and respect your decisions.

  WEIGHT CHECKS make sure that you’re gaining enough weight for your baby’s health; they are not to keep you from gaining too much. And by tracking the growth of the uterus, your health-care provider can make sure that your baby is growing well. If your uterus gets larger more quickly than expected, it may indicate something quite different: multiples.

  BLOOD TESTS identify a number of factors, including your blood type and cell count, iron level, immunity to chicken pox and other diseases, and Rh factor, as well as certain sexually transmitted diseases or infections. They are considered standard and acknowledged as important by all because they help established your overall wellness.

  URINE TESTS monitor the status of sugars and proteins in your body. High sugar levels may suggest diabetes, and high proteins in your body can indicate a treatable bladder infection. Protein in the urine, especially in the last trimester, can indicate pregnancy-induced hypertension (see above).

Although simple urine tests have been done routinely for years, there is little data to show that they are important for healthy women, especially if they don’t have high blood pressure.

  FETAL HEART TONES can be monitored by your health-care provider with a fetoscope (a type of stethoscope) or handheld Doppler device. This test may reassure you that all is well, but your own knowledge of your baby’s movements throughout the day and night is equally important. There is no need for sonograms or electronic fetal monitoring to test these indicators.

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