Not sure about the first tri screening

[Snugglebugmom]

This is my third pregnancy, and due to several circumstances beyond my control, I have no health care and will be paying for everything out of pocket. DH lost his job ten days after we found out we were having a baby, so money is a big issue. I will have to make due with minimal prenatal care. The OB I went to at 7 weeks told me she wants me to have two ultrasounds done, one around twelve weeks for the first trimester screening. Nuchal fold and some blood work, if I'm not mistaken. Then another ultrasound later on, probably between 16 and 20 weeks.
I am seriously considering skipping the first tri screening one. I know the number of false positives is huge, they only give you odds but no actual concrete information, and if your odds for Downs or neural tube defects are high they recommend an amniocentesis. That's all fine and dandy, but there is no way in hell that DH and I can afford to have the amnio done, so that point is moot. And if they do find something wrong with the baby, there is no way we will terminate the pregnancy. So at this point I am wondering what the point of that early screening would be.
What would you do? I'd appreciate any and all insights.

[Got_Cloth]

I am not/did not do the nuchal test. My opinion is, it doesnt matter to me. I will not end a pregnancy, no matter what i would be told, so why put myself thru the stress, and the baby thru the test.
I also will not be having the second tri quad test. I will do the 20 week ultrasound. We are considering going unassisted, and i need to know if there is a reason, like a heart condition, or spina bifida, that would require either a hospital birth, or MW attended home birth.

They didnt even have the first trimester screen with my first 3 kids. And since they are pretty young, it must be fairly new.

I think you need to decide, what you will do with the information, if you get not so great news? if you wont do anything, like abort, then i would skip it. Just my opinion.

Good luck.

[jessieb503]

I totally agree with above poster- I, too, skipped the first tri screen and am just getting the 20 week ultrasound.

[Got_Cloth]

I also wanted to mention that your state will most likely offer you free health insurance to cover your pregnancy. being totally stressed out about finances during your pregnancy is not good.
My husband might be losing his job in a couple weeks, and we will also lose our crappy health insurance with that. I will be applying for medicaid for myself, to cover this pregnancy. I have been hospitalized for preterm labor with previous pregnancies, and if i was put in the hosptial this time, it would kill us financially, and we just went thru bankruptcy, so it is not like we could write off the medical bills.

Just a thought. I hate to hear of mamas being totally stressed about money, when the federal govt, has medicaid to help in these situations.

good luck!

[Snugglebugmom]

Melissa, I know the US has ways to offer prenatal care for women without insurance. But I'm in Canada, on a visitor visa, in the process of applying for permanent residency, and as such there are absolutely no options for any kind of free prenatal care. I have no status here, since my visa expired last October due to an employee at CIC losing my extension application along with the fee paid. We are trying to get it sorted out but all of it takes months and there is no way around it.

[Got_Cloth]

Originally Posted by Snugglebugmom

Melissa, I know the US has ways to offer prenatal care for women without insurance. But I'm in Canada, on a visitor visa, in the process of applying for permanent residency, and as such there are absolutely no options for any kind of free prenatal care. I have no status here, since my visa expired last October due to an employee at CIC losing my extension application along with the fee paid. We are trying to get it sorted out but all of it takes months and there is no way around it.

Oh that sucks. I am sorry. I didnt know you were in Canada. I dont know how very much works there, but we too are planning on applying for residency in canada. We know we will qualify, but know the process takes a long time.

Good luck to you!

[CherryBomb]

Originally Posted by Snugglebugmom

Melissa, I know the US has ways to offer prenatal care for women without insurance. But I'm in Canada, on a visitor visa, in the process of applying for permanent residency, and as such there are absolutely no options for any kind of free prenatal care. I have no status here, since my visa expired last October due to an employee at CIC losing my extension application along with the fee paid. We are trying to get it sorted out but all of it takes months and there is no way around it.

That sucks My dh lost his job 2 weeks before I found out I was pregnant, but I'm here in the states so thankfully I was able to get medicaid (which suuucks, but at least I have prenatal care).

Does your hcp understand that you don't have insurance and have to pay out of pocket? The NT scan is not cheap, from what I understand. I'd absolutely skip it and just do the 20 week anatomy scan. Since you wouldn't abort the baby I don't see any reason to pay out of pocket for screening tests that have high false positive rates, anyway.

Good luck

[BlackSheepPDX]

We only do the 20 week u/s. No reason to do the "screening" test IMO, because they always default to an u/s followup if they suspect anything anyway. So the u/s tells me all I really need/care to know.

[Snugglebugmom]

Katie, yes, she knows. I've had one appointment and paid for that in cash, and I asked her about the early ultrasound and she said it would probably cost around 500 dollars. A lot of money for something I'm not sure makes any difference whatsoever.
Right now I am leaning heavily towards just doing the 20 week ultrasound.
The thing is, we have had so much stress and drama lately that I am half convinced that this little one is not going to make it. Seeing the heartbeat on an u/s would put my mind at ease in that respect. That is really the only reason I would do it.
My next appointment is at 11w 5 days, which is still early to hear the heartbeat with a Doppler, but maybe I will get lucky and that will give me peace of mind.

[horsecrazy100]

DH and I didn't get the tri screening done either. Our view was similar to yours, that we would never terminate the pregnancy, so why bother? And if it makes you feel any better, this was all based on ethical choices to us only, as we're in Canada, and it's fully paid for here if we'd wanted it.

We did however do the 20 week anatomy ultrasound. Just to make sure things looked to be developing properly.

[HeatherB]

Yikes. I would not do it. I don't even do it if insurance will pay for it. I don't see a point in doing it, as it won't change how I handle my pregnancy. I do the mid-term u/s to get a peek at the baby and look for any major issues, that, perhaps, could be dealt with in utero or prepared for at the birth. Here, that costs me about $150 cash.

[Qbear'smama]

Originally Posted by Snugglebugmom

Melissa, I know the US has ways to offer prenatal care for women without insurance. But I'm in Canada, on a visitor visa, in the process of applying for permanent residency, and as such there are absolutely no options for any kind of free prenatal care. I have no status here, since my visa expired last October due to an employee at CIC losing my extension application along with the fee paid. We are trying to get it sorted out but all of it takes months and there is no way around it.

Sorry for the dumb question since I am sure you have already checked around, but I used to be a social worker in a large Canadian city and I recall being able to refer clients who had no legal status to specific services for pregnant women that were free. I am appalled that you have no options for free prenatal care where you are!
I am 12 weeks and thinking about that early u/s too. We didn't hear a heartbeat with the doppler yesteday, so I was thinking about doing it just to check the heartbeat, but DH and I have decided against it. I used to think I would terminate if I got bad news, but now that I am actually pregnant, I realize that there is no way I could do it and DH agrees, so why do it?

[karen1968]

We did the NT scan and quad screen last time, but skipped it this time...even though I am over 40 and we have the same insurance coverage. I agree with PP that the way to decide is to look at what you would do with the information gained. If you are against termination no matter what, the 20-week anatomy scan is all you need (and some skip that).

[MeepyCat]

If I wouldn't follow up with amnio, and wouldn't take action based on the results of the NT screen, I wouldn't get it even if I didn't have to pay. If the results of the test won't change your actions, you do not need the test.

I'm sorry you're in this spot regarding health insurance, mama. I hope you can get it straightened out soon.

[2boyzmama]

I don't do first trimester screens personally.

BUT...remember that knowing about birth defects before birth is not just so you can terminate. There are a lot of reasons why knowing before hand can be helpful, including so you can plan the birth and post partum period better, you can choose your medical team, you can have the time to talk to counselors and geneticists and specialists to understand as much as possible before the baby is born.

My second son was born with multiple unexpected birth defects, and it took about 18 months after his birth before things started to settle down. We were taken completely by surprise, our entire life was turned upside down. We all survived it, he's happy and healthy and thriving today (although will always be special needs), but boy that period suuuucked.

That said...I still didn't do the first tri screen with my third baby. But I did do a thorough 2nd tri ultrasound and was prepared to do a few extra tests if the ultrasound showed any concerns (in my case, I agreed ahead of time to do a fetal heart echo if indicated, but not an amnio until 36 weeks).

So anyway, why am I saying this? Because I hear so many women say "I wouldn't terminate, so why screen?" but that isn't the only reason to screen.

In your shoes, I wouldn't do a first tri screen, but I wouldn't discount all prenatal screenings.

[karen1968]

For ME, terminating is one of the few reasons to do a FIRST TRI screening. I agree that there are many more reasons to know if the fetus has birth defects or genetic disease. But those are just as easily caught at the 20-week mark, when most will have an anatomy scan, thus avoiding the addition cost, not to mention the potential stress and further testing that comes with a positive screen. Plus, IIRC, NT/quad screen just checks for 4 trisomies, and will not catch many other potential problems. If money is an issue, the 20-week scan is the one to get.

[Snugglebugmom]

I talked to DH about it at length, and we have reached the conclusion that for us the first trimester screening serves no purpose other than getting a peek at the baby. If it gave us any concrete information it would be different, but as it happens, the only thing that will give us an absolute answer is the one thing we cannot afford to have done... the amnio. So we've decided against any kind of screening, and we are just going to do the anatomy scan at 20 weeks. If anything turns out to be wrong with this little person, we will deal with it if and when the time comes. Boy, talk about a leap of faith!
Thank you all for your insights, it's been very helpful!

[umsami]

We were in a similar situation. I didn't do the nuchal scan... but did pay out of pocket for the 20 week. I found a midwife who would give me monthly care for $50/appointment.

We were not eligible for medicaid for pregnant woman in my State at the time due to income, but recently became eligible (I'm now 29/30 weeks). I did apply and was approved in less than two weeks, which is nice.