What do I need to know if I birth over 35?

[phatchristy]

I've been thinking about this, and I feel like I need to almost get mentally prepared.  I do NFP here, and though all the kiddos have been planned here I am now over 35 and wonder what would change in the kind of care I receive.  

I went through a local birth center, but took their homebirth option and had all four babies at home (well, in fact my last baby was an accidental UC that DH caught while we were on the phone with the midwife!).  I have had the quad screens (and the similar ones) done in the past.  I thought mainly that the issue after 35 would be an increased risk of genetic abnormalities.  I'm also aware that fertility overall goes down dramatically at this point.  Though I am not even sure if we would even attempt to try for another, though it is possible that it could still happen.  

I'm fairly certain that DH might want some genetic testing done if I was in that situation, though I know there are less invasive tests they can do nowadays (that I'm not aware of).  Any information or website links you could share would be greatly appreciated.

Thanks!

[MeepyCat]

The genetic testing I had done was a twelve-week ultrasound and a blood test.  The results returned were not very precise - they told me I had a 1 in something like 500 chance that the baby I was carrying had a chromosomal abnormality.  If we'd received results indicating much higher odds (1 in 100 or 1 in 50), we'd have had an amniocentesis.  If you wouldn't have the amnio, it doesn't make a lot of sense to do the quad screen - probably better to just check for structural abnormalities at the 20 week anatomy screen.

[Catubodua]

alot depends on what you would do with the results you get.  if you would have an abortion if they find xyz then you'd have more testing done earlier.

if nothing they can say would convince you to have an abortion, none of that stuff is necessary, imho.

[puddle]

For me, being 35 for this pregnancy hasn't changed anything about my care.  I'm seeing an OB and she didn't bat an eye when I declined the quad screen.  I did have the anatomy scan and everything was fine.  My younger sister, on the other hand, opted for the quad screen for her second pregnancy.  The results were slightly abnormal and she was referred to genetic counseling, where they scared the crap out of her and caused her lots of stress and worry.  Her daughter ended up being perfectly healthy.  My sister is a major worrier, so it wasn't a healthy situation for her and she's decided she will never go that route again if she has another pregnancy.  So--part of your decision needs to take into account how it will affect you emotionally to opt for additional screenings.