I am 42 and will be 42 when I give birth. My first trimester screening came back as 1/587, negative, which is good. Docs don't reco an amnio
Yet I am struggling with this. I guess I have heard for SO LONG how dangerous is it to have a baby so late in life, I feel frightened
and yet, the thought of miscarrying due to amnio terrifies me too!
I am not looking for a moral debate about the amnio, just wanted other moms to weigh in their thoughts
I think the main thing to think about is what you would do with the results. I think that your results so far are good, but do you want to know for the piece of mind, or would you terminate? (No judgment at all from me) I think that if you would not terminate then you should not have the test because, although rare, I have read stories of women miscarrying and finding out their baby was healthy. I thought that I would have the amnio if my tests came back as a high chance because I thought that I would possibly terminate because we already have a special needs child, but then decided that I really knew I wouldn't because if someone would have told me while pregnant that my baby would end up being autistic, it would have been devastating to me. Now that he is here I truly can not imagine my life without him, nor imagine being sad that he is the person he is. He really blesses everyone he comes into contact with. I feel like I would have a similar feeling towards a baby with DS. It is also worth mentioning that the doctors would likely be able to see any possible major deformities that would require surgery right after birth at your 20 week ultrasound. Good luck in your decision. 
I am over 40 and pregnant with my second. My DH and I decided right at the beginning that while we would terminate for any abnormalities that would cause pain and suffering for our baby, we would not terminate for Down's or conditions that were successfully treatable. I had the blood screens and a nuchal translucency ultrasound scan done, and the results from that showed I was at low risk for carrying a child with chromosomal abnormalities, so I elected not to get an amnio done (with the full support of my midwife). There didn't seem to be much point, as the blood tests/scan showed that I was at no more risk for anything diagnosable via amnio than your average 25-30 year-old. I had the standard 20-week ultrasound done yesterday and (to my unprofessional eye anyway) everything looks fine.
Unless the pregnancy was high-risk to start (ie IVF) I don't see any reason to do an amnio if the blood tests/NT scan come back similar to what one would expect from a younger woman. Not all your eggs get fried just by hanging around ;)
I turned 35 this summer, which is the cutoff when they start suggesting a higher risk for chromosomal abnormalities. I wasn't worried but I did the blood tests and nuchal ultrasound so we could cross it off of our list, and everything came back normal. At my 20 week ultrasound the tech noticed a very tiny spot near the umbilical cord that is either an umbilical hernia or an omphalocele (the second is surgical). They sent me to the hospital for another ultrasound and consult with a maternal-fetal dr, and she starts talking about how small omphaloceles can be associated with chromosomal abnormalities and suggested an amnio, which I really didn't want to do because of the miscarriage risk. It took 4 years to conceive this baby, I don't want to take any risks, which is why I did the earlier tests. Every Dr I saw kept asking if I wanted an amnio, and my OB told me that the only reason they kept asking was because the cutoff for termination in my state is 24 weeks, and I was at 22 weeks. But if we weren't considering terminating, there really wasn't a reason to do an amnio, so not to read into their sense of urgency. I told him I just wanted to know whether I should be a little worried or a lot worried, so he spoke with a geneticist about all of my test results, and he said it was highly unlikely that there is anything more going on given that everything else looks great so I've taken his advice.
I thought I'd tell you the story because I was able to get the answers I wanted without doing an amnio. Good luck and I wish you a healthy, low-stress pregnancy too!
I had my first child at 36 and my last child at age 40. I was worried with the last one, because of all they say, and because of a history of miscarriages, and the difficulties I'd had with the first pregnancy. However, I had no problems at all. I was so healthy it was amazing! No issues whatsoever. My daughter was/is very healthy. In fact, due to the Braxton Hicks contractions I had been having for much of the pregnancy, my uterus was really in shape for the big day. I didn't even know I was in labor, and when my water finally broke, she was here in only three and a half hours!
I don't have any great advice for you, just some support. These are hard decisions. I agree with others that if you're not going to terminate, I don't see the point in the amnio with such low risk factors. If you would considering terminating, I'd still wait and see what the next round of tests brings. You still have the AFP and another ultrasound before you have to make a decision on the amnio, right? (At least, I do, and I'm also past the "old person" mark.) LOTS and LOTS of people have totally healthy babies in their 40s, and your numbers are really great.
We are pregnant with twins, and decided that we would only do an amnio if the screening revealed something that led us to believe that both babies were at a high risk of genetic abnormalities.
I hope you get the answers you need, either way. Good luck!
sorry ive jumped in here,im 42 recently found out im pregnant to my delight and everyone eles horror ! im to really scared that im being selfish to continue with a pregnancy which is high risk due to my age,i think its what you would do after the results of amo,if you would carry on regardless i dont see the point of having the test i myself will only have it if there are factors which then say they may be a problem but not as a routine test,its very early days for me still in first tri and getting cramps but no spotting,worrying that this is sign of misscarrying,and sick of being judged by people because im having a baby in my 40s,its really good to hear of others pregnant at 40 good luck with your pregnancy and hope and pray it goes well for you xxxxxx
I just want to point out - no judgement, a lot of people have very different feelings on this and it's all ok - but Down's is NOT the only chromosomal anomaly out there that's picked up by blood screening and amnio. Personally I would not terminate for Down's - it isn't associated with a super-high risk for other health problems (although Down's people usually have shorter life spans and are prone to cardiac issues later in life) nor is it associated with a lot of pain, suffering and surgery to make life even possible. Plenty of people with Down's live full, satisfying and happy lives.
But trisomy 13 and trisomy 18 are a whole different ball game. Very poor outcomes there, not much hope of a pain-free life, never mind full and happy adulthood. This is why I had blood testing done. I would be perfectly happy with a Down's baby. But I would not ask a baby to live with other trisomies, no matter how much I wanted that baby.
So I think that the BLOOD tests are a good idea - no risk to the fetus, and can provide peace of mind to the parents if they're negative (as most are). Amnio if the blood tests are negative isn't necessary as it's unlikely to show anything other than "all good" and it DOES carry some risk. The difficult choice, to my mind, is what steps do you take if the blood tests are positive. For me, it would become a statistical problem - risk of carrying a baby with a most-likely-fatal trisomy vs risk to a Down's baby vs risk to a potentially normal baby.
I don't think it's a good idea to avoid the blood tests simply because one is afraid of having to make decisions with the information they might provide. But, that's me. I understand that other people would prefer to defer those decisions to a higher power. I just think everyone needs to be very clear - to themselves - where they stand on that.
Oh, I get the religious objections and I can't argue with them - it's just not something you argue with, IMHO. But I have a pathological aversion to flying blind on anything (research! it's my friend!) and I think that if I were who I am, only religious and convinced, as your DH is, that termination isn't an option - I would still do the blood tests. And the amnio, if it came to that, despite the risks, probably. I just think it would help the situation if I could be a bit prepared, in advance. I also dislike expending hopes on things unknowingly, when I can make a choice and know whether that hope is justified or not. But again, that's me, and that's why it's a totally personal decision that everyone has to make for herself. I can certainly see the other side of it but I can't see myself making those choices.
I guess my point is, this isn't something the internet should decide for you 
Anyway, I'm at 12 weeks and very hesitant about doing CVS or amnio, so I'm doing the MaterniT21 blood test. I know it is new and it is less accurate than amnio for Trisomy 13, but at 99% accuracy for 21 and 18, I think it's a great option.Personally, I think the risks of older moms have been amplified to a point that it is no longer doing good and is doing the oppsoite. I personally would not have the amnio done. For me, it isn't worth the miscarriage risk. The biggest issue with older motherhood is an increased risk of Downs Syndrome (and it is still not that high of a risk). I personally don't beleive there is enough I would have to prepare for in the early years for caring for a downs syndrome child and I would not terminate based on that.
I also look at the years before amnio, we got a long fine. My great grandmother had my great uncle when she was 47 and that was in 1957. She didn't have amnio In fact, for most of her pregnancy she thought it was early menopause.
Congrats on your pregnancy! I hope you can enjoy it.
I think that your doc is right on not to recommend an amnio because the risk of miscarriage from the amnio is higher than your chance of having a baby with a genetic birth defect.
I was 35 and 39 with my last two pregnancies (including the newborn on my lap) and choose to do CVS with both of them. The risk is very small when done by an expert, much lower than the reported risk which is old data and it was totally worth it to me for my piece of mind. I was very worried with both and the peace I gained allowed me to go on a happy home birth.
The risk is low enough that the benefits (whatever you want from it, choice to terminate, peace of mind, thoughtful preparation for a new life with a special needs child) really outweighed with the risk for me.
I'm 39, and the baby (#2 for us) is due right around my 40th birthday. I had some abnormalities that showed up on my 20 week ultrasound, so we went to see a specialist and geneticist. They did another ultrasound, and determined that I was at a slightly increased risk of having a Downs baby. Because the risk was only slightly reduced, we decided to wait on the amnio. We are going to have another ultrasound at 32 weeks. If that shows an increased risk, I think we'll opt for an amnio, just so we're a little more prepared. One of the reasons that we decided to wait is because of the increased risk of miscarriage. It's not an easy decision!
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