More to the point, what can you expect when you are unexpectedly expecting? In my case, a missed period saw me frantically googling “early signs of menopause” and “why am I so moody?” Even a couple of nausea-fuelled days saw me clearing out the fridge of leftovers, rather than reaching for a pregnancy test. But when my boobs became sore and I suddenly couldn’t stomach the smell of my morning coffee, the penny dropped – could I really be pregnant?
In my defence, and like many other mothers out there, my road to motherhood has been long, checkered and peppered with my fair share of fertility issues. I had three miscarriages in my mid-30s, one at fifteen weeks. After much testing, and a considerable amount of angst, my miracle baby, Isabella, was born in 2013. I was 37. A fairly average age to be honest these days but at the time, years behind many of my friends and colleagues, most of whom had been happily increasing the size of their families whilst I quietly waded through the fertility wilderness.
And then…nothing. And not for lack of trying. Having a very close relationship with my own sibling, I couldn’t imagine not providing one for my own daughter but it seemed it was not to be. When you have struggled to have one baby, it’s difficult to feel sorry for yourself when a second does not materialise. By the time I turned 40 I had more or less written off the prospect of becoming pregnant again, and by 41 had settled comfortably with the idea of being lucky enough to have one amazingly bright, vivacious and beautiful child. And then out of the blue came a missed period.
And it seems I am not alone. CSO figures reveal that 4, 202 women aged 40 and over had babies in 2015, 988 for the first time. Births to first time mums aged 40 and over have nearly doubled in the last 10 years. Older mums are on the increase and it is an upward trend unlikely to change any time soon.
For me, the euphoria of an unexpected pregnancy did not last long. Try googling pregnant over 40 and you will see a dizzying array of facts, figures and statistics, none of which, at least at first blush, appear particularly encouraging. Every page described increased risk of miscarriage and serious foetal abnormalities. Recognising that google probably isn’t the best place for medical advice, I immediately contacted the Evie Clinic, one of the best destinations for antenatal care in Ireland, run as it is by obstetricians Prof. Sean Daly and Prof. Fergal Malone, the former Master of the Coombe and current Master of the Rotunda respectively.
Evie is a multi-disciplinary experience, a warm, supportive and entirely welcoming environment, in which the very best antenatal care from some of the country’s top consultants is provided alongside a team of experts including clinical midwives, lactation consultants, physiotherapists, nutritionists and more. It also happens to be home to world class prenatal screening diagnosis and management, including early viability scans and non-invasive prenatal testing (NIPT).
An early viability ultrasound scan is quick, completely painless and can reveal a heartbeat as early as seven weeks. NIPT is a simple and reliable blood test which looks at DNA from your baby’s placenta in a sample of your blood in order to pinpoint your baby’s risk for a number of genetic disorders, including Down’s Syndrome. Incredibly, it can be performed as early as nine weeks and its accuracy rate can be higher than 99%. Combined, these tests are the very essence of reassurance for mums like me in the early stages of pregnancy.
Ireland is one of the few places in Europe where diagnostic tests are not conducted as a matter of routine. Ordinarily pregnant women here have to opt for invasive antenatal tests, such as chorionic villus sampling (CVS) or amniocentesis (amnio). CVS can be carried out between 10 and 13 weeks of pregnancy, whilst amnio is usually conducted between 15 and 20 weeks: both hold a small risk of miscarriage (around 1%). The anomaly scan at around 20 weeks will examine your baby’s fetal structure, ensuring that baby is normal from an anatomical point of view. This check will look for all types of abnormalities but less than 50% of babies with Down’s Syndrome will be identified at this scan.
The results of a NIPT screening will tell you the likelihood, from low to high, of your baby having one of the most common genetic disorders. It cannot tell you for sure but it is highly accurate – between 97 and 99% – and it will help you and your doctor to decide next steps, such as whether to have one of the more invasive diagnostic tests.
Not one to deal with an increased risk of miscarriage or the anxiety of a long wait, I popped in to Evie the week before Christmas for the NIPT ultrasound and blood test. There are two variants of test, Panorama or Harmony, depending on your circumstances. I opted for the Panorama test and was in and out in half an hour complete with printed scan of a tiny throbbing heart as an early Christmas present. The blood sample is shipped directly to the USA for testing and results are usually back in 10 to 12 days so I settled in to chocolate-fuelled festivities (in lieu of wine!) and didn’t expect to hear back for a few weeks given the time of year. Not a bit of it. The lovely staff at Evie were on the phone the following week and well in advance of the New Year. They are sensitive to just how nerve-wracking it can be to wait for results. And happily the results were good – a low probability of any genetic disorder. The reassurance was wonderful and I immediately began to relax. Ten years ago, I could not have imagined being pregnant in my 40s. And yet here I am, looking forward to my pregnancy and the arrival of a new baby in a way that I would not have thought possible. Maybe age does have its benefits, although the supportive team at Evie certainly helps.
Evie is located at Suite 36, Beacon Hall, Sandyford, Dublin. For more information about the Total Care Packages and Once-Off Screening Tests available at Evie, contact 01 293 3984, email@example.com or www.evie.ie. You can continue to follow Suzanne’s Diary of an Expectant Mum here and online at www.pregnancyandparentingmagazine.ie.
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