I was counting the weeks, then days, HOURS, until our 20-week scan for our second pregnancy. We were so excited just to see our baby again and of course we knew deep down that everything was just fine. Our 12-week scan gave us a glowing report and the clearest ultrasound photo the sonographer had ever seen. We were literally floating and catching another glimpse of our baby was too exciting to resist.
I love scans, I have to admit. That sneaky glimpse into your precious womb and your unborn baby's cosy first home, there's always been some reassurance there for me. Until last week that is.
The results were fine, our baby is kicking, wriggling around and growing beautifully. But I already knew this. My belly moves quite noticeably when he or she is awake and has quite a left foot just like their Daddy.
This time however, there was a "The only thing we've found is..." My heart dropped. I wasn't expecting this - I didn't want a 'but' or 'only thing is'.... I couldn't even look at Fabs and I could feel the colour draining from my face.
"Yes?" I said.
"We can't find your baby's nasal bone."
"And?" I said. I think I thought the less I speak the more information I'd get told...
"Well no nasal bone at this stage can mean nothing at all. And sometimes it's a soft marker for Down's Syndrome. Babies with Down's Syndrome have no nasal bone."
"Right." Again with my one-word answers.
I guess I didn't know what else to say. There were too many questions in my head.
What followed was basically a long chat with a suit-clad Consultant giving us more information and discussing our 'options'. Amniocentesis, Harmony Test then to my utter horror, the T-word. Which I can't even type. That was it for me, the tears filled my eyes. I know it's his job to speak plainly but I wanted to soundproof my womb space and my baby's ears from this conversation because "how dare you say that?! This is my baby you're talking about! My living, kicking, breathing, hiccuping, blinking, yawning child!" I didn't say any of this of course.
So, I'm not writing this post to tell you my full story here I'm afraid, because, well...some things are too current and fresh (and personal) to share for me right now, however, our 'risks' of having a baby with Down's Syndrome are still very low, baby's organs are all perfect and River, our first born, has the tiniest nose bone so it's quite possible the hospital just didn't bother to mention River's nasal bone to us at his scans.
Importantly though, we've opted out of further screenings and tests because no result alters how we feel about our baby - and that's our very personal decision on the matter. We just don't care.
The reason for me writing this is to share some knowledge about the nasal bone finding and open a discussion in your mind, pregnant or not, about access to information versus intuitive knowledge and trust.
What I now know
Rudimentary ossification of the nasal bone is a soft marker for Down's Syndrome and increases your 'risk' by 23 times.
If your baby has no other structural abnormalities or secondary markers for chromosomal abnormalities your risk will be recalculated once more. Ours then came up to multiplied by 8 times.
The only way to rule out Trisomy 21 (Down's Syndrome) is with invasive testing that brings with it a risk of miscarriage.
The invasive test offered on the NHS is called Amniocentesis and it involves the removal and testing of cells in your baby's amniotic fluid.
1% of women who opt for Amniocentesis have a miscarriage.
Miscarriage is defined as the loss of a pregnancy before 23 weeks. After which your loss will be called a stillborn baby.
98-99% of women will be given a conclusive result (a yes or a no) after Amniocentesis
The non-invasive test is a maternal blood test called the Harmony Test.
The Harmony Test is not offered on the NHS and privately you can expect to pay £400-£500.
The Harmony Test has a 99% accuracy.
No Down's Syndrome screening is 100% accurate
Current guidelines say that a screening test must detect 75% of babies with Down's syndrome with a screen positive rate of no more than 3%.
The term "screen positive" describes those women who were given an "increased risk" result which is a result giving a chance of between 1 in 2 and 1 in 149 of the baby having Down's Syndrome.
Ethnicity is a factor in the development of the nasal bone.
Pros and Cons of Ultrasound Scans
Let's think for a moment. Everything, and I mean everything in your pregnancy and birth is optional. You have choices at every stage and you can enlist the services and support of healthcare professionals, Doulas, family or friends to support you in your journey as you wish. Every woman has the right to opt out of scans, they are not law - and sometimes scans save lives and are a fantastic medical diagnostic tool. So let's look at pros and cons, because access to information is everything.
There are no KNOWN risks for ultrasounds but there can be some bodily effects, such as tissue heating and cavitating (producing small pockets of gas).
In some countries ultrasound scans are only offered in pregnancy for medically indicated cases.
Can give false results and cause unnecessary worry for the parents. Some developmental disorders cannot be detected by ultrasound.
Can feel quite uncomfortable for some women.
Excessive testing, hospital appointments and screenings can take us out of our intuitive headspace that we need to refine and tune into during pregnancy and for birth.
Safer than X-Ray or CAT Scans (no radiation)
Reassurance for anxious parents to see heartbeat and be told their baby is developing normally.
Can highlight abnormalities that some parents want or need to know.
Can determine the position and condition of the placenta - placenta previa for example (if your placenta is blocking your cervix) in very late pregnancy can result in an advised C-section.
Can estimate the growth of the baby, which in some cases is useful information.
And my Doula Superpower: SIGNPOSTS that you might find useful
BIRTH RIGHTS http://www.birthrights.org.uk/
NHS on Amniosentesis - https://www.nhs.uk/conditions/amniocentesis/
ARC - Antenatal Results and Choices - http://www.arc-uk.org/
Down’s Syndrome Association - https://www.downs-syndrome.org.uk/
AIMS - Who says Ultrasound is Safe? A journal. https://www.aims.org.uk/journal/item/who-says-ultrasound-is-safe