Prenatal Testing: Many Tests and Many Decisions

You want to experience your pregnancy in peace and as free of worries as possible. At the same time, you may want to know before the birth whether your baby is healthy and have a guarantee that you can make the right decisions as early as possible in case of a bad test result. This is exactly what prenatal testing is all about. With the help of several types of tests and examinations before birth, gynaecologists can look for indications of disease or fetal malformation. Part of it is part of the normal prenatal care examinations. However, there are a number of additional prenatal diagnostics procedures that belong to what are known as ‘individual health services’, often shortened to ‘IGel services’ (IGeL-Leistungen). You usually have to pay for these additional services yourself. In certain cases, however, health insurance companies will cover the costs.

Before you decide on any type of prenatal examination, you should ask your gynaecologist for detailed advice about the procedure. For example, it is important for you to know what exactly the aim of the examination is, how it is done and when you will find out the results. How reliable are the results? How often does a false alarm occur? If the results are good, can I be sure that my child will be born healthy? It is also important to know if there are any possible risks to you or the fetus associated with the examination. You should also discuss with your doctor what to do if the results of the examination are bad and the fetus is probably ill. Do further examinations have to be done then? What are they? What can you do if you feel unable to raise a child with a disability or chronic illness? After consulting your doctor, you do not have to decide immediately for or against the respective examination. It's best to take a few days to think about it. All prenatal testing is voluntary and your choice.

Many parents think that more screenings mean more safety. But that's not necessarily true. In fact, they can also be unsettling and cause anxiety. One of the reasons for this is that many of the tests do not provide a clear result. They only give probabilities for your pregnancy. In addition, in the event that the child does have a disability or illness, it still remains unclear how severe this limitation will be and what symptoms may occur. Many diseases can present very differently. It is also rare for an examination to produce a worrying result, but the baby is later born healthy. Also, amniocentesis, for example, can lead to miscarriage in one to two cases out of 1000. This presents expectant parents with some very difficult decisions. That's why it's best to do your research before getting a prenatal checkup. This includes considering what further steps you do and do not want to take in the event of a poor outcome. But you do not have to clarify these questions alone or only with your partner. You can get help from professional counsellors in weighing your options, as there are many support services available. A good place to start is the pregnancy counselling centres in your area and specialists in prenatal diagnostics.

Maybe you got some disturbing news. Instead of hearing that there is nothing wrong, your doctor says that there is probably ‘something wrong’ with the fetus. There may also be evidence that it has a hereditary condition. Then you shouldn't rush into anything. Many parents-to-be find it helpful in this situation to have everything explained to them in detail. Gynaecologists will discuss everything important with them in several meetings and never leave their patients alone with the results. There are also specialists in prenatal diagnostics and paediatricians who specialise in treating children with disabilities or chronic illnesses. In the event of abnormalities, it is in most cases advisable to obtain a second opinion from specialists with extensive experience in this field. Together with your doctor, they will help you better understand your situation and clarify any questions you may have. What does the diagnosis mean for the child's life chances? Are there any treatment options? What would my life be like with a child if they were terminally ill or had a disability? What can I do if I can't imagine living with a child who is sick or has a disability? Some parents-to-be find it helpful in such a situation to seek advice from good friends or from their own family. However, you may prefer to contact an outside person. Then you can always contact one of the pregnancy counselling centres in your area. There, specially trained counsellors and psychologists can help you to shed light on all the important thoughts and feelings so that you can make the right decisions for yourself. If you are being cared for by a midwife, you can also confide in them and make use of their support.

The counselling centres, doctors and your midwife can also put you in touch with associations of affected people. Groups of parents who have themselves had children with a disability or chronic illness, or disability associations, can give expectant parents an idea of what they might face. They can also report from their own experience on the quality of life associated with certain diagnoses.