Pregnancy Week by Week : Week 16 (part 2) - How Your Actions Affect Your Baby’s Development

5. How Your Actions Affect Your Baby’s Development

Amniocentesis

If necessary, amniocentesis is often performed around 16 to 18 weeks of pregnancy. By this point, your uterus is large enough and there is enough fluid surrounding the baby to make the test possible.

Fetal cells that float in amniotic fluid can be grown in cultures and can be used to identify some birth defects. We know of more than 400 abnormalities a child can be born with—amniocentesis identifies about 40 (10%) of them, including the following:

• chromosomal problems, particularly Down syndrome

• fetal sex, if sex-specific problems, such as hemophilia or Duchenne muscular dystrophy, must be identified

• skeletal diseases

• fetal infections

• central-nervous-system diseases

• blood diseases

• chemical problems or enzyme deficiencies

Ultrasound is used to locate a pocket of fluid where the baby and placenta are out of the way. The abdomen above the uterus is cleaned. Skin is numbed, and a needle is passed through the abdominal wall into the uterus. About 1 ounce of fluid is withdrawn from the amniotic cavity (area around the baby) with a syringe; if you are carrying twins, fluid may be taken from each sac.

Risks from amniocentesis include injury to the baby, placenta or umbilical cord, infection, miscarriage or premature labor. The use of ultrasound to guide the needle helps avoid problems but doesn’t eliminate all risk.

Bleeding from the baby to the mother can occur, which can be a problem because fetal and maternal blood are separate and may be different types. This is a particular risk to an Rh-negative mother carrying an Rh-positive baby and may cause isoimmunization. An Rh-negative woman should receive RhoGAM at the time of amniocentesis to prevent isoimmunization.

Over 95% of women who have amniocentesis learn their baby does not have the disorder the test was done for. Fetal loss from amniocentesis is estimated to be less than 3%. The procedure should be done only by someone who has experience doing it.

Are You an Older Mother-to-Be?

More women are getting pregnant in their 30s or 40s. If you waited to start a family, you’re not alone. Close to 15% of the mothers of new-borns are now 35 or older.

When you’re older, your partner may also be older. You may have waited to get married, or you may be in a second marriage and starting a new family. Some couples have experienced infertility and do not achieve a pregnancy until they have gone through testing or surgery. Or you may be a single mother who has chosen donor insemination to achieve pregnancy.

Today, many healthcare professionals gauge pregnancy risk by the pregnant woman’s health status, not her age. Pre-existing medical conditions have the greatest impact on a woman’s wellbeing during pregnancy. For example, a healthy 39-year-old is less likely to develop problems than a diabetic woman in her 20s. A woman’s fitness can also have a greater effect on her pregnancy than her age.

Grandma’s Remedy

If you want to avoid using medication, try a folk remedy. If you’re coughing, try 1 teaspoon of regular honey or dark buckwheat honey to help quiet your cough. It’s sometimes as effective as cough medicine.

Most older women who become pregnant are in good health. A woman in good physical condition who has exercised regularly may go through pregnancy as easily as a woman 15 to 20 years younger. An exception—women in a first pregnancy who are over 40 may have more problems than women the same age who have previously had children. But most healthy women will have a safe delivery.

Some health problems can be age related, and the risk of developing a condition increases with age. You may not know you have a problem unless you see your healthcare provider regularly.

Genetic Counseling May Be a Wise Choice. If either you or your partner is over 35, genetic counseling may be recommended; this can raise many questions for you. The risk of chromosome problems exceeds 5% for the over-35 age group.

Genetic counseling brings together a couple and professionals who are trained to deal with the questions about the occurrence, or risk of occurrence, of a genetic problem. With genetic counseling, information about human genetics is applied to a particular couple’s situation. Information is interpreted so the couple can make informed decisions.

When a mother is older, the father is often older; the father’s age can affect a pregnancy. It can be difficult to determine whether the mother’s age or the father’s age matters more. More research is needed before we definitely know the effects of a father’s age on pregnancy.

Will Your Pregnancy Be Different If You’re Older? If you’re older, your healthcare provider may see you more often or you may have more tests. You may be advised to have amniocentesis or CVS to find out whether your child has Down syndrome. Even if you would never terminate a pregnancy, this information helps you and your healthcare team prepare for the birth of your baby.

If you’re over 35, you have a greater chance of having problems. You may be watched more closely during pregnancy for signs of those problems. Some can be troublesome, but with good medical care, they can usually be handled fairly well.

Pregnancy when you’re older can take its toll. You may gain more weight, see stretch marks where there were none before, notice your breasts sag lower and feel a lack of tone in your muscles. Attention to nutrition, exercise and rest can help a great deal.

Because of demands on your time and energy, fatigue may be one of your greatest problems. It’s a common complaint. Rest is essential to your health and to your baby’s. Rest and nap when possible. Don’t take on more tasks or new roles. Don’t volunteer for any big projects. Learn to say “No.” You’ll feel better!

Moderate exercise can help boost energy levels and may ease some discomforts. However, check first with your healthcare provider before starting any exercise program.

Stress can also be a problem. Exercise, eating healthfully and getting as much rest as possible may help relieve stress. Take time for yourself.

Some women find a pregnancy support group is an excellent way to deal with difficulties they may experience. Ask your healthcare provider for further information.

Through research, we know labor and delivery for an older woman may be different. Labor may last longer. Older women also have a higher rate of Cesarean deliveries. After baby’s birth, your uterus may not contract as quickly; postpartum bleeding may last longer and be heavier.