First OB visit

Yesterday was our first official OB visit. (Apparently the other 5 times didn't count!) This one was with my nurse practitioner (who works with my ob/gyn). She was very nice, but a little too mellow for my tastes. Or maybe I was just annoyed because she was already running 45 minutes behind for our 8:40am appointment. Since I had clients starting at 10, this cut our visit a little (actually, a lot) short. Ugh!

But, we got to see our little bean again, and s/he continues to measure right on track for "age." This time s/he was wiggling and squirming about - I think s/he was excited to see us! :) For some reason I had always imagined fetuses just floating around all zen-like, but that was not what our bean was doing!

So now that we've made it this far, we actually have to make some decisions! We have 1 week to decide whether we want to do the First Trimester Screen, which has to be done between weeks 11 and 13 (and is apparently a little difficult to schedule). As best I can understand it, this is a blood test plus a fancy ultrasound that will tell you your personalized risk of having a baby with Trisomy 21 (aka Down syndrome), and Trisomy 13 or 18 (both of which are ultimately incompatible with life - if they even make it to full term, they usually die within hours to days).

We have a little longer to decide if we want the Maternal Quad Screen, which is done between weeks 16 and 18. This is just a blood test, and it screens for all of the above plus neural tube defects (such as spina bifida). It's a little less accurate than the First Trimester Screen for detecting the chromosomal abnormalities.

No matter what, we definitely get the 18-20 week ultrasound, which would be able to detect (with pretty good accuracy, except for Trisomy 21) any of the above as well.

The advantage of doing either of the screenings is that it could (a) give us peace of mind or (b) give us an early indication that something might be seriously wrong, so we'd have more time to make decisions. The disadvantage is that these are all fairly rare problems and if there seem to be any issues we would be referred for more invasive tests (such as CVS or amnio) which both have a risk of miscarriage (1/100 for CVS, 1/300 for amnio).

Here's more info from the Mayo Clinic website:  http://www.mayoclinic.com/health/prenatal-testing/MY01403

We're going to think about it a bit longer, but at this point we're leaning toward just waiting for the 20-week ultrasound. If we have a baby with Down syndrome, we wouldn't do anything different. If we have a baby with Trisomy 18 or 13, or with neural tube defects, the 20-week u/s would tell us and we'd be able to make decisions then.

Besides, I'm really trying to be all zen and just trusting that everything will work out this time.

Anyone see any flaws to our logic? Any pros or cons that I'm not considering?