Advanced Maternal Age Counseling? What happens?

[Peggy O]

Hi all. I'm 37 and expecting our 1st. I feel like I have kinda been railroaded into this "Advanced Maternal Age Counseling" situation by my NP. They just automatically have the hospital call you and schedule it if you are over age 35.

Things have become more complicated since I agreed to go to the counseling, I had a big gush of bleeding, followed by on and off bleeds (lighter after the initial one) for 2 weeks. It has stopped (*fingers crossed!*) for now. I am really having a hard time with this situation, and I just feel like I don't want any more negative news or stuff to worry about right now. I have had 6 appointments in two and 1/2 weeks, so far so good. Very stressful though.

So my question to fellow over 35-ers...is did you choose to go to the AMA counseling? How was it? Was there any helpful info given, or just a list of the dangers of pregnancy over 35? I had a friend go to the same type of appointment in TX, about 3 years ago, and she came home in tears worried about all the possibilities (This was her 5th child, only one over 35) . Her baby was fine in the and. I am just not sure if the stress of worrying about extra stuff that most likely will not happen is a good idea right now. I am already a nervous wreck.

 

[chattyB]

I've never heard of it before!! Could you phone the hospital before hand and ask what the session entails? At least then, you'll be able to make an informed choice as to whether or not you feel it would be beneficial. Remember, this is your pregnancy, your baby, your choice and you DO have a choice ... It's very easy for the medical profession to railroad pregnant mothers, particularly first time mothers into decisions as they don't always know that they can (and should) say "no" if they want to.

I hope the pregnancy gets easier for you soon

 

[Peggy O]

I have a regular prenatal tomorrow with my usual NP. I plan to ask her what they are going to tell me at the hospital (Where the AMA counseling is scheduled), I believe it is about increased risk for defects, and amnio options and all that. I don't want amnio, no matter what they see on the nuchal fold screening scan. I kind of don't see the point in going if all the appointment is about is my options if something is wrong. That's the impression I get. I may just skip it unless they cover some other topics that may be of use to me. I don't want to get extra upset. It really is very overwhelming....sometimes I feel like a product (Pregnant Lady) on an assembly line! :/

 

[gryphongrl]

Peggy, hi. I'm 36 expecting my first. When I went in to my first appointment with a NP I had expected a midwife, but the NP explained that because of my age (and solely because of age) I was "high risk" and assigned a NP pending an OB/GYN. She was there, apparently, to do this counseling thing.

Like you, I had already decided to decline the amnio, CVS, etc no matter what, and am not a big fan of frequent ultrasounds. I told her that... and she didn't stop. She started up with "don't you want to know if it has a heart defect" and "don't you want to know if it..." Basically like your friend said, it was upsetting. I was newly pregnant, not super confident in being pregnant yet, and saying "NO" "NO" "NO" to this lady was extremely stressful. It was hard to get out of her office, she just didn't want to take no for an answer. Like you... I waited a long time to have a baby, and had researched thoroughly what type of testing I wanted. I transferred care after this to an actual midwife practice and when I explained what had happened to my new midwife, she said "you must have VERY good insurance!". Funny, but possibly true!!

 

[Peggy O]

I talked to my NP this morning...she said I absolutely can and should decline it if it's just going to cause me stress. I am just kind of ticked that this is automatically scheduled, rather than suggested! Not everyone worries that their baby isn't textbook "perfect". I knew what I was signing up for when I made a baby at 37. I am an endometrial cancer survivor...I fought like h*ll to keep my uterus and just be able to have this baby at all. This extra *OMG WHAT IF?!?!?!* feels upsetting right now. I'm gonna' try to be polite tomorrow though....They better not give me a hard time. If they are rude I may go hormonal.

 

[Livsmom]

I just had the genetic counseling appt today, although mine was at a specialist and not a hospital. It was very helpful and I opted for an amnio for peace of mind. However, they did not push it AT ALL and were very nice and actually reassuring that things were likely normal even though I was older. I am in California so maybe that is why it is different. So sorry you are feeling stressed and pushed into this! This is definitely something you should have a right to choose and I hope you have an easy and good appt tomorrow. If not, tell them to stuff it and leave! This is YOUR baby, not theirs!

 

[Peggy O]

Thanks...I am feeling a little better about the situation since I explained my concerns to the NP this morning. I thought she would be pushy about it...but the minute I expressed concerns she immediately sided with me 100%. That is very reassuring to me. I am going to try to go in with an open mind tomorrow, I do want the sonogram, I just like seeing the baby after thinking he-she was a goner in the ER for 6 hours (No one explained to me we might still be Ok, till the OB from this place I am going to tomorrow arrived) The ER experience was horrid and just the idea of going back to any hospital scares me a bit. I think that's alot of this. Unknown territory.

 

[Larkspur]

I talked to my NP this morning...she said I absolutely can and should decline it if it's just going to cause me stress. I am just kind of ticked that this is automatically scheduled, rather than suggested! Not everyone worries that their baby isn't textbook "perfect". I knew what I was signing up for when I made a baby at 37. I am an endometrial cancer survivor...I fought like h*ll to keep my uterus and just be able to have this baby at all. This extra *OMG WHAT IF?!?!?!* feels upsetting right now. I'm gonna' try to be polite tomorrow though....They better not give me a hard time. If they are rude I may go hormonal.

I actually think it's a good thing that it's automatic sign-up but that you should feel free to opt out. I was never offered any age-related maternal counselling and I felt a bit left to wander in the dark and search on Google.

Before I got pregnant, I would definitely have said I would abort if there were serious genetic issues revealed at the 12-week scan. But after seeing the fetus at 12 weeks, with a little nose and hands and legs, I felt totally ill at the thought I might have to make such a decision. Fortunately my test results were very very low, but I dread having to go through it again for the next child. My OH is firmly in the camp of not wanting to go through with a high-defect-risk pregnancy and I thought I was too, but we will have to have a very serious chat before we try again, as I can't guarantee I still feel the same way.

 

[Peggy O]

My mom worked with seriously disabled children for 20 years (Retired now) My sister works with physically and mentally (Sometimes both) adults in a dayhab program....I see these folks often and I always knew I would keep any baby that came my way. I know my family will be great if anything is different about our kid. I think this is part of the reason I feel so strongly about it.


I fell in love with my baby at 9 weeks (first sonogram) too. It's so overpowering to see. I had no idea.

I was thinking earlier that many religious funded hospitals and centers may not offer these tests, that would suck if I wanted them. I wasn't offered an opt out option though. When I 1st brought it up with the scheduler on the phone I was met with a slightly snoOoOoty resistance. Like I was a dum dum for not wanting them. Ug. I really hope everyone is not like that tomorrow. I bet they'll be nice and it'll be fine. Hope so anyway.

 

[Livsmom]

Thanks...I am feeling a little better about the situation since I explained my concerns to the NP this morning. I thought she would be pushy about it...but the minute I expressed concerns she immediately sided with me 100%. That is very reassuring to me. I am going to try to go in with an open mind tomorrow, I do want the sonogram, I just like seeing the baby after thinking he-she was a goner in the ER for 6 hours (No one explained to me we might still be Ok, till the OB from this place I am going to tomorrow arrived) The ER experience was horrid and just the idea of going back to any hospital scares me a bit. I think that's alot of this. Unknown territory.

I am sorry you had such a horrible experience in the hospital! Having a baby is stressful enough without crappy medical attention. Do try to go in with an open mind. My genetic counselor was sooo sweet and after talking to her, my husband wasn't even sure he wanted to proceed with an amnio. The statistics of having a baby older are a bit scarier, but not ridiculous and your odds of a healthy baby are much greater than that of a baby with problems.

 

[Peggy O]

Right! The odds are in our favor. I think I am just freaking out. I'm gonna get a meatless egg McMuffin. lol (Bad craving) and be there at 7:45 tomorrow with a positive attitude

 

[Livsmom]

OMG I craved sausage mcmuffins ALL the time until about 12 weeks then suddenly they made me sooo ill. LOL. Thankfully! My poor taster is so screwed up.

 

[daisy72]

I was never offered any additional councelling related to my age, and I honestly have no idea what exactly they can offer rather than giving juicy details about the risks. If there's an actual problem, I will deal with it, but I refuse to worry about all potential problems.
Luckily, my OB and everybody I meet at the MFM clinic that I attend due to diabetes, are very laid back and reassuring.

 

[Peggy O]

I get the sausage on the side and the Scott (Other half < ) Puts the extra sausage on his. Lol. I know I shouldn't be eating this crap but I am an out of control food elimination machine lately ;/

The appointment went well! I made my feelings clear to all of the providers I saw and no one was weird about it. They were really nice and presented the info unbiased. I left really happy knowing that the nuchal fold measured 1.5 (Supposed to be under 3 at this age), nose bone and limb ,length is good, good heart rate, and that there were no visible soft markers at this time.

I am going back for the 18 week scan Sept 22. I love this place! (Women's and Children's Hospital Of Buffalo NY Regional Perinatal Center). It was so much better than my ER experience, or even my usual NP/OB office. Better equipment, more professional. I got some info about their birthing classes. I will wait till after the 18 week scan to sign up.

 

[Peggy O]

https://s258.photobucket.com/albums/hh278/darkharlezucreek/?action=view&current=Baby128004.jpg

Whoops...tried to post a picture but I guess I don't know how. Oh well.

 

[Livsmom]

YAY! Glad you had such a positive experience! My regular ob is lacking this pregnancy as well. I am tempted to find a new one actually. But so glad you got good news and feel better about it!

 

[Peggy O]

I may end up switching basic providers as well. I will have to be seen at the hospital perinatal center, but then keep going with a regular OB/NP somewhere too. We'll be moving soon, so I am just going to wait on that one. Our new house is an hour from here, but we'll be out in the sticks so I am not sure what will be available out that way. I am just hoping I make it to town in time when it's time to have the baby. It's only an hour but it feels like a million miles for some reason.

 

[Livsmom]

I may end up switching basic providers as well. I will have to be seen at the hospital perinatal center, but then keep going with a regular OB/NP somewhere too. We'll be moving soon, so I am just going to wait on that one. Our new house is an hour from here, but we'll be out in the sticks so I am not sure what will be available out that way. I am just hoping I make it to town in time when it's time to have the baby. It's only an hour but it feels like a million miles for some reason.

You will just have to pay special attention to your body and head to the hospital at first sign of labor. If you are like me, you will make it with MANY hours to spare. LOL. My first I went into labor and 5 hrs later out she popped. Thought wow that was easy. The next two my water broke and they ended up inducing me. This is a slow procedure and I was in labor forever. Both ways though, the end result is the same and you soon forget what you went through.

 

[Peggy O]

I am kind of terrified, in a curious happy way...if that makes any sense.

 

[Livsmom]

I am kind of terrified, in a curious happy way...if that makes any sense.

Makes perfect sense! And it is not as bad as people say.