The doctor or ultrasound technologist places a transducer on the abdomen or in the vagina, and an outline of the baby can be viewed on a monitor. It takes a trained eye to properly interpret the images, but usually a parent can spot the heartbeat and larger features as the pregnancy progresses. You may even see your baby sucking his or her thumb! Whether or not you will have an ultrasound depends on if the doctor has an ultrasound machine in the office and/or if there is cause to warrant the test. In most cases the doctor will give you a print-out of the ultrasound -- your first baby picture!

AFP Screening
The alpha-fetoprotein (AFP) test is a screening device used to check for the possibility of Down's syndrome or spina bifida in the unborn child. It's a simple blood test given to the mother which checks the levels of three hormones in the blood. Varying amounts of the hormones can be a sign that the child has a disorder. About five percent of those women tested have a positive result, meaning that the hormone levels fall outside of the norm. However, only about one in thirty of those with a positive result actually have a problem. Over 95% of babies who test positive have neither Down's syndrome nor spina bifida.

Presently, the state of California requires all doctors to offer this test to pregnant women. However, if you are pregnant you may refuse the test. Although many doctors feel that it's best to have as much information as possible, a positive test can cause an unnecessary amount of stress and worry. Abnormal tests are usually followed up by additional tests, including amniocentesis (described below). Neither the American College of Obstetrics and Gynecology nor the American Academy of Pediatrics recommend routine AFP screening.

Amniocentesis
Performed usually at sixteen weeks or later, amniocentesis is a surgical procedure of extracting amniotic fluid from a pregnant women to determine the sex of the fetus, detect disease, etc.. Guided by ultrasound, a long needle is inserted into the uterus and fluid is extracted. The fluid is then evaluated by a laboratory for certain defects, infections, and/or fetal maturity.

Amniocentesis poses a significant risk to the unborn child. Approximately one in 200 are miscarried as a result of the test. Your doctor should explain his or her reasons for asking you to have this test performed. It is usually recommended if the mother is over age 35, the couple has had a previous child with chromosomal defects, or if the parents carry certain genetic disorders. Nonetheless, you may refuse this test in the interest of the baby's well-being.

Chorionic Villi Sampling
Chorionic villi sampling (CVS) is used to detect genetic defects in the unborn child early in pregnancy, at about ten weeks as opposed to sixteen for amniocentesis. The doctor inserts a long, thin tube into the uterus and snips off a small piece of the chorionic villi, tissue between the uterine lining and the fetal membrane which will become the placenta. The tissue is then analyzed for genetic abnormalities.

The results from this test are available sooner than with amniocentesis, but the rate of miscarriage is about three times higher (1.5%) and the results may not be as accurate. There has also been some concern about fetal limb abnormalities as a result of CVS. Find out exactly why your doctor is requesting this test before agreeing to it. You may refuse this test in the interest of the baby's well-being. More about CVS.

Dealing with a Negative Test Result
An amniocentesis or other test may indicate that your unborn child has a genetic defect or disease. However, these tests cannot determine the severity of the problem. Many persons with genetic disorders such as spina bifida, Down's syndrome, and cystic fibrosis still lead rich and rewarding lives and are only mildly affected, though some disorders may present themselves as more severe. The important thing to remember is that although you and your baby may face the challenge of a handicap, he or she is still a precious human being who needs your love and care more than ever. If you feel unable to care for a handicapped child, there are many couples waiting to adopt special needs children. Contact your local crisis pregnancy center for more information about your options if you are faced with this situation.