All About Baby

At week 18, your baby-to-be’s senses are maturing. She’s able to hear sounds within her own comfortable environment, such as the sound of your heart beating, as well as external sounds, such as your voice. She may become more active for certain sounds, and you’ll feel her movements. At this point in her development she’s still small enough that she has plenty of room to wiggle.

All About You

By now you’re feeling your baby-to-be wiggle inside you. The excitement surrounding her first movements will probably help you forget some of your pregnancy woes. As your tummy continues to expand you may notice stretch marks and have itchy skin. Your back will ache as your body adjusts to its new alignment. Thankfully, nausea is mostly likely a distant memory.

Understanding Pregnancy Tests

Between your 16th and 20th weeks of pregnancy you’ll be offered a series of tests to determine if your baby-to-be is at risk for certain genetic problems. Notice that these tests are offered but not required. Before you submit to the tests, it’s important to understand what each entails and what the results will tell you about your developing baby.

Risk Assessments, Not Tests

Rather than view genetic tests as pass/fail, physicians see them as risk assessments, looking at whether your baby-to-be has a greater risk for certain genetic problems. For instance, a “positive” result doesn’t necessarily indicate a problem with your baby, but that you might consider additional — and more definitive testing — to determine your baby’s health. “The way I describe it to my patients is that these tests are like casting a wide net,” explains Dr. Joanne Motino Bailey, a certified nurse midwife and a professor of women’s studies at the University of Michigan. “You have plenty of healthy babies that are caught in the net” along with a handful of babies with genetic concerns.

Non-Invasive Tests

The main reason for so many false positives, according to Dr. Motino Bailey, is that physicians want to offer the safest, most non-invasive way to test your unborn baby for certain genetic disorders. These tests involve a simple blood test with virtually no risk to your baby-to-be.

  • Quad test/triple screen: Your healthcare provider will draw your blood and test it for elevated levels of certain hormones and proteins, which may indicate your unborn baby has a genetic problem. The quad tests for Down syndrome, spina bifida, and other genetic problems. Keep in mind that this test has a high false positive and a high false negative rate.
  • Depending on your healthcare provider, you may be offered the triple screen, which includes looking at two hormone levels and one protein, or the quad test (quickly becoming the norm), which tests for an additional protein that may indicate genetic problems.
  • Nuchal translucency screening (NTS): A more recent test option combines a blood test with an ultrasound to look for risk factors that may indicate that your unborn baby has Down syndrome. The test is highly specialized, however, so it may not be available in your area.
  • Cystic fibrosis: Your blood sample will also be tested for cystic fibrosis. The test will determine if you are a CF carrier. If you are, your partner may then be tested. Because this is a recessive disorder, both you and your partner must be carriers for your unborn baby to be at risk. If both parents are carriers, according to ACOG, your unborn baby has a one in four chance of developing the disease.
  • Ethnicity-based blood tests: Certain genetic disorders tend to appear in certain ethnicities. Your physician will ask a series of questions about your background to determine whether these tests are necessary for you.

Invasive Tests

If your first round of screening comes back with positive results (again, not meaning that your baby has a problem, but that she might be at a risk) you will be offered additional tests to give you a definitive answer about your unborn baby’s genetic makeup. While these tests offer the yes/no answers you may be looking for, they do carry a risk of miscarriage.

  • Amniocentesis: With an amnio, your healthcare provider inserts a long needle through your abdomen and into the uterus to collect a small sample of amniotic fluid. The fluid is then tested for genetic problems, such as Down syndrome, neural tube defects, and other disorders. The test is done between pregnancy weeks 16 and 20.
  • Chorionic villus sampling (CVS): In CVS, a needle placed through your abdomen or through your vagina withdraws a tiny portion of the placenta. The sample can then be tested for Down syndrome, sickle-cell anemia, and cystic fibrosis. The test is performed between pregnancy weeks 10 and 12.

Note: CVS, a first-trimester test, provides parents with an earlier diagnosis than amniocentesis, a second-trimester test. Until recently, CVS had been associated with a slightly higher rate of miscarriage, but findings published in the September 2006 issue of Obstetrics & Gynecology show that the miscarriage rate is actually the same for both CVS and amnio, below two percent.

These tests are not to be taken lightly, advises Dr. Bailey. Take time to ask your healthcare provider about each test.

Related Post

Q & A

Got questions about Week 18? Other ladies have wondered…

Q: Should I eat differently now that I know my baby’s gender?

The tried-and-true practice of everything in moderation is really the best approach here. Eating too much of one type of food can lead to not having enough room to eat other things that you need. So eat a colorful, varied diet. Take in a balance of fruits, veggies, grains, proteins, and fats. Read more about eating healthy while pregnant.

Q: At an ultrasound, my doctor found a bright spot on my baby’s heart. What is it?

This is a hard question to answer without more information. Screening for Down syndrome is complex, because there is so much overlap between findings in babies with Down syndrome and what’s seen in typical babies. Several findings on an ultrasound are called ‘soft markers’ for Down syndrome. Read more about Down syndrome testing.

Q: Why do some pregnant women need to go on bed rest?

Bed rest can be recommended for many different reasons in pregnancy. Read more about pregnancy bed rest.

Q: How can I treat this severe heartburn?

Usually heartburn is harmless in pregnancy, but it can be very uncomfortable. Chewable antacids like Tums neutralize acid and may give temporary relief, but the calcium in the antacid actually stimulates more acid production an hour later, and symptoms can actually get worse. Read more about severe heartburn during pregnancy.

Your Partner

Beginning to Build Your Bond

As a dad-to-be, you don’t have the same connection to your baby as your partner does. If you’re looking for a fun way to build a connection with your unborn child, one of the best ways to get started is to talk to or read to your baby.

You might think talking to your partner’s belly is a little embarrassing. Don’t! Reading to baby can become a very special time between you and your partner; a new form of intimacy and sharing (and some quiet time that will be harder to come by after your baby is born).

But maybe even more importantly, reading to your unborn baby helps you relate to your baby as a person, giving you a head start for when your little one arrives in person.

In addition, your baby can now hear sounds and voices from the womb. This means you have a unique opportunity to help your little baby begin to recognize your own voice. Of course, your baby has a good chance of recognizing your partner’s voice because she is with your baby all of the time. Reading, talking, and singing are all ways to share your voice with your baby.

After my twins were born, I stood next to my daughter in the hospital and called her name … and she turned her head to me, confirming all the time I had spent communicating with her while she was in the womb was worth it.