3rd Trimester Surrogacy Tests
Welcome to your third trimester! As you enter the “home stretch” of your surrogacy journey, you may be surprised at all the tests your doctor may be suggesting. Chances are you’ve experienced these tests before in your own pregnancies, but if it’s been awhile, it can feel overwhelming.
Chances are that there is nothing going wrong with your pregnancy. Doctors begin to monitor you more closely as the birth draws near, and as technology advances, scientists have developed new tests that help them do this. That means the medical protocol and series of standard tests may have changed since the last time that you were pregnant. Here’s a look at a few common third-trimester tests and what they mean.
Office Visits
As the birth nears, your standard office visits will also increase. Most doctors will move from once-a-month office visits to bi-monthly visits at the start of your third trimester. These visits will increase to weekly around the 36-week mark. The frequency of office visits begins sooner in the pregnancy if you are carrying more than one fetus. Again, this is standard practice and no cause for concern.
Office Tests
You’re probably used to giving a urine sample at each office visit. As visits increase, you can expect this practice to continue. Doctors screen the urine for protein, sugar, bacteria, and any possible dehydration. If present, these things could indicate gestational diabetes, pre-eclampsia, or infection. You can also expect your doctor to check your blood pressure, uterine growth, and the baby’s heartbeat at every visit.
Movement Test
Also called a “kick-count” test, doctors typically order this test if you’ve gone past your due date. The test is simple. You’ll lie on your side and monitor how long it takes for you to feel 10 movements. Generally, this takes anywhere from 10 minutes to 2 hours.
Non-Stress Test
Typically ordered after a poor kick-count test, a non-stress test can also be a routine test for women carrying multiples, or who have diagnosed gestational diabetes. In these cases, non-stress tests can become a part of the routine office visit as early as 26 weeks. In this test, doctors use a fetal heart rate monitor to watch how the baby’s heartbeat responds as he/she moves around. You’ll have a trigger to indicate when you feel motion, and doctors will reference that against the heart rate. Generally, this test takes about 20-40 minutes.
Group B Streptococcus Test
Up to 30% of women carry the Group-B Strep bacteria. It doesn’t cause symptoms in most women and causes you no ill effects. However, you can pass it along to the baby that you’re carrying during childbirth. If that happens, it can be quite serious for the newborn. As a result, doctors will screen you for GBS around the 28-week mark of your pregnancy. Since the bacteria can be picked up at any time in your life, you will need to have doctors test you with each pregnancy. If you test positive, chances are doctors will test again closer to delivery. The bacteria can clear up on its own, and may not be an issue later on. If it is still present when you go into labor doctors will likely treat with antibiotics.
Cervical Change
Generally, around the 34-36 week count, your doctor will begin conducting “internal exams” on your pelvis. This is when your doctor will insert a gloved hand into your vagina to check for changes to your cervix. As labor approaches, your cervix may begin to shorten, thin out, or open. While these changes do not mean that labor is impending, it can be an indicator of when you’re approaching labor. The test isn’t uncomfortable and is quick.
Biophysical Profile
This test is typically only completed in the event of an overdue pregnancy or in the instance of other complications. Examples could include if you have low amniotic fluid, decreased movement, or other problems with the placenta. The test is a hybrid of a standard ultrasound test and a non-stress test. When considered together, the composite results can indicate if the baby is in any distress that may prompt an induction of labor.
Amniocentesis
Typically this test is only ordered in the second trimester following a poor result on a non-invasive chromosome screening. However, it can also be beneficial in the third trimester if your doctor believes that you are at risk of premature delivery as the result of a certain type of uterine bacterial infection. A doctor could also order a third-trimester amniocentesis if the fetus may have prenatal anemia. If your doctor orders this test, try not to worry. The doctor will insert a long needle will through your abdomen and into the uterus. The goal is to remove a small amount of fluid that will contain cells shed by the fetus. The process is generally brief and presents only minor discomfort for you.
The third trimester is a busy time in your pregnancy! Remember to ask any questions that you have while you’re at the office, and be sure to ask your intended parents if they have more questions for your doctor as well.
Posted by Dr. Kim Bergman in Resources for Surrogates on 14/06/18
Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for Intended Parents, Surrogates and Donors. She is the co-owner of Fertility Counseling Services and Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the upcoming book, Your Future Family: An Essential Guide to Assisted Reproduction (Red Wheel Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. Her two daughters are in college.