3rd Trimester Tests for Your Surrogate

Welcome to your third trimester! As you enter the “home stretch” of your surrogacy journey and prepare to meet your child, you may be surprised to hear about all the tests your surrogate’s doctor may be suggesting.

First of all, take a deep breath. Chances are that there is nothing wrong. Doctors begin to monitor women more as the birth draws near. If people in your support network suggest that they weren’t exposed to that many tests during their pregnancies, understand that as technology evolves and new tests become available, doctors are ordering new tests as more precautions for all patients. It’s a great way to monitor a pregnancy and doesn’t mean that anything is wrong.

Here’s a look at a few common third-trimester tests and what they mean.

Office Visits

As the birth nears, standard office visits will also increase. Most doctors will move from once-a-month office visits to bi-monthly visits at the start of the third trimester. These visits will increase to weekly around the 36-week mark. The frequency of office visits begins sooner in the pregnancy is your surrogate is carrying more than one fetus. Again, this is standard practice and no cause for concern.

Office Tests

At every visit, the staff will ask your surrogate to provide a urine sample. 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 surrogate’s doctor to track her 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 your surrogate has gone past her due date, indicates that she doesn’t notice much fetal movement, or is are carrying twins. The test is simple. Your surrogate will lie on her side and monitor how long it takes 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. Your surrogate will have a trigger to indicate when she feels 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 her no ill effects. However, your surrogate can pass it along to your baby during childbirth. If that happens, it can be quite serious for the newborn. As a result, doctors will screen for GBS around the 28-week mark of the pregnancy. Since people can pick up the bacteria at any time in life, doctors will test your surrogate even if she has never tested positive before. If she does test positive, think of it as a ‘common cold’ scenario. She didn’t do anything wrong to catch it and has not been behaving irresponsibly. Chances are doctors will monitor her and 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 she goes into labor, her doctor she will likely treat +her with penicillin.

Cervical Change

Generally, around the 34-36 week count, the doctor will begin conducting “internal exams” on your surrogate’s pelvis. This is when the doctor will insert a gloved hand into your surrogate’s vagina to check for changes to her cervix. As labor approaches, the 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 labor will onset. The test isn’t uncomfortable and tends to be 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 your surrogate has 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 the doctor believes that your surrogate is 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 doctors order this test, try not to worry. A doctor will insert a long needle through the 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 your surrogate.

The third trimester is a busy time in pregnancy! If you have additional questions, be sure to pass them along to your surrogate so that she can ask her doctor. Generally, it’s kindest to send her these questions in a message or email, as she is quite busy with appointments at this time. She’s likely tired, sore, and just as ready as you are for the birth to happen. Despite this, the only person who knows exactly when your baby will be born is your baby. Your surrogate can only share with you what she feels and what her doctor says.

Posted by Dr. Kim Bergman in Surrogacy Resources for Intended Parents on 26/06/18

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.