Geboortecentrum Amsterdam

Prenatal test or not?

‘I really have no idea what to do! Last time I did that combination test and had a bad result. I was miserable for 3 weeks thinking that there was something wrong with our baby, that we might have to terminate the pregnancy. Turned out everything was fine after all. I told Mark that I never wanted that again. So now I don’t know anymore.


Floor has just become pregnant again. They are very happy with this new pregnancy but are faced with a dilemma: to do a prenatal test or not? Last time after the combination test they found that they had an increased risk of having a baby with Edwards syndrome. One of the 3 syndromes that are examined with the combined test.

Edwards syndrome is a chromosomal abnormality associated with severe physical and mental abnormalities in the baby. From a jubilant mood because of the pregnancy, they plunged into a pool of uncertainty, sadness and fear. A follow-up test eventually revealed that no abnormalities were found in their baby after all. Floor had a very difficult time during that first pregnancy. She did not dare to trust that her baby was indeed well, and that had quite an impact on her pregnancy. She was constantly worried, had all kinds of symptoms and was by no means a happy pregnant person. She finally gave birth to a healthy baby girl at just over 41 weeks of pregnancy, after a lengthy, difficult delivery in the hospital.

It had taken 3 years before she and Mark dared a second pregnancy. Now the time had come and at 8 weeks of pregnancy I had to ask her again if she wanted to be informed about the prenatal tests that are possible. In any case, she and Mark did want the information so I told them about the NIPT and the combination test.


I told Floor and Mark as objectively as possible about the pros and cons and the differences between each prenatal test. They both visibly struggled with the subject and wanted to know what my advice was. We are often asked that, but we are very clear about that: we do not give advice. The considerations are too personal and everyone has to make their own decision.

Because I noticed that they couldn’t make up their minds, I told them that they didn’t have to decide yet, that they still had more than three weeks to do so. I also told them that nobody forced them to do a test at all. So that was also an option. The next time I saw Floor again she was 22 weeks pregnant. The previous 2 checkups she had been with my colleague and I read in her file that she and Mark had decided not to have any testing at all this time.


I naturally asked her about their struggle and how the decision felt now. Floor said radiantly that she felt super good and was very happy that she had not had a test done. That she was all confidence and very much enjoying this pregnancy. She was indeed remarkably relaxed and had no pregnancy symptoms. All the check-ups were fine and she left the door as excited as she had come in.

Her pregnancy was going very well and at 39 weeks she told me that she was very much looking forward to giving birth. She had done an abbreviated yoga course and was still confident despite the difficult previous delivery.

The next evening at ten o’clock my shift phone rang. Mark told me that Floor had been having contractions since that afternoon and that she would like me to come and take a look. I went over and saw that Floor was indeed having good contractions. I sat down with her while Mark was busy with their oldest daughter and noticed that she was very relaxed handling the contractions. It was clear that it would not take very long anymore and the contractions were growing in strength.

They had planned to deliver in the hospital but when I asked Floor after an hour if she wanted to go that way, she asked if she couldn’t stay home for a while. I told her that she was really starting to have good contractions now and that if she stayed here any longer she might not be able to get to the hospital in time. I added that there was no objection at all to staying home and that it might also be relaxing for Pientje, their daughter. She looked at me startled and asked if I meant that she would give birth at home. I said that I did indeed mean that and that there were no medical reasons not to. As the contractions claimed their attention every 3 minutes, Mark came in with Pientje on his arm.


I told Mark that Floor was considering not going to the hospital anymore and Mark responded wonderfully. He told Floor that he thought it was a very good idea, that he was sure she would be fine and that he had complete confidence in it. From then on, there was no stopping them. The contractions took control and Floor had to pull out all the stops to handle them well. She did great. I ran to my car to get all the supplies for a home birth and Floor toiled through the intense contractions. In no time, everything was ready, the maternity nurse was on her way and Floor was climbing onto the birthing stool because she was pushing. Mark sat behind her and supported her perfectly. Little Pien of almost 4 came and sat next to me and found it all very interesting.


Ten minutes later Floor got an enormous urge to push and while she gave in very gently, Pien and I soon saw a piece of the baby’s head appear. Pien did not change her mind and very carefully put her hands on the head. Like an accomplished midwife, she gently said to her mother what she had heard me say the whole time: “good Floor. During the next contraction, her little brother was born. A shiny, sturdy little guy who gave a little cry and then thought it was okay. I dried his wet body and then he was subjected to a careful inspection by his mother and big sister. Pien thought he was dirty because there was blood in his hair but Floor was over the moon. She turned to Mark and said, “I want another one”.