• Sarah R. Cox


As you go through pregnancy, you will have many decisions to make—What foods should I eat? Who is the best health care provider for me? Where should I have my baby? What should I do about pain in labor? Some of the first decisions you make will be what—if any—tests you have to check for birth defects in your baby. Most women will be offered a “triple marker” test. Some women (those over age 35 or those with a family history of birth defects) may be offered amniocentesis, chorionic villus sampling, or high-resolution ultrasound. You do not have to have any of these. You get to decide whether you will have one or more of these tests.

What Are These Tests?

Triple Marker (sometimes called the AFP test for alpha-fetoprotein) is a blood test that is done between 16 and 20 weeks. This is during your fourth or fifth month. This test measures the levels of three substances in your blood. If the levels are too high or too low, it can be a sign that there might be a problem with your baby's brain or spine. A high or low result on this test does not mean your baby has a problem for sure. These results only identify which women should have more thorough tests to find out if something is really wrong.

Amniocentesis is a test of the fluid in your uterus. The fluid is taken out with a needle that is put into the uterus through the skin in your lower abdomen. It is done after 14 weeks of pregnancy. The tests that are done on the fluid can find Down syndrome and a few other genetic problems that are passed from the parents to the baby.

Chorionic villus sampling is a test done on a very small piece of your placenta—the afterbirth that filters food and oxygen to your baby. The test is done by putting a tiny tube into your uterus through your vagina or by putting a needle into your uterus through the skin on your lower abdomen just above your pelvic bone. It is usually done between 10 and 12 weeks of pregnancy. This test can find Down syndrome.

High-resolution ultrasound is a special way of looking at your baby inside your uterus with a sonogram. It allows your health care provider to see your baby's bones and organs. It can be done any time, but is most helpful if it is done after 18 weeks of pregnancy.

How Do I Decide?

Some important questions to ask when making decisions about these tests are:

  • What information will the test give us?
  • How accurate is this test?
  • What risks are there for my baby and for me if I have this test?
  • Will I do anything different if the test results are abnormal?

It may help you to use the decision-making process on the flip side of this sheet.


What Are You Trying to Decide?

Tell your health care provider that you want to share in making decisions. Ask your health care provider to clearly state the decision that needs to be made. Ask your health care provider what the options are.

I am trying to decide about:_____________________________________________________

What Do You Need to Know?

If there are things you do not know about your options or the test itself, get the facts. Use your local library, the Internet, and your health care provider. Ask about side effects, pain, recovery time, or long-term results. Make sure the information you gather is based on sound facts.

I need to know: _________________________________________________________________


What Do You Think?

Some facts are more important than others. You will decide which facts are most important based on your own values. Once you think you have all the facts, sort them out by “pros” and “cons” from most to least important. Share the list with your health care provider to be sure that you have not missed anything.

Pros: _________________________________ Cons: __________________________________

_______________________________________  ________________________________________

_______________________________________  ________________________________________

Make a Decision

After you have thought it over for a while, you might want to talk with your health care provider again to see if your expectations are right. At this point, talking with a friend can be very helpful too. Then, make a decision.

I have decided to:________________________________________________________________

Take Action

Once you have made your decision, take action. Go forward and feel confident that you have made the best decision for you and your baby. You will have to make more decisions along the way, but you can do it.

For More Information

Maternity Center Association

This Web site from the Maternity Center Association has information on many maternity care practices. The site is dedicated to helping women make informed decisions and provides excellent reviews of the best evidence-based practices.

March of Dimes


The March of Dimes Web site describes all the prenatal tests. The timing, meaning of results, and risks of each test are listed.

Flesch-Kincaid reading level: grade 5.5.

This page may be reproduced for noncommercial use by health care professionals to share with clients. Any other reproduction is subject to JMWH approval. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JMWH suggests that you consult your health care provider.