hi B., this is a really hot topic, and i dont want to upset anyone, but i suppose i might. its an extremely personal thing, but i learned an awful lot and so i will tell you my experience with it.... we had the same thing, 1/34 with my son, and i was 38 at the time, so even higher risk. however, i knew i wouldnt terminate no matter what the results of an amnio were, so that was really my deciding factor. however, it was nowhere near as simple as that. i didnt have an amnio with my first 2 pregnancies, but i had good test results for those. we found that it is one thing to have an opinion about terminating a pregnancy in the abstract, and a very different thing when it is staring you in the face, especially when you are older and with 2 other kids, as it is likely that they would be the ones caring for your other child down the road. it brought up a lot of very heavy and unpleasant conversations. but it was good that we had them and that we were able to agree. and luckily my doc doesnt push anything. i couldnt believe how many of my friends were under the impression that they HAD to have an amnio past 35. you dont. the vast majority of amnios have no bad side effects. however, a small percentage does. this was a factor for us as well, the biggest one. if it was a simple blood test, i would have done it in a heartbeat. even if it was positive for downs, though we personally wouldnt terminate i would certainly like to be more educated and prepared. there is a very wide range of downs syndrome, and no test can tell you where the baby will fall on the spectrum. my husband and i have both worked with children with downs, some were an absolute delight, and some were extrememly challenging, to put it mildly, especially down the road. most were somewhere in between, but all have a special something, imo.
i did lots and lots of reading and talking... you do need to know a couple of things... first of all, the FREAKIN AFP test, as i so fondly like to call it, has a very high rate of false positives. it is not a diagnostic test, it is a screening test, and not a very good one. i cannot tell you how many women i spoke to who had false positives. i actually got in touch with a doctor who had left his practice because he had this same awful experience when his wife was pregnant, and he is dedicating his time to developing a better non-invasive diagnostic test. i had found a paper that he published on it... hopefully someday soon! ... also, you took a blood test at about 15 weeks, you need to look at those numbers too. mine were great, that was also a factor for us. also, you can and should have a detailed genetic ultrasound. it is a long ultrasound where they look for all the genetic markers of downs syndrome and other things. there are many. most people look at the nuchal fold at the back of the neck, and the length of the limbs, but there are actually a lot more. if you arent going to a doc with state of the art machines, find one. ours had great results, no markers were found, and this was also a factor for us.
in the end, we didnt have the amnio, but it pretty much ruined the rest of my pregnancy, which makes me very very sad. my son was born "normal" and healthy, tg, but i was so completely stressed out about it, it was all i could think about. i remember after he came out, all i kept asking was if he was ok over and over :( ... even the first couple of doctor appts, i just couldnt shake it. so you have to weigh that also. stress isnt good for you, as you know, and you have to think about whether an amnio will be worth the peace of mind, it might be. my sister skipped the amnio also, also high afp results, and she was fine with it, just had faith. i wish i could have been like that. my girlfriend skipped both the afp and the amnio, also, just had faith. and all these kids are fine, by the way. only you and your husband can decide. you have to think of all these things. i wish you all the best... just remember that of all these women i spoke to, and there were many online, sites just like this, there were soooooo many false positives, the babies were fine. good luck, and feel good :)