Why Your Surrogate May Need a Late Amniocentesis

Most intended parents are at least familiar enough with an amniocentesis procedure to know that, if it’s needed, it’s typically done in the early second trimester. This test is completed as part of a diagnostic screening to evaluate the risk of a fetus having chromosomal abnormalities such as Down syndrome. Typically it is only ordered following a poor or inconclusive test result on a triple test, NT scan, or other non-invasive diagnostic test completed around 10-12 weeks gestation. For most intended parents and surrogates, a good report from these non-invasive tests means that they will not need to think about an amniocentesis procedure again in the course of this pregnancy.

Considering that the amniocentesis is generally only spoken about in the first trimester, it can be jarring to hear that a care provider may want your surrogate to have one in the third trimester. When administered in the last 12 weeks of pregnancy, the test takes on a different purpose. Here’s a look at what it means when one needs this invasive test in the week leading up to delivery.

The procedure itself is identical no matter the timing of the delivery. A doctor will use an abdominal ultrasound to guide a long needle into your surrogate’s uterus to extract some amniotic fluid. All care will be taken to not touch the baby with the needle. The entire process takes about 45 minutes and is generally not incredibly uncomfortable for the surrogate.

However, when completed in late pregnancy, the goal of an amniocentesis is not to evaluate the risk of chromosomal abnormalities. Instead, your surrogate’s care provider is likely looking for one of 3 potential conditions. These include:

  1. Detection of uterine infection after a premature rupture of the membranes (if her water broke too early, or there is a small tear causing amniotic fluid to leak.)
  2. Fetal anemia in the instance of a fetus with Rh disease. In some cases, fetal anemia is a life-threatening condition that requires a fetal blood transfusion.
  3. To evaluate lung maturity preceding a premature delivery.

The follow-up and recovery of a late amniocentesis is similar to that of one performed in the second trimester. Your surrogate may experience some leaking, discomfort at the needle injection site, and general tenderness. In general, however, doctors consider the procedure safer at this stage of the pregnancy than at the 18-week mark.

Most women will never encounter the need for a late-term amniocentesis. If a doctor suggests a third-trimester amniocentesis, you absolutely will need to consult with your case specialist and your surrogate’s doctor right away. In most cases, it is not advisable to decline the test at this stage.

Dr. Kim Bergman

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: The Essential Guide to Assisted Reproduction (Conari 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.