Deciding to Have Another Child
Parents who have grieved the loss of an anencephalic child may be interested in trying for another baby. Having a healthy child can help heal the loss of the first child and aid a family in moving on from anencephaly. There are some things to keep in mind, however, before trying to conceive again.
Risk of Recurrence
All the causes of anencephaly aren’t known, but one thing doctors do know is that individuals who have had one child with an open neural tube defect are more likely to have a second one with the same defect. The recurrence rate of an open neural tube defect is 3-5%, and the defect experienced could differ from anencephaly; spina bifida is a related disorder of the spine that sometimes occurs in families with a history of anencephaly.
Genetic Counseling
Genetic counselors are a type of health care worker that can advise couples on their likelihood of having a child with a genetic birth defect. Couples who have had an anencephalic child may want to meet with a genetic counselor before they try again to become pregnant. The genetic counselor will take the couple’s family history and can arrange appropriate screening tests to help the couple make a more informed choice about their decision to conceive. They can also provide advice and support, should the couple have another child with a genetic defect.
Folic Acid
Getting an adequate amount of folic acid is especially crucial for mothers who have had a previous pregnancy with an open neural tube defect. Folic acid, a type of B vitamin, has been shown to decrease the chances for recurrence of a neural birth defect. The vitamin must be consumed for a month or two before pregnancy, and throughout the first trimester.
Women who have had a previous neural tube defect need to consume more folic acid than the Center for Disease Control’s 0.4 mg recommended daily dose. These women can take up to 4 mg of folic acid daily to help prevent a recurrent neural defect. These high-dose folic acid pills can be obtained via a prescription from your doctor.
Prenatal Genetic Screening Tests
If you and your partner decide to try and conceive again, there are options open to you to see if your child has anencephaly or another neural defect early on in the pregnancy. One blood test, called the Multiple Marker Screen (MMS) can determine your risk for having a baby with a spina bifida, anencephaly, or Down syndrome. This test is done in the second trimester of pregnancy, between 15 to 20 weeks, and looks at four proteins in the blood. The results of the MMS test, along with an ultrasound, can usually tell with relative surety if a child has a neural tube defect.
Amniocentesis is another test than can check for anencephaly, after the fifteenth week of pregnancy. In amniocentesis, a long needle is injected into the uterus to remove a small amount of amniotic fluid. Amniocentesis carries a small risk to the fetus, and you, your doctor, and genetic counselor will decide if it makes sense for you to take this test. If your second child is found to have a neural tube defect, you will be able to discuss your options for proceeding with the pregnancy with your genetic counselor and doctor.
Sources:
Prenatal Genetic Testing Program at Penn. (2006) University of Pennsylvania.
Neural Tube Defects. (2005) Duke University.