Updated November 14, 2014.

Prenatal testing has come along way in recent years. It used to be awkward and a somewhat risky affair that was reserved for only mothers who met select criteria for being at risk for having a baby with problems. As new technology came about and testing became, easier, faster, earlier, and less physically risky, more women were offered the option.

If you are a proponent of prenatal testing, you may not understand why someone would choose to forego the testing and want to understand a bit more.

Or you may be here because you are not sure what is the right answer for you in your pregnancy. The truth is, there are many reasons, but here are a few:

1. You wouldn’t do anything differently with your care. Regardless of the results, some parents would not change their care or terminate the pregnancy. This can be a difficult decision and parents would prefer to enjoy their time with the pregnancy, dreaming of a perfect healthy baby, than worrying or dreading something that they cannot fix.
    
   
2. You don’t trust the results. While the technology does have limitations, the vast majority of the testing is accurate when you look at diagnostic testing (Testing that provides a diagnosis, as opposed to screening, which merely tells you your personal risk levels.). That said, there is never a 100% and some parents simply don’t want to jump into that arena.
    
   
3. Don’t believe that they are at risk. Some parents do not believe that they are at risk for the genetic issue or disease that is being screened for in a certain test. They may have been tested prior to pregnancy and know that they are not carriers. They may be willing to take the risk of a certain amount due to their age or other factors in order to avoid the mental and/or emotional exhaustion of additional testing.
    
   

1. Doesn’t fit with their belief system. There are some parents who do not believe in genetic testing or prenatal screening. This can be a religious or simple philosophical issue and may influence the type of care they seek out in pregnancy in general.
    
   
2. Testing is not available to them. This could be because of the practitioner they have chosen, where they live, or even the type of insurance or payment system that they use. As the technologies and testing has come about, many of the tests are proprietary and can cost thousands of dollars above what a typical prenatal care package would cost. Sometimes you are seeing a low risk care provider who does not offer testing for specialized risks like certain forms of genetic testing. (Though in this case, if they wanted testing, they could get a one time referral to a geneticist or high risk specialist.)
    
   

Currently the recommendation from the American Congress of Obstetricians and Gynecologists (ACOG) is that prenatal testing should be offered to every patient. There is a big difference between being offered a test and having a test forced on you. Many offices just assume that there are some tests that everyone wants and don’t even present it as a choice, they simply lay out – here is the testing we do in pregnancy. You do have the right to refuse prenatal testing, even if your doctor or midwife thinks it is the best idea. This is what ACOG calls informed refusal.

If you are simply unsure and don’t understand – do not hesitate to ask someone to help clarify the questions and issues that you have this pregnancy. Sometimes that is your care provider, or your spiritual leader, or even a genetic counselor. This parenting thing is harder than it seems sometimes.