Overpaying on Pregnancy To Prove My Worth As a Parent

From fish oil to genetic testing, how can you say “no”?

My first pregnancy-related purchase was prenatal vitamins: Vitamin Code Raw Prenatal, for a great low price at the Park Slope Food Coop. I took them for a week until my initial prenatal appointment, when my doctor suggested switching to a pill containing DHA. Slightly annoyed that I had already bought the Vitamin Code pills, I then checked out the vast — and vastly more expensive — prenatal vitamin selection at Whole Foods, where I zoomed in on the cheapest, Whole Foods brand with DHA. “What do you think of these?” I asked a saleswoman, expecting her to affirm my choice.

She winced, then gave me a crash course on omega-3 fish oil. Instead of the Whole Foods brand, I should go with a prenatal that contained fish oil verified by a third-party, to ensure high quality, she explained. Fish oils can carry toxins and high levels of mercury, obvious no-nos for my still reptilian-looking baby. She suggested Nordic Naturals Prenatal DHA, nearly double the price but pure, verified and unadulterated, just like the Scandinavians.

I hesitated, feeling slightly judged. Then I did something very much out of character: I chose the more expensive brand.

Back at the doctor’s, this behavior pattern continued. Until recently, my bare bones Bronze insurance plans have ranged from mediocre to downright abysmal. I’ve ponied up for cheapies with low ratings and high deductibles (R.I.P. Health Republic) until, in April, I got married and upgraded to my husband’s work-provided plan.

I’d grown so accustomed to insurance loopholes, people saying, “I’m sorry, miss, your appointment was covered, but the blood work comes out to a jillion dollars,” and I’d heard so much about the high cost of pregnancy, even with insurance, that I was shocked to learn my $5 copay covered not just that first visit, but all my prenatal visits, at least for basic services.

At last! That rare unicorn of quality insurance coverage was mine, just when I needed it most! Why wouldn’t I milk it for all it’s worth? MaterniT21 prenatal screening for chromosomal disorders? Sure! Nuchal Translucency scan, which also tests for chromosomal disorders? Sounds like fun, I’ll take seconds! Okay, early anatomy scan it is! Genetic testing? I must be living in the future.

I should clarify that these tests were not mandatory, but strongly encouraged for women 35 and over like myself. I knew optional translated to higher copays, and that for certain screenings, like genetic testing, the majority wasn’t absorbed by insurance. So far, I’ve paid $90 out-of-pocket for the Nuchal Translucency scan. I’m still waiting for the bill on the other tests. The more information, the better, I figured.

But that’s not the only reason I said yes, to all of it. I felt the sort of sales-pitchy pressure one feels when told they can supersize their meal for just a buck more. Think of all I’d be getting: highly detailed images of my growing baby, the most accurate tests on the market, and assuming everything is normal, peace of mind. Isn’t that worth the cost, whatever the cost may be?

I sensed the same dynamic with my doctor as I did with the saleswoman at Whole Foods: that my choices, and my instincts, were being questioned, and my capacity for motherhood was being gauged by how much I was willing to spend. I feared opting out made me seem stingy, overly confident about my pregnancy, or worse, indifferent to the health of my baby. I wanted to do my due diligence. I wanted to be a thorough, A+, overachieving fetus-gestator.

My capacity for motherhood was being gauged by how much I was willing to spend

The irony is that the abundance of information available to me has made me feel anything but empowered. “Nervous wreck” is putting it mildly. The more options I have, the more I’m certain I’ll make the wrong choice. The more I know, the more I tend to worry. I’ve also learned that non-invasive prenatal tests (NIPT) like the ones I had done aren’t always accurate. It’s a phenomenon chronicled in a Quartz article aptly titled “Prenatal testing is about to make being pregnant a lot more stressful”:

One post about a false positive result on Babycenter.com elicited more than 1550 comments, mostly from women angry that they weren’t warned about high NIPT false-positive rates.

Women “are not saying, I don’t want the test,” says Mayo Clinic bioethicist Megan Allyse, PhD, who is currently leading a study interviewing women who’ve had positive test results with NIPT. “They’re saying: I wish I’d known” that the false positive rate was so high — “I wish somebody had explained this to me.”

I realize I’m paying a pregnancy tax, so to speak, that was levied even before conception, when I used an app to chart my fertility, including my moods, my every cramp and headache, the viscosity of various bodily fluids and the position of my cervix. With the power to break down the very human and very mysterious process of reproduction into bite-sized chunks of data, I had no reason not to excel, right? If I had trouble conceiving, and thankfully, I didn’t, the problem would be me, not the data.

It was then that I first realized how information could be a key, or a cage.

What bothers me most is that this modern pregnancy hyper-vigilance feels retrograde. My fear that I’m not doing pregnancy “right” is targeted with “pure” and “natural” labels, plus a slew of (expensive) screenings that promise to let me know if my child is “normal” early on. I can’t help but wonder if these modern tests and products are simply old-fashioned notions gussied up with new packaging, notions of purity and perfection that make women feel ashamed of their bodies, thereby mitigating the magic of what those bodies can create.

My second most expensive pregnancy-related purchase thus far, the Snoogle pregnancy pillow — $47.99 at Bed Bath & Beyond, including a 20% off coupon — was perhaps my best investment yet. Old-fashioned sleep, I’ve heard, is good for the baby. And it’s free.

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