Monthly Archives: March 2013

Non-Invasive Prenatal Genetic Testing

Blood TestGotta love prenatal testing.  The timing, the blood draws, the more invasive tests, the waiting, and – finally – the sometimes vague results.

At the time that I was pregnant, I had three fetal testing options available to me: Quad Testing, Amniocentesis, and Chorionic Villus Sampling (CVS).  I go into the details of each in my Prenatal Testing post, and the reasons why I selected CVS.  Basically, it was more diagnostic than quad testing, and could be conducted sooner than an Amnio (between 10 and 13 weeks of pregnancy vs. between 14 and 20 weeks of pregnancy).  The one aspect of the CVS test that gave me pause was the fact that it did and does carry a small risk of miscarriage.  Ultimately we decided to move forward with it, but spent an anxiety-ridden few days in bed post-test, hoping and praying that no miscarriage would result.

So I am delighted to hear about the new non-invasive prenatal genetic tests now available to pregnant women.  Finally expectant mothers can be empowered with knowledge – without any risk of complication.  Ease of administration, decreased costs, and available timing make them even more attractive.

Tests like Sequenom Center’s MaterniT21 PLUS (T21) and Integrated Genetics’ Harmony are up to 99% effective at detecting Trisomy 21 (Down Syndrome), 18 (Edwards Syndrome), and 13 (Patau Syndrome).  Performed around 10 weeks gestational age or later, these tests require a simple blood draw to analyze cell-free DNA in maternal blood for extra chromosomes.  While not technically considered diagnostic tests, they come pretty darn close; and any positive results could subsequently be confirmed with a true diagnostic such as CVS or Amnio.

Test results are typically returned within about 2 weeks, and costs of the tests appear to range from about $0 – $400 out of pocket after insurance (still significantly cheaper than either CVS or Amino – I am hearing $235 as a common copay).  An added bonus?  The test will also provide gender confirmation.

So what are the limitations?  Well, both CVS and Amnio test for a much larger array of potential disorders – these new blood tests just focus on some of the more common.  Also, these tests do not screen for open neural tube defects (only an Amnio will do that).  Some doctors remain skeptical about these new tests, and I’m told that not all offices will offer them.

But for parents without known genetic issues, I think they offer a very viable alternative to more invasive methods.  Much more accurate than traditional quad testing, these tests finally provide women a safe and relatively inexpensive option to better understand potential fetal risks.  I am all for these tests and only wish they had been available when I was pregnant.


Workplace Flexibility

HomeOfficeWe all talk about it.  We all want it.  Workplace Flexibility – That vague phrase that conjures up images of PJs and fuzzy slippers, a businessperson leisurely reviewing email with a coffee mug in hand and the morning news on the TV.

But how important is it really?

To me, a new mom with a previously established career, very.

As an older mom, I had worked for many years to establish my career before I had my son.  Long days, long nights, lots of travel, and emergency conference calls were the norm.  And I loved it.  I was in the thick of things, on the cutting edge, making things happen.  I was the person who was called when there was an issue, an emergency.  The person who could jump in at any time and help.  The person who never said No.

But as I neared the end of my maternity leave, I knew that things had to change.  I knew implicitly that it would be extremely difficult to juggle the professional role I was in with a newborn.  I doubted that I could fully tend to my son when I was scheduled to be on call, or when I was an escalation point for emergency issues.  I fretted about the 1-2 hour commute to and from the office each day (wasted time).  I worried about being so far away from my son in the case of an emergency.  And it led me to very seriously consider leaving my career.  I just couldn’t imagine being able to give my all to both conflicting worlds.

But then, as I returned to the office, I was given the opportunity to move into a new role.  A role that I was not only excited about professionally, but that would allow me some increased flexibility.  Telecommute days, earlier work shifts, the absence of consistent and ongoing on-call responsibilities.  A role that came with increased responsibility, but also increased flexibility.

And to date, it has worked out amazingly well for both me and my employer.  I am able to schedule times in and out of the office as it makes sense – ensuring I am in the office when appropriate, and working from home when appropriate.  I am saving literally hours a day in commuting time.  I am close to my son in the event of an emergency.  I am working an earlier shift that is more conducive to the schedule of a young child.  Simply said, the flexibility has allowed me to retain my career, and remain successful, while layering in the additional responsibilities of parenting a young child.

And believe me when I say that there are no TVs on, no PJs, no mid-day drinks or parties.  I’m not trying to watch my child while I work.  It is truly all work all day.  In peace and quiet and with the ability to continue as long as necessary to reach my goals – vs. scheduling my day around a bus schedule.

And my employer?  For starters, they get 2+ more hours out of me a day.  I consistently start 1 to 1.5 hours before my shift, rarely take lunch (although it is wonderful to have the option should I need to run an errand), and often work late.  I log in on weekends to tie up loose ends.  I am able to work in a quiet home office with no knocks on the door, no idle chit-chat in the breakroom, and with the ability to make important calls without interruption.

I follow the same philosophy with my own team.  Incidentally, not one of them is based out of my local office (and only two are even in my state), so our relationships are almost entirely virtual.  And for high-performing team members, what matters to me is that they are A) available when I need them (I don’t ever want to be kept waiting for an instant message response), and B) producing quality and timely deliverables.  How do we get around our geographic challenges?  Technology.  Holding people accountable.  We are in contact daily over the phone, Office Communicator, email, and via virtual meetings.

And it works.  Well.

I recently conducted a survey with my team – a required survey asking questions about retention and the like.  The number one response I received in terms of what would motivate a team member to start looking elsewhere?  Lack of workplace flexibility.  So I suppose I am not the only one it is important to.

Which makes it all the more disheartening when I hear that Yahoo’s CEO, Marissa Mayer, has banned telecommuting.  And that Best Buy is following suit – with a flimsy provision that all telecommuters must have written approval from their managers.

Why are these organizations moving backwards?  Is this a thinly veiled attempt to clean house?  Poor management?  Lack of employee accountability?  Both are flailing organizations and the recent announcements seem desperate, with a stick-to-the-wall-ish quality that doesn’t appear to be well considered.

I am most disappointed with Mayer’s announcement and approach.  After all, she is the mother of an infant herself.  A mother who infamously returned to work a mere 2 weeks after giving birth.  Is a mother even physically healed at two weeks??  Are these the lengths she feels she must go to compete with her male contemporaries, to make a name for herself?  And what about the impact to other women?  As it is, the United States is the only industrialized nation in the world with no federal law mandating paid time off for new parents (in fact, 1 of only 4 countries internationally) – but that’s another post.

What kind of example is Mayer setting?  The new Yahoo mother who doesn’t return to work 4, 5, or 6 weeks after delivery, or who opts to leverage her full <gasp> 12 weeks of job protection – what’s in store for her?  Is she labeled, whether overtly or tacitly, uncommitted to her career?  Has Mayer set a bar that other high-performing women in her organization or industry are going to feel compelled to meet?

Either way, her approach is at best a bit hypocritical.  Perhaps returning to work a mere few weeks after delivery wouldn’t be so bad if other mothers had the option to build out a full private nursery, complete with nannies, next door to their offices.  I don’t see too much of a difference between that and the mother who works from home.

I’m told that Mayer concedes that this situation wasn’t handled as well as it could have been.  But that she walked into the office one day midweek to find that nobody was around, and it pissed her off!  She was joking, surely, yet I truly hope that wasn’t the impetus for such a short-sighted approach.

Which brings us to the question of tipping point.  What is it?  How much flexibility is enough to retain key employees, while meeting some employers’ need for hands-on control?  What’s going to happen 2 or 3 decades from now?  I see the single corporate office becoming a thing of the past.  Maybe a small corporate office remains, but local hubs pop up for telecommuters to come together as appropriate for synergy, etc.  Technology nearly eliminates the need for actual face time.  The office will become wherever the employee is. 

And I am a huge proponent.  Once more employers begin catching on to this  secret sauce of employee satisfaction, it is a win all around.  Employees will remain engaged and motivated, retention will increase, and employers will benefit from the fruits of their labor – along with decreased overhead.

And then perhaps working mommies will have a real shot at “having it all.”