Pregnancy Kits

A do-it-yourself test

Ancient Egyptian women urinated on the leaves of the papyrus plant. If the plant died, everything was as usual. If it survived, they were pregnant. Such self-diagnosis among would-be mothers (or those who would prefer not to be) is still coveted today. Despite some frowns from the medical establishment, a growing number of women are using commercial kits, sold over the counter in pharmacies, which are designed to allay their fears--or confirm their wishes--about pregnancy. Says one proponent of the do-it-yourself trend: "It gives me the opportunity to find out whether I am pregnant in the privacy of my home, to get accustomed to the idea of being pregnant long before I need to go through a gross examination in a doctor's office."

Widely advertised in women's magazines and even on television, the inexpensive kits (typical prices: $7 to $10) have been on the national market for about a year. First developed in Europe, they depend on a simple application of immunology: the interaction between the hormone HCG (for human chorionic gonadotropin), which is produced as soon as a fertilized egg imbeds itself in the wall of the womb, and the specific antibody formed--in rabbits--against it. If a reaction occurs between the urine and the kit's chemicals, the hormone is present--and so most likely is a baby-to-be.

Using highly sensitive radioactive tracing techniques, laboratory workers can spot HCG with almost 100% accuracy. The home kits use a somewhat less sophisticated procedure. Typically, they contain a test tube with the HCG antibody, sterile water, a stand and a dropper. If the woman adds a few drops of her first morning urine to this test-tube brew, then lets it sit for about two hours, a doughnut shape or ring should form on the bottom of the glass if she is pregnant. Warner/Chilcott, producer of one popular line of the kits, claims that its product, on first test, is 97% accurate if the results are positive and 80% accurate if the results are negative.

Often cheaper than lab tests offered through gynecologists, these simple early warning systems save women money and, if they are unmarried, possible embarrassment. They also appeal to feminists, who feel women should rely on themselves and whenever possible avoid the male-dominated gynecological establishment. Indeed, the kits even have the blessings of many doctors, provided they are properly used. Unfortunately, that is not always the case. Despite its simplicity and relatively high potential accuracy, the home test has shortcomings.

In trials performed by one pharmaceutical company, patients at Manhattan's Eastern Women's Center had trouble following the printed instructions. One potential problem for kit users: some women tend to rush into the tests, failing to wait at least nine days after a missed period, as the instructions direct. Thus they get negative results even when they are pregnant.

A more serious objection: if a woman thinks that she is not pregnant when, in fact, she is, she may delay going to a physician. Such procrastination can be particularly dangerous in tubal pregnancies, which require early medical attention because the fallopian tube can rupture and possibly cause death.

Critics conjure up still other grim possibilities. What if a pregnancy is not detected and the woman continues to take drugs that could damage the fetus? Such a tragedy might not be discovered until long after she can have a safe abortion. Obviously worried about the legal consequences of such situations, the manufacturers provide warnings in the kits that they are not 100% accurate.

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