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Ultrasound image of a baby's head in black and white showing absent nasal bone indicating Down Syndrome.

Celeste Blau’s first pregnancy was smooth from the beginning. She stayed active and kept working at the gelato shop she owns with her family outside of Cleveland. She wasn’t ignoring the pregnancy, exactly—it was planned—but she didn’t think of herself as a very maternal person, and pregnancy seemed like something to endure rather than to enjoy. At her first ultrasound, she was mostly excited to find out whether she was having a boy or a girl. She was 31, relatively young, and it didn’t occur to her that anything could be wrong.

The ultrasound appointment at the Cleveland Clinic took three hours. She only realized that was unusual a few years later, when she was pregnant again and the same process took 30 minutes. Lying on the table, her belly smeared with gel, she started to feel a niggling fear when the technicians weren’t laughing at her and her husband’s jokes. (“And we’re funny!” she said.) Afterward, the doctor asked to speak to them in his office. He was concerned because the baby’s brain ventricles looked enlarged, Blau recalls, and... see more