What it means to have a baby at an "advanced maternal age."
Nothing knocks the thrill out of your first trimester like a bit of stern advice just moments after, “Congratulations! You’re pregnant!” After giving me the good news, my young, usually chipper female doctor looked at me and said, sternly, “At your age, I strongly suggest serious genetic counseling.” Serious genetic counseling? Was there any other kind?
I was over thirty-five and pregnant – or, as I was graciously labeled by my gynecologist, AMA – of Advanced Maternal Age. I was already keenly aware of the grim facts. The odds of getting pregnant and being able to deliver a healthy baby decrease dramatically over the years. (I think we all know this by now, don’t we?) Once you start circling forty, you feel like you’re trying to make a three-minute egg with eggs that are already scrambled. When columnists and Sylvia Ann Hewlett, author of Creating A Life, start telling me when I should procreate (or should have procreated), it makes me feel bristly and defensive; unfortunately, a lot of what they say is true.
And now that I was indeed pregnant, and no spring chicken according to my ovaries, I was in for a huge array of tests: blood work, Ultra Sound Levels I & II, Amniocentesis . . . every month was something new. I didn’t feel sorry for myself – well, maybe just a little once they started bringing out the really long needles – because I had accepted all the realities that came with being AMA and had decided to give pregnancy a shot anyway.
I should mention that I didn’t have a baby when I was younger for the simple reason that when I was younger, I didn’t want one. Unlike the plight of many woman, like the ones in Hewlett’s book, I was not older and childless because of a soaring career, a lack of opportunity, or because I thought time didn’t matter. The discipline and devotion required for a sixty-hour work week is so beyond my lady-of-leisure temperament that just thinking about working that hard makes me start to hyperventilate. I was definitely not one of Hewlett’s high-achieving uber-broads. Not once did I look around my quiet apartment and sigh, “All that is missing is a baby.” Just the opposite: I was in love with my solitude, my dog, my spur-of-the-moment vacations, reading in peace until the wee hours.
Being from New York City, most of my friends started having children “late,” after their twenties. One by one, my clan of girlfriends began bringing their progeny home. The kids were cute (most of them), but I was never tempted to hold them, or baby-sit, or better yet, produce a bundle of joy of my own. Let’s just say that babies never enthralled me. I didn’t suffer any feelings of longing, or emptiness, or of being left out of the human experience. But, I never didn’t want a child; as a matter of fact, I felt sure I would have one – later.
The physical pull to have a baby, which really does feel like tug somewhere between the fifth and seventh Chakras, didn’t start for me until my mid-thirties – the age one officially becomes AMA. All of a sudden, I found myself following mothers around the neighborhood just so I could look at their infants bouncing in their Baby Bjorns. I loved their little baby legs hanging down, their chubby faces gazing up at Mommy. I wanted to hold them. I wanted one.
And I wanted one without drugs or IVF or ART or borrowed eggs. Nothing against the many women who do try these methods. I have a friend who made a mighty fine baby after a few rounds of IVF. Just not my cup of tea. My philosophy was: since I waited so long to have a baby, I was prepared to live with the possibility that it may never happen. Instead, I cut out sugar, caffeine and all refined food completely from my diet for six months, practiced lots of yoga, and went to my acupuncturist and told him to rev me up for fertility. And voila.
Whether it was the unblocking of my meridians, luck, fate, God or the lack of MSG in my diet, I got pregnant. First try. Well second try. I had one miscarriage. The egg never “developed,” my doctor said. But suddenly, there I was, pregnant again and completely aware of how lucky I was.
And how absolutely not lucky at all. On my doctor’s advice, I was facing months of serious genetic testing: to see if the fetus “took”, to see if it had Down Syndrome, Spina Bifida, arms, legs, a heart, a list of birth defects so long that even the idea of being happy about being pregnant seemed ridiculous. It was best to tell no one, to keep it private, until all the results were in. I didn’t need a parade of people, who had already seen me through a lot in life, calling me with condolences in case it all didn’t work out. I didn’t need the world knowing that.
So instead of feeling giddy and euphoric, as many newly pregnant women do, I began to feel like an alien abductee. They (doctors, not aliens) covered my belly in goo, obtained detailed photos of my innards on a regular basis, pierced my skin with long metallic instruments that went right into my womb to remove genetic information, as well as acquiring countless urine and blood samples from my body that were sent to laboratories. I was a science project.
The Amnio was definitely the most terrifying. Not because it hurts (it doesn’t, and it only takes about a minute). But, one, you are there to find out if the baby is healthy, and two, there is a slight risk of miscarriage – some docs say one in 200, some one in 300. Just the thought of screwing up a perfectly healthy fetus just to see if its viable – it’s aThe irony is, I had a great pregnancy. very heavy decision to make, one that involves every part of your being, intellect, spirit, logic, heart. I thought I would implode that day. And then the days that follow, you wait, you have small contractions, you hate yourself for sticking a needle into your womb, and at the same time you thank God for the test, you know there is a certain level of abnormality you can’t deal with – to carry the baby for nine months and then to have it born only to then die or suffer.
I’m extremely thankful to my doctors and the medical community for all of these tests. The odds of having a baby with Down Syndrome go from one in 1,200 to something along the lines of one in thirty by the time you hit the big four-o. And even though it is a high functioning disability, still, you worry, you panic, you feel guilty for caring so much. Then there are the really severe disabilities, like Spina Bifida, and much worse.
The irony is, I had a great pregnancy: no puking, no hemorrhoids, no constipation, but I couldn’t really appreciate my carefree pregnancy – my anxiety level was through the roof.
Like a good little trooper I carried around my secret pregnancy and showed up to all my nerve-wracking appointments. I felt lonely, insecure, self-conscious and really hungry. Still, I told almost no one. My best friend and mother had both recently died. The risk of having a baby without your clan, your favorite women around, also goes way up as you age. This may seem obvious, but it didn’t hit home until I was actually pregnant and gazing at the phone. There was no close relative or soul sister to call, to just comfort me, to be gentle, to get me through the really hard weeks.
As far as an actual father for the baby, I managed to find one, a good one, not a husband (I tried that in the ’90s), but a boyfriend/companion-like person who was number one on my sperm-donor list. Yes, I made a list. I needed to know the father, to see him, and hopefully to engage in the “act” with him. I asked my boyfriend first and he sort of made a noise that was more yes than no, not exactly a dialogue. More like I asked half-jokingly, “You in?” and he acquiesced half-jokingly. And I’m glad he did, because if he hadn’t, I would have met baby-daddy number two in time for my ovulation. This may sound a little cold and calculated, but all I can say is, it was not cold. It was boiling hot.
I already had a burning passion for my baby. I had so much love for my child it became like an object, like a big Panda lying in my hallway that I tripped over every day. I needed to give this love to my child, but where was the child?
Until that ultrasound, I was in some sort of pregnancy purgatory that women my age must experience until all the testing is over. I could calm down enough to use the logical part of my brain.
Do I have good insurance? Check.
Do I have a willing sperm donor that is smart and kind? Check.
Do I have the means to move into a bigger apartment? Check.
Am I healthy and fit? Check.
So, there I was in my fifth month and there was no denying that I was really with child. I’d gained twenty pounds and come to realize that a Quarter Pounder with Cheese is a culinary masterpiece. I had yet to buy maternity clothes, afraid that bad test results would be harder to deal with if I had to face a closet full of colorful twin sets from Pea in the Pod. It was then that I had my last major test, the Level II Ultrasound, done in a hospital at the crack of dawn. More goo on the belly, followed by a good half hour of silent scanning of my womb. The sweet young thing running the scanner across my abdomen watched the screen with a serious expression and took pictures of what I could only assume to be my baby. She was just the technician and could not discuss what she saw; for that, I had to wait for the doctor. It was a long half hour. Finally, the doc arrived and was very kind, showing me the baby’s heart, the legs, the spine, the penis, the face. The fetus looked like a mini person, a hyperactive person. He never stopped moving. Instead, he swam like a little silver fish in a bowl, up and down, back and forth, around and around. Could that really be happening inside me? I couldn’t feel it yet. In the next two weeks, I would, the doctor said. My son looked content, truly in his own world, busily enjoying his brand new body.
He was healthy and it all finally became real. I’m not quite sure what it was before, but it was something on hold, some sort of pregnancy purgatory that women my age must experience until all the testing is over. And even though I hadn’t been able to wear any of my clothes for months, and had looked absurd in my boyfriend’s jeans and T-shirts, and even though I’d been eating like a lumberjack and napping for the first time in my life, I only become officially pregnant on that day, twenty weeks in.
I knew it was a common occurrence – females making babies. In fact, they say it’s been going on for millions of years, but it felt like a miracle, like magic, like something greater than myself, my careful planning, my decisions, my anxiety, my sadness, my own life. It couldn’t be clearer, watching him flipping around in my womb, indifferent to my concerns, my past, my lower back pain. There he was, in his own translucent skin, on the edge of his own life. His life, not mine. In the past, when I was much younger, this would all have been impossible for me to grasp. But now I am as ready as a well-tilled field. It’s the gift of age.