I'm Not Too Old for Motherhood!
Pregnancy and Birth at 40+
The Old Eggs, Tests, and Good News
Mike accompanied me to my hospital appointment the following week, when we would meet my obstetric consultant for the first time. It was the first of several appointments requiring me to exercise dexterity in urinating into a two-inch diameter plastic cup without dribbling all over my hands. The next humiliating stage was standing on the scales, with the nurse shouting, “You’re putting on weight nicely dear,” in earshot of the rest of the waiting room.
When we were finally ushered into the consultant’s room, he immediately launched into a bulletin of depressing statistics on the chances of a woman over 35 conceiving a child with some degree of chromosomal abnormality, Down Syndrome being the most common. He also talked about the increased risks of miscarriage, pre-eclampsia, pre-term labor and multiple births.
He said that because women are born with all the eggs they will ever have, a woman of 40 effectively has 40-year-old eggs. Apparently, the longer an egg sits around in the ovary, the more likely it is to develop chromosomal abnormalities. Men, on the other hand, continue to manufacture fresh sperm throughout their lives. It takes approximately 90 days for a sperm to reach maturity, so we had basically combined a 90-day-old sperm with a 39¾-year-old egg!
I felt like saying, “And will I be able to use my zimmer frame during labor or would you prefer to use one of those hoists that you attach to elderly people when lifting them out of the bath?”
Following the pessimistic views of the consultant, the conversation naturally led to the option of prenatal testing, the obvious choice being amniocentesis. He briefly mentioned other non-invasive, but inconclusive tests such as the Nuchal Translucency and Bart’s Quadruple risk-assessment tests.
There was never any doubt in our minds that we would opt for amniocentesis. While we were fully aware of the miscarriage risks, we were far more concerned about having a congenitally handicapped baby. The date for the amniocentesis was duly booked for June 10, 1999, four days after my fortieth birthday.
I didn’t find the procedure particularly pleasant but, by far, the worst was the waiting between the amniocentesis and the arrival of the results. I imagined awful scenarios where we would be forced into making a decision about whether or not to terminate the pregnancy, if the baby were handicapped in some way. I also visualized joyous images of being told that the baby was healthy. These were the ones on which I tried to focus, for fear of negative thoughts attracting negative results.
Exactly two weeks and two days following the amniocentesis, while I was still lying in bed, Mike came bounding up the stairs brandishing a brown envelope, bearing the postmark of the hospital that conducted the tests on the fluid sample.
“Shall we open this together?” he asked, launching himself horizontally onto the bed and creating a catapult effect, sending my backside two feet off the mattress and back down again.
We huddled together, as he ripped open the envelope and unfolded the official, white letter, which was headed, “Oxford Medical Genetics Laboratories.” I cannot describe the rush of ecstasy that I felt as I read and re-read the letter, almost in disbelief. Our baby had “no major chromosomal abnormalities,” and when I read that we were going to have a little girl, I let out a whoop of delight.
I felt slightly triumphant in that I had reached 19 weeks without any significant problems and that these results were another token of proof that advanced age alone doesn’t automatically write a woman off regarding a healthy pregnancy with a normal outcome.
I can’t deny that I didn’t exactly bloom over the following months as a result of the general discomforts of pregnancy, including the hyperemesis that seemed to linger for a lot longer than is regarded normal, but I had suffered in exactly the same way with my other pregnancies, so I knew that the degree of sickness was in no way related to my age.
At each appointment, my blood pressure was comfortably low, my uterus was exactly the right size for dates, the baby’s heartbeat was strong and, for all intents and purposes, my pregnancy was extremely healthy and progressing normally.
The Final Trimester
During the third trimester, when I triumphantly strode into my antenatal appointments, my midwife was as jovial as ever.
“Oh dear. Rather a lot of glucose in your water. That’s three consecutive occasions now. Better make an appointment for you to have a glucose tolerance test. Gestational diabetes can be more common in older mothers you know,” she chortled, forever reminding me that I was an antique.
The test for diabetes was done a week later, and the test results were completely normal. I didn’t have diabetes. Yet another bonus point. Were there any age-related conditions or risks left to throw at me before I delivered my daughter?
“She’s still lying with her spine to your spine,” said the midwife at my 37-week appointment, after vigorously pressing around my lower abdomen and then announcing that she had been squashing the baby’s cheeks. She shook her head and chuckled to herself, muttering something about a prolonged, backache labor.
“Of course, it is your fourth child and there’s the age factor to consider,” she said in her don’t-say-I-didn’t-warn-you voice. “You realize that because everything’s stretched and not as firm as it used to be, it’s more common for the baby to be lying in an awkward position.”
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