It was late last fall when I started to feel grossed out by meat products- particularly anything that had come within an inch of barbecue sauce. Gross. And then my chest started to feel heavy, like it was preparing for something- and that’s when I started to think I needed to go to Target and buy a test.

For my past pregnancies, I had always gone to Target, bought the test and being totally incapable of patience, I would walk into the restrooms and take the thing right then.

So, that’s what I did. It was an early morning, and I felt mildly nauseous- not unexpected at that point- but probably of dual cause. I wasn’t only the victim of HCG, I was also simply nervous. I opened the package without once wondering if anyone in the room would think I was stealing something, and did the deed. I waited, my heart pounding into my throat. A few minutes later, I looked down at the digital screen (no more blue lines, just words) and knew for sure- which was when my ears started ringing and my head started spinning.

I decided I shouldn’t drive for awhile. I walked around- looked in the pertinent department at all the new things that were probably considered essential since nine years ago, and waited to feel better.

That was the beginning. I had never particularly wanted to be one of those women who had a late baby. My mind, grasping at any kind of helpful thought, reminded me on the way home that Lucille Ball was somewhere around my age when she had Little Ricky in the 1950s. On television. If she could do it at a time when you couldn’t even say “pregnant” on television, why should I worry?

Plenty of reasons why, as it turned out.

Because I had done this before, and because I haven’t gotten around to finding anyone but a PA for my personal care since we moved, I waited until after Christmas to do anything. We told no one. I caught my 15 year old looking at my belly one day, a thoughtful look on his face- but other than that? No one knew. Baggy sweaters. Big coats. Cold winter did it’s job.

After Christmas, I started looking at providers, but it isn’t as easy to find someone as it used to be. There is a shortage of OBGYNs in the country and after calling multiple offices and being told they were full, I opted for the midwives at the University.

They were also going to be short two providers by the time I delivered, but at least I had an appointment.

We showed up and had the first ultrasound. Everything looked fine.

But then the appointment with the midwife happened- two hours of lecture about the likelihood of something going terribly wrong because of my age. Fear, fear, lecture, lecture- we were all probably going to die. But hopefully not. There were risks though. Because of my age. But maybe it’ll be fine. Hopefully. You stupid idiot. You know you’re old, right? They used to call this a geriatric pregnancy. Funny, haha. Maybe you’ll be fine. Your baby, though.. maybe not. Likely not. Let’s schedule you in for next month, moron. They know  what causes this you know, har har, nudge, wink.

It was horrible, and nothing like what one expects from a midwifery experience. I spent the next month stealing myself for any bad news that would come out of the 20 week anatomy scan and the meeting with the Maternal/Fetal Medicine Specialist that I required because, ahem- I’m old. My rational side was not sold on the fear- but my rational side was not loud enough to silence that seed of worry she had planted.

I won’t waste my time or yours listing the actual stats regarding AMA (or advanced maternal age “geriatric”) pregnancies. It’s out there if you’re interested, and it isn’t a happy read. It’s frightening in that way that only a parent (or parent to be) can understand. Even if the odds are in your favor, the thought is there. In that month, I avoided researching anything and waited.

The following month, we had the anatomy scan and while the tech went over the heart- I saw an echogenic foci- a soft marker for down’s syndrome, and completely harmless. There’s one, I thought. She spent a lot of time looking at the length of the baby’s nasal bone. There’s another, I thought. The mat/fet specialist came in with her group of students and one of them, with fingers twisting nervously in front of her, asked me in a small voice, “Have you ever heard of Down’s Syndrome?”

I looked at her in disbelief. I said “uh, yeah..” She’s young, I thought. Take it easy on the her. “What did you see?”

“Well, we spotted two- what we call ‘soft markers’. A shortened nasal bone and…”

“And an echogenic foci.” I said.

Yes, I’m not ignorant. I’ve been through this before. The supervising doctor looked at me.

“We’re soft marker collectors. Did you know that both of those markers are also more likely to occur in asian babies?”

She looked at the supervising doctor, who nodded at her. “That’s right”, she said. “It sounds like you have a pretty good handle on this, and everything else looks just fine, so..”

“Oh” the student said. “Um, the other thing we’d like you to do is take a baby aspirin every day to lower your blood pressure.”

“But my blood pressure is on the low side of normal, and what about postpartum bleeding? Wouldn’t that possibly exacerbate that?”

“Well… we just want to prevent the possibility of pre-eclampsia, because at your age..”

“So you want to prevent a problem I’ve never had and possibly make a problem I do have worse?”

And we were out of there, because these were soft markers and not structural markers. And because everything was fine. It was fine. And because I had stopped listening after the aspirin advice.

From there, things went on, time went by. We survived winter, we lost our old dog to cancer, we made our pregnancy Facebook Official and told all the family.

The boys were excited. Really, truly excited.

I thought- please let everything be okay. For them, let it be okay.

When we came to the last weeks, I was required to come in for non-stress tests- which ended up being the most expensive part of this pregnancy, including the whole hospital stay. What is that about?

Anyway, a non-stress test consists of an ultrasound to measure amniotic fluid, and sitting in a chair for at least a half hour wearing a monitor to measure and count the baby’s heart accelerations. These went fine and then.. and then..

They began telling me about the likelihood of stillbirth if I went the full 40 weeks. Apparently, the likelihood of this happening in late pregnancy is high enough in women over 40 to warrant delivering before that mark as a general practice. Induction. The thing I had always resisted.

A little background- I used to read birth reports as a part time job. I worked at a hospital and went through charts on the postpartum floor, gathering information for state statistical purposes. I got to the point that I could begin to read a report and know how it would likely end. I didn’t like what I saw when women were voluntarily induced before that 40 week mark. It didn’t always end well, and I remember things I read. They started to play out in my imagination and it wasn’t good.

But then I sucked it up. How many women had been through exactly this? Tons. I had been extremely lucky in the past, and maybe it was my turn to listen to the people I’d trusted with my care for once.

We scheduled the induction, and it went fine.

There are things I want to write about my delivery experience, but I will save that for another day. What I really want to close with is that just like being a good advocate for yourself during any kind of medical process, it is just as valuable to advocate during the conversations leading up to it. If I had been honest about how much they were frightening me by focusing on my age, rather than my medical record and prior experiences- they might have learned something, just like that poor newbie doctor who wanted to educate me about Down’s Syndrome and blood pressure. Fear doesn’t always motivate, sometimes it freezes people in their tracks. If I hadn’t been so afraid, the decision to go forward with the induction wouldn’t have been as difficult, and I might have had greater joy through the whole process of pregnancy.

Isn’t that what we want? Calm, confident mothers who are able to trust their providers. Will things go wrong sometimes? Um, yes. And that’s unfortunate enough without adding additional pessimism and fear in the name of patient care.