I'm Not Too Old! Pregnancy and Birth at 40+
In March 1999, at the tender age of 39¾, I discovered that I was pregnant for the fourth time. My three other children from my first marriage had been conceived when I was barely twenty-something, at a time when I was still regarded as a normal, young mother. This time around however, I was horrified to find myself being referred to as a geriatric mother who, by the time my child had reached school age, would have a brain like a soggy rusk and would have the personality and mobility of a stuffed parrot.
There was never any doubt in my mind that I would conceive easily, despite my advancing years and, after the first time of trying for a baby with my partner Mike, who is 12 years my junior, I was not totally surprised to discover that I was pregnant. I remember feeling rather proud that all my important parts were still in superb working order and grateful for the fact that I had religiously taken a Folic Acid supplement for three months prior to conceiving.
I immediately scoured the internet for articles and statistics on pregnancy over 40, since that was the age I would be at the time of the birth.
What I discovered set me into a state of premature panic.
Terms like chromosomal defects, foetal abnormalities, miscarriage, Diabetes, placental abruption, Pre-eclampsia, Placenta Previa, prolapse (of everything) and stillbirth leapt out of the page at me. The consensus of medical opinion seemed to be that I was completely past it and that I was taking a huge risk even considering pregnancy at my pre-pensionable age.
I soon became convinced that if I didn’t miscarry within the first 12 weeks, I would go on to deliver some grotesquely deformed monster who wouldn’t look out of place in a Star Wars’ movie. Even if I did succeed in producing a full-term, healthy baby, apparently my tortured pelvic muscles would cause everything to collapse and my bladder and reproductive organs would dangle precariously between my legs for evermore. Not to mention my boobs, which would probably metamorphose into two flaps of skin, as they had done before, after many months of breastfeeding my previous children.
Despite the severe nausea and vomiting, I very quickly assumed the appearance of a small Hippo and, at eight weeks gestation, I could no longer fit into any of my regular clothes. The fact that Mike began addressing me with such endearing terms as ‘Pudding’ indicated to me that I was gaining weight rather rapidly.
I also suffered from heartburn, headaches, abdominal pain associated with stretching of the ligaments and extremely inflated, tender breasts. Everything smelled grotesque and everything I ate made me sick. I would often sit in the restroom at work communicating with the toilet bowl and thinking I would never make it through another day feeling so ill and, at 14 weeks, I was admitted to hospital because I became dehydrated. However, on the other hand, I welcomed all of these symptoms as signs of an elevated hormone level and a pregnancy that was definitely here to stay.
At 11 weeks, I met with my midwife for the first time. Now was my opportunity to bombard her with all those awkward questions that had been racing haphazardly through my mind over the previous few weeks.
“Ooh, an older mum,” was the first thing she said, followed by a non-too reassuring chortle, as she began filling out the reams of documentation and noted my date of birth. “You don’t look that old,” she said, apparently trying to make me feel better.
“I’m in my 40’s”, she continued, “and knowing what I know, I’d never have the courage to have another one at my age”, she said, chuckling even more heartily. “If I became pregnant now, it would be a complete disaster!” She snorted loudly, her ample chest vibrating in synchronisation with each peal of laughter.
After completing all the relevant forms, a process through which the midwife merrily cracked jokes about prehistoric mothers, she took my blood pressure and checked for the baby’s heartbeat which, she said, she didn’t expect to pick up at such an early stage of pregnancy.
I was instructed to lie on the floor whilst she pulled out an electronic device that resembled a thin, white vibrator. She then squirted the obligatory cold gel onto my abdomen before probing around my pubic area rather aggressively and commenting on the rather large size of my abdomen for dates.
“Could be twins”, she grinned. “You have an increased chance at your age, you know.”
After a few minutes of prodding and further cracking of insensitive jokes, she detected a very definite, fast heartbeat. It was wonderful. My baby was real and to add to my joy, she had a really strong heartbeat.
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 where I would have to exercise dexterity in urinating into a two-inch diameter plastic cup without dribbling all over my hands. The next humiliating stage was having to stand 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 labour and multiple births.
He said that because women are born with all the eggs that they will ever have in their lives, 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 labour 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 on to the option of pre-natal 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. Whilst 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, therefore, duly booked for 10 June 1999, four days after my 40th birthday.
I didn’t find the procedure particularly pleasant but, by far, the worst time was the waiting period 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 visualised 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 attractive negative results.
Exactly two weeks and two days following the amniocentesis, whilst I was still lying in bed, Mike came bounding up the stairs and appeared at the bedroom door 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, which created a catapult effect, sending my backside two feet off of 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 with regard to 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. However, I had suffered in exactly the same way with the others, so I knew that the degree of sickness was in no way related to my age.
At each antenatal 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.
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 a day ward 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 conducted a week later and the test results, which I received the following day, 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 whilst muttering something about a prolonged, backache labour.
“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 type of voice. “You realise 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.”
At 38 weeks I went to the hospital for, what I hoped would be, my final appointment with the consultant. And it was. Although I never actually got as far as seeing the consultant.
Sitting in the waiting area, I bent forward to pick up a magazine and my waters broke.
As soon as I arrived on the delivery ward (with water still gushing out of me), the contractions began coming every three to five minutes, increasing in intensity. My wet clothes were put into a plastic bag and I was enrobed in one of those attractive nylon hospital gowns with broken ties at the back. This afforded the rest of the ward and excellent view of my bum and of the wad of sanitary pads stuffed between my legs to soak up the fluid that was draining ceaselessly from me!
Mike arrived in a whirl of excited anticipation, clutching my inadequately packed hospital bag. This was the same bag that I had packed 10 weeks earlier, but then decided to unpack the day before and only put in the barest of essentials, since I had planned to go home within 24 hours following the birth. The ‘essentials’ included a packet of fudge, a Feng Shui book (so I could re-arrange the labour room between contractions) and a pair of jeans in anticipation of my body springing back to pre-pregnancy size within two seconds of the birth.
After lying in a pool of amniotic fluid for half an hour, I was given an internal examination but told that I wasn’t at all dilated. The cheerful midwife also informed me that because my waters had broken first that I would have what was termed as a ‘dry’ labour, meaning that it could be prolonged and more painful. And no, it wasn’t anything to do with my age.
After the first half hour in one of the delivery rooms, Mike was high on entinox (“I love this stuff”, he slurred, eyes rolling back in his head) and I was hanging over the bed in pain.
Several hours and hundreds of sanitary pads later, I had been pierced with a variety of needles in miscellaneous parts of my body, wired up to an assortment of drips, including an epidural, after screaming for total pain relief. The first epidural only numbed one side of my body, but that’s another hysterical story.
By midnight, Mike was asleep in the rocking chair, after having consumed the entire bag of fudge, and I counted the cracks in the ceiling whilst pondering my fate.
By the time I gave birth to our beautiful, perfect baby daughter, Lauren Erica at 6.20am on 12 November 1999, after a 14 hour labour and no sleep, I was in a better condition than Mike. He was sporting the 6am shadow, office attire that he’d been wearing since dawn the previous day, dark circles under the eyes and was shuffling around like a cripple as a result of having nodded off to sleep in an awkward position. I also believe he was suffering from an overdose of entinox, if that’s possible.
Two clamps were needed for the baby’s cord, which the midwife said, was the longest and thickest she had ever seen. She said that Lauren had obviously been a very well-nourished baby. Hah! Another point for the antique!
The day following the birth, Lauren and I came home, both in excellent health.
Life with a new baby, after a twelve-year break, has been a breeze. Apart from my breasts, which still enter the room half an hour before the rest of my body, all my other vital organs have resumed their original and rightful positions. OK, so my abdomen resembles a blancmange but, of course, it has nothing to do with my age!
Folic Acid is a B vitamin that can help to protect your unborn baby against birth defects of the spine and brain. Folic Acid is found in green leafy vegetables, beans, citrus fruits and juices, whole grain foods and liver. However, Liver should not be eaten during pregnancy because of the high content of Vitamin A, which can be damaging to the foetus. The latest findings published in the American Journal of Clinical Nutrition suggest that taking a Folic Acid supplement can also help to prevent Down Syndrome.
Nuchal Translucency Test = an ultrasound examination that measures the layer of fluid at the back of the neck (Nuchal Translucency Layer). Babies with Down Syndrome have an increased thickness of this layer.
Hyperemesis = severe sickness, often resulting in dehydration.