What I Don’t Know Can Hurt Me

October 12, 2007

“Late Maternal Age,” they call it. It’s a fancy term for OLD MOM.

I was not late of maternal age when I had Wonderbaby. I was not entirely early of maternal age, but still – I didn’t qualify as elderly. Somehow, between the time of her birth and my current pregnancy, I became old.

I don’t mind being old. I much prefer the older me to the younger me, and I intend to go on liking myself even more as I continue along the long and winding road of time. But I’m still don’t like the euphemism that is “Late Maternal Age.” I don’t like it because it’s code, because it’s troubling code. It doesn’t refer to my maturity, or to the wisdom that time has conferred upon me as a mother – it refers to the long list of negative factors bearing upon the odds of success of this pregnancy.

Because I am now over 35 years of age, I have an increased risk of miscarriage. I have a markedly increased risk of carrying a child with fetal abnormalites. There is an increased risk of Spina Bifida and Down’s Syndrome and Trisomy and all those other terrible disorders whose names we prefer not to speak. Because I am now over 35 years of age, the doctor puts pamphlets about Chorionic Villus Sampling and Amniocentesis into my hands and refers me to genetics counsellors.

Because I am now over 35 years of age, my doctor tells me that I must consider seriously tests that will tell me the odds of this being a “problemed” pregnancy. Tests that will give me information that might lead me to consider terminating the pregnancy.

Before I was pregnant with Wonderbaby, I underwent genetic testing and genetic counselling, because my nephew’s disorder, the one that will kill him, is hereditary, passed along the female line of the family. I swore at the time that no matter what the tests revealed, I would proceed with starting a family.

When I was pregnant with Wonderbaby, my doctor offered to conduct amniocentesis, because I was already in my thirties, and because there was a history of genetic difficulties on both my husband’s and my own side of the family. She said, because there is a risk of miscarriage, I only recommend this if the results would effect whether or not you would continue the pregnancy. I was going to continue the pregnancy no matter what, I told her. The results of an amnio test wouldn’t change that.

She said the same thing to me this morning, although she added that, because of my age, the odds of miscarriage due to amnio are now precisely the same as the odds of the test results showing Down’s Syndrome. It’s a worthwhile risk, she said, if knowing the results of the test are important to you. What she meant: if a certain result would lead you to consider terminating the pregnancy.

I told her that I didn’t know. I told her that I didn’t know. I don’t know. I just don’t know.

That I don’t know – that I don’t have the conviction of the last pregnancy, that I don’t have the faith of the last pregnancy, that I don’t know what I’d do – is hurting me. It’s hurting my heart.

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    wordgirl October 13, 2007 at 10:05 am

    Whatever you choose…I support you completely. Peace to you.

    Susan Getgood October 13, 2007 at 10:13 am

    My son was born when I was 37, almost 38. I had amnio, and truly don’t know what I would have done had there been a problem. We didn’t even tell anyone except immediate family about the pregnancy until the results were back

    But there weren’t any issues, and the peace of mind let me enjoy my pregnancy.

    Perhaps the tests would let you have the same, and give you some of the certainty you are craving.

    Bon October 13, 2007 at 11:08 am

    ah Bad. the power to make decisions is sometimes unwelcome in its weight, huh?

    don’t judge yourself for your lack of faith. a second child IS different, in that a sibling will impact Wonder’s life so much too. no matter who s/he is…but some impacts on the family may be more than you are honestly prepared to handle. you are allowed to doubt that. it doesn’t make you a bad mama, even to this new little creature. it makes you practical, and honest. you’re grieving the loss of that certainty that you had…and it hurts, the way you think it reflects on you. that’s hard.

    go gentle on yourself, and take your time with the decisions, and most of all, know that you’re supported and loved, whatever’s ahead.

    something blue October 13, 2007 at 2:16 pm

    I had amnio with the first but not the second. I was told the risk of miscarriage at some of Toronto’s hospitals is much smaller than the widely used statistics.

    Numbers always seem to be turned into a fear factor.

    Lisa b October 13, 2007 at 2:46 pm

    Catherine I have so much I could say about this.
    I have typed and deleted several times.

    Ultimately the stress of prenatal tests that were inconclusive and the being asked to decide whether my child should live far outweigh to me the minor hardships of caring for her.

    Of course with a more severe disability (or acutal diagnosis) my decision may have been different. You have wonderbaby to think of and your decision may be differnt this time too. That is ok.

    You also may have nothing to worry about! Yay.
    Something great could happen – you could have another perfect baby!!

    I just had to throw that in there because if you are about to go down that path of prenatal testing you need some positive vibes to go with you.

    I’ve heard the same as Jana – the risk of amnio’s in hosptials that do them often are really theoretical.

    Naomi (Urban Mummy) October 13, 2007 at 6:26 pm

    Okay, I can weigh in here.

    I was of “advanced maternal age” with both of my kids. I did not have an amnio with either.

    There is the “other” test that they can do first – with the ultrasound/blood combination. I figured if that one came up with high odds, I would do an amnio.

    It didn’t, I didn’t, and I have 2 healthy babies.

    That being said, risk of miscarriage from amnio is actually very low, and for doctors that perform this procedure often, it is even lower. As the others have said, often the risk is purely theoretical.

    Nichole October 13, 2007 at 8:36 pm

    I have no better advice to give you than any of the other fine women who have commented before me. I only wanted to pop in and say I’m keeping you in my thoughts. Ultimately, you will make whatever decision you feel is best for you, and will not be judged by any of us I’m sure. Much love and super big hugs.

    Pgoodness October 13, 2007 at 9:06 pm

    I feel your pain of not knowing. I had a lot of the same lack of conviction with my second pregnancy. It hurt my heart, too, and I wasn’t even Late Maternal Age. Hugs to you. Not knowing is ok. Not knowing is fine. It seems to me that once we become mothers that weighing risks is that much more difficult.

    Blog Antagonist October 13, 2007 at 10:54 pm

    Sometimes, I think there is truth to the saying “Ignorance is Bliss”. Sometimes I wonder if we were ever meant to have a window into the womb. And yet…if someone told me something might be wrong with my baby, I would insist upon arming myself to the eyeteeth with information. It’s a uniquely modern affliction, I think, this dichotomy.

    It so tough. Good luck with whatever you decide and well baby wishes times ten.

    Femme October 13, 2007 at 11:01 pm

    Oh sweet [her]“bad” mother. The most painful things in this life are when we doubt ourselves, when we are ashamed due to our own lack of conviction or are surpirsed by our own lack of faith.

    Not Knowing IS fine. Not Knowing is a sign of all those positive things that come with being OVER 35. Those years of experience and maturity. Those years of seeing and living with the situations that Younger You would have rushed headlong into.

    Not Knowing will change you. Will make you accept things about yourself that you hdn’t accepted – and that’s the journey, right? the one that got you this far?

    You will choose wisely; you will choose with your hurting heart and you will learn to not jugde yourself so harshly.

    Much Love

    Femme x

    nomotherearth October 13, 2007 at 11:12 pm

    I’m sorry I don’t have any words of wisdom for you. My brain always freezes just when I need it most.

    But my heart is with you, all the same.

    Major Bedhead October 13, 2007 at 11:59 pm

    I went thru this, too, with both Boo and The Bug. I’d had a miscarriage before getting pregnant with Boo so was given all the same information you were given. I decided that I’d just go for the level II ultrasound. If that had shot up any red flags, I would have considered amnio, but only to find out so that I could get more information on how to deal with what might be. I wouldn’t have terminated. I just wanted to be prepared.

    Fortunately, my ultrasounds were both fine and I didn’t have to go down that path. I’m not quite sure what I would have done, to be honest.

    I know the heart-hurting feeling of this. I wish I had words to make it easier. I wish you peace in your hurting heart to help you make the decision that’s right for you.

    Fairly Odd Mother October 14, 2007 at 4:01 am

    It’s ok you don’t know.

    Do what you think feels right for you and your family. That is really all that matters.

    the mad momma October 14, 2007 at 6:21 am

    God bless you.. may it all go well. may there be no red flags. may we have a bonny little wonder baby #2 and may you be healthy and happy through it all. hang in there.. that is all we can offer – words and prayers. i have an award i’ve offered you too… but i have a feeling you may not have the time to collect it.

    Susanne October 14, 2007 at 10:46 am

    When I had my son I was just 35. If I had become pregnant a year earlier nobody would have asked me to do an amnio. I had to find out that the risk of something going wrong because of the amnio and the risk for having child with down syndrome were exactly the same. One was supposed to be negligible and the other was supposed to be totally worth it.

    It’s you who has to decide but it isn’t as if great test results make our children safe for life. Nor are bad test results always correct.

    Of course the decision is yours to make.

    (Um, I wrote about my own thoughts about this decision here if anybody is interested.)

    Amy October 14, 2007 at 12:14 pm

    We have a genetic disorder in our family. Both my girls now have it. We’re not talking about Down Syndrome- we’ve been very lucky that they are active and healthy aside from a few things which we really can’t do anything about at this point. I have alot of guilt about passing this on to them but I would never trade them in for the world.
    I’m going to tell you: don’t feel guilty for weighing what having a child with Down Syndrome or some other disorder would do to your family and how it would affect the child you already have. That is a totally rational, a totally responsible response – and you KNOW in your heart if someone handed you a baby, you’d love that baby just the same whether it had Down Syndrome or not, but to willingly take that on is a heavy decision and then of course, the risk of the test– it is a difficult decision. Sometimes it would just be nice if we didn’t have to make those difficult decisions. If only we could look into a crystal ball…

    Redneck Mommy October 14, 2007 at 2:42 pm

    My lovely Bad, I just wanted to say I love you. Tis a difficult dilemma, one I often pondered myself. If I had taken an amnio, or had an ultrasound beyond my first at nine weeks, and it had shown Bug’s abnormal health, what would I have done?

    Would I have been brave enough to choose to love him, flaws and all? Or would I have been brave enough to terminate a difficult pregnancy?

    I don’t know. I DO know I was and am thankful not to have had to make that choice.

    I don’t envy you one bit.

    Know that I love you.

    Even if you are of advanced maternal age, you old goat.

    kittenpie October 14, 2007 at 8:17 pm

    I can understand that, though, and I think it is no shame to consider the other factors. You have a much-loved child already, and a child with special needs would have a major effect on her life as well as yours, for one thing. And you know now how hard it is to raise a child without extra challenges, I can understand how much more daunting the prospect looks. I think it’s important to consider all of these things, no matter what your decision would be in the end. By considering, you can figure out, with greater conviction than you feel right now, where you stand.

    iheartchocolate October 14, 2007 at 8:55 pm

    You know what? You are a wonderful mother. Don’t beat yourself up over what you are feeling or aren’t right now. Remember hormones are flowing too…just relax. Do what you think is best in your heart.

    mamadaisy October 14, 2007 at 9:54 pm

    when you exercise your ability to procreate, you roll some mighty big dice.

    I ended a pregnancy due to obvious malformations and probable trisomy 18 or 21. we knew that it was the right decision when we started quietly hoping I would miscarry.

    with my subsequent pregnancy and healthy son, we agreed to a neural translucency scan — non-invasive and very accurate. i don’t think i could have survived if we had encountered the same problems twice. even with a clean bill of health, it was nine months of gut-wrenching anxiety.

    there is enough to worry about that is real and actual. try not to let the what if’s hurt you unless they arrive at your doorstep. i wish you peace.

    Wolfie October 15, 2007 at 1:25 am

    Just want to give u a hug..*Hug*..
    Praying for u..by the way i’m sure u’re a wonderful mum..

    Lisa October 15, 2007 at 2:52 am

    Things aren’t so bad if we choose to look at it on the bright side.

    Anonymous October 15, 2007 at 11:21 am

    honey don’t feel bad, its easy to say we will have this baby no matter what when you don’t know what to expect, its easy to have no misgivings. But now you have wonderbaby and you know how HARD it is, and how much WORK it is. Yes its rewarding and you love her to bits but its hard work that is TIRING. Which means you don’t KNOW, you can’t know, b/c if there were genetic issues you just can’t know what you would do. and that is OKAY. Hugs Hugs and more hugs!

    ImpostorMom October 15, 2007 at 4:41 pm

    I don’t know how I would feel either. I think I would agree with Mom-101 though, I’d have the test. I like to know what I’m dealing with regardless of the outcome.

    Barb October 15, 2007 at 10:21 pm

    I consider tough situations like as a struggle against negative thoughts. If we continue to have negative thoughts, it will only make us miserable.

    gingajoy October 16, 2007 at 10:22 am

    well–I opted not to do it, and also have shrivelled ovaries. The results would not have changed anything. I know it’s hard–the main thing is deciding if you *want* to know. What will you do with the knowledge. I know you won’t love the baby any less. Sorry. I’m being didactic. But I second the motion for “feel the joy.” (and I am not just referring to you grabbing my ass, although that is always a welcome surprise.

    Lawyer Mama October 16, 2007 at 2:05 pm

    Oh, I so understand. I haven’t read all the comments though, so maybe someone else has brought this up. There is another reason to do the test – preparation. Of course, it’s harder if you really don’t know what you’d do.

    When I was pregnant with Hollis, my blood tests came back with a 1 in 30 chance of down syndrome. I had the amnio because our nephew has down syndrome. My BIL and SIL did not know and their baby had to be airlifted to another hospital several hundred miles away. He had scary heart complications. It was so frightening for everyone, we wanted to know.

    Amanda October 16, 2007 at 10:14 pm

    Oof. Wishing you strengtha nd wisdom as you make your decision. Hugs.

    Tiffany October 18, 2007 at 12:05 pm

    I’m sorry you are having to deal with this.

    I lost a niece to a genetic disorder and it was horrible.

    I wish you all the best, and wisdom in making your decision.

    A question may be- is it better to have loved and lost? Or better to never have loved at all.

    And no matter what your answer to that is, it will be hard.

    Kian October 18, 2007 at 3:57 pm

    You don’t know me, so my opinion means diddly, but I had my first child at 36 and opted out of the amnio. He’s perfectly healthy. I had my second 5 months ago, when I was 38. I opted for the amnio knowing I’d continue the pregnancy no matter what. I’d just be prepared better if something was wrong. There wasn’t and he’s perfectly healthy. I think that is the benefit… being able to not have an unwelcome surprise, of having the right doctors available, of getting better information early on when you have the baby safe inside.

    Best of luck and good wishes.

    Rusti October 19, 2007 at 4:43 pm

    I can’t even possibly know what you are going through, as I haven’t had any children yet, but a friend mentioned it while talking to another who was trying to conceive, I didn’t know that it was even possible, but it got me thinking then… and even now as we begin to think about having children I wonder what I would do in the same situation… not the age thing (I think it’s ridiculous!) but the test or don’t test, and what to do if there will be problems. I’m not even pregnant yet and I’m already scared. I’ll be praying for you as you deal with this choice, and the pain it’s causing you… those who believe, they say that it’s all up to God… I like to think so…

    good luck, and though you don’t know me – hugs to you.

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