I could sense the talk was coming. It came with a vengeance the last time, and I was 37. Now, I am 39 and approaching the second trimester of my second pregnancy. I knew the "advanced maternal age" talk was on the horizon. It finally went down yesterday, when I got my first ultrasound.
Since we weren't exactly planning on having this baby, I had no idea how far along I was. I know that sounds pretty stupid, but I really didn't think that conceiving a baby was something I could do with no effort. It took years of trying and every trick in the book to conceive our first. I guess there is something to the "All you have to do is stop trying!" mantra that everyone likes to shove down your throat when you are infertile.
Anyway, I needed to have an ultrasound so I could date the pregnancy. If the memory of my last period was serving me correctly - I would be about 12 weeks along. This is about the time that the first set of genetic tests can be done if you are "advanced maternal age," so we decided to kill two birds with one stone. Needless to say, I was nervous.
I have really been trying not to live in fear through the first trimester of this pregnancy. I think I have been doing a pretty good job. But there was definitely some sweaty palms and hand-wringing before I went into that ultrasound room. When you have suffered a pregnancy loss, there is always a flicker in the back of your mind that it could happen again.
I entered the ultrasound room, and waited patiently for the tech. When she finally arrived, I smiled and said "Hi." She responded with, "How old are you?"
"Thirty-nine," I said.
"Forty?" She replied.
"No, thirty-nine." I insisted.
"Almost forty," she decided.
"Fine. Almost forty," I conceded.
(Photo: Gladskikh Tatiana / Shutterstock)
Then the ultrasound began. I'm not one of those people that thinks the whole world should greet me with a smile at all times, but there are some professions where bedside manner should be a prerequisite. Dealing with nervous pregnant ladies when they are seeing their fetus for the first time is definitely one of them. "I'm a little nervous," I confessed. "This is my first ultrasound of the pregnancy." No reply from Miss Congeniality, just a barely audible grunt. Okay. We wouldn't be buddies. She slathered a bunch of that weird gel on my belly and got to work.
There was a giant screen perched on the wall in front of me, just waiting to be examined. I was looking away, trying to muster the confidence the look forward. It took about 30 seconds, but I finally turned my head and faced an image of what looked to be a human baby; little arms, little legs, and a beating heart. Yes! There's a baby in there, and it has a beating heart. Score!
Meanwhile, stone-faced ultrasound tech is measuring all angles of the baby and saying absolutely nothing. Usually, there is some kind of chit-chat happening by now. You know, something along the lines of, "Everything looks great, measurements are good, don't worry," etc. This woman is saying absolutely nothing and it is really starting to freak me out. Finally, she opens her mouth and speaks.
"Oh. Does everything look okay?"
"Yes. You can head down the hall for your blood draw."
"Can I get a picture to take to my husband?"
She lets out an audible sigh, and begrudgingly prints one for me. The one she chooses looks like a kidney. Thanks for nothing, lady. I head down the hall.
I take a seat in a small room. There is a chair, a counter and a giant billboard. The billboard is overflowing with prenatal genetic testing brochures. There must be 30 up there - and they are all different. Wow. A young woman walks in the door a smiles. She says hello and leans against the counter next to me.
"So, as you know, there are about 5000 different types of genetic disorders we can test for in a woman your age." She's sort of whispering, and using an apologetic tone.
"No. I didn't know that actually. Wow." Her tone is confusing me, and I am anxious to stay in the I just had a great ultrasound space, rather than going down the I am so old my child will definitely have a genetic disorder rabbit hole. "I'm just here for the NT scan."
An NT scan, also known as a nuchal scan is a is a "sonographic prenatal screening scan to help identify higher risks of chromosomal defects including Down's syndrome in a fetus, particularly for older women who have higher risks of such pregnancies." They recommend it for all women over 35. The results of the test basically give you the statistical probability that you will have a child with certain types of genetic disorders. I took the test in my last pregnancy and my probabilities were those of a 24-year-old woman so I am pretty confident that everything will be fine.
"I know you are here for the NT scan, but if you give just three more tubes of blood we can also perform something called the 'harmony' test. It is brand new - about two months old. We've done it on about 100 patients. The NT scan is only about 90% accurate. This test is about 98% accurate. Do you want it?" She is already pulling out the extra blood vials, so I'm pretty sure she thinks my answer will be yes.
She looks confused. "Um, oh. Can I ask why?"
What? Why the hell does she care? That seems like kind of a weird question. "I don't want to have a shitty pregnancy because of the results of some brand new test that you've only done on 100 people. No thanks." My good ultrasound glow is starting to wear off. I am getting annoyed.
She launches into a speech about the different types of genetic disorders it tests for and keeps reiterating that I can only legally terminate my pregnancy until I am 24 weeks pregnant. I repeat again that I don't want the test, and she finally prepares a needle to draw the apparently disappointing one vial of blood.
Right before she sticks the needle in my arm she asks, "Can I ask - would you terminate if you found out something was wrong?"
Am I conscious? Did this woman just ask me that? What the fuck is going on? Are we best friends? Is this any of her business?
"Can you please just drop it? I really don't want to have this conversation anymore." I answer, trying to remain as cool as possible. At that moment it hits me. I have a question for her.
"Do you have kids?"
"No," she responds.
"When you get pregnant, are you going to take all of these tests?"
"Oh, no way. I don't want to know. I'd rather leave it in God's hands." She flippantly replies, as if she hasn't just spent the past 40 minutes trying to convince me of the opposite.
"Perfect!" I start laughing uncontrollably. She looks confused. "That is so perfect. You are really great at your job." Well, she is.
I know it is a fact that the risk for genetic abnormalities increases the older that you conceive. But having been through it twice, I can tell you that there is a lot of training and grooming involved in convincing all women they need these intricate - and I'm sure very expensive - tests. There is no history of any of this in my family, we had no issues with our last "advanced maternal age" pregnancy - and apart from the few tests that they almost insist you have when you are my age, I will not be partaking in anymore genetic counseling, screening, or testing.
Just let me and my old uterus enjoy this pregnancy in peace, please.