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I immediately resurrected all my old pregnancy and babycare manuals, which, although a little out of date, still contained information that applied today, 12 years on. I also 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 develop every pregnancy complication on the book. 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 breasts, which would probably metamorphose into two flaps of skin like Spaniel's ears.
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.
The ultrasonographer who conducted the scan, prior to my abdomen being stabbed with a sword-length needle, told us that she was almost certain the baby was a girl. I felt a rush of ecstasy when she said that because, although my main concern was that the baby was healthy, I was secretly hoping that it was a girl. At that point I felt like leaping off of the couch and not going through with the amniocentesis. Supposing the procedure damaged my baby in some way or caused me to miscarry a 100% normal, healthy foetus? I watched our perfectly formed little girl waving around her tiny arms and legs and felt this almost unbearable guilt at invading her secure environment and potentially causing her harm.
Once a suitable pool of amniotic fluid had been located, a mark was made on my abdomen with a felt tip pen, the point at which the needle would be inserted. The doctor, who spoke unintelligible English and sported a manic grin, proffered a consent form for me to sign giving my permission to go ahead with the procedure. At that point I could still have changed my mind but I looked at Mike and knew that I was making the right decision.
The whole time, the ultrasonographer talked us through the procedure, explaining that once the needle had been inserted into the amniotic cavity, the sharp bit would be removed leaving a thin plastic tube through which the fluid would be withdrawn. She reassured us that even if the baby reached out and touched the tube, she would not be harmed.
I felt Mike wince as I dug my nails deeper and deeper into his hand that he had proffered in order to act out the supportive role.
Following this torturous experience, we were ushered into a post-procedure rest room to have a drink of tea or coffee before being allowed to leave the hospital. However, because I was in so much discomfort I was then taken to another room and instructed to lie down. "Oh, you mean Jan?" chortled Mike, as he climbed off of the couch still clutching the hand that I had gripped with such ferocity. The manic doctor came in, still grinning and almost choked me on a Ventolin inhaler, which apparently relaxes the uterus.
The ultrasonographer poked her head around the door at regular intervals to ask how I was feeling and to offer reassurance that what I was feeling was perfectly normal.
I couldn't fault the sensitivity of the ultrasonographer, although I felt that the doctor had treated me like a slab of meat, as just another number in his daily routine of treating maternal fossils.
When the cramping had finally eased, I was allowed home. I still had a vague feeling of discomfort where the needle had been inserted but was told that this was due to bruising and was nothing to be alarmed about. I was also instructed to drink 2-3 litres of fluid within the same number of hours to replace the fluid that had been withdrawn from the uterus. I couldn't think of anything more revolting since I didn't drink that amount even during periods of intense thirst.
Mike tucked me up in bed and told me that I was only allowed to get up to go to the bathroom. He brought me pint after pint of iced water, switched on the TV and glared at me in a, "If you even think about moving from there, you'll be punished" type of look.
Two days before we received the results, I had a routine antenatal appointment with my jovial midwife. "No news is good news," she chortled, after I'd expressed my anxiety at not having yet heard anything.
"You've asked to know the sex too haven't you?" she asked, as she poked my abdomen viciously with her portable vibrator. "Sounds very 'boyish' at the moment," she announced confidently, as she monitored the baby's heart rate.
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 ample 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 emitted 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.
At 31 weeks, I was diagnosed with Symphysis Pubis Dysfunction. During pregnancy the hormones soften and stretch the ligaments of the body in order to enable the pelvis to open slightly during labour, affording a quick escape route for the baby. During pregnancy the Symphysis can separate slightly, causing pain and making everyday functions like walking or turning over in bed difficult or even impossible.
Again, I was told that this wasn't a condition of age but, on the contrary, a condition that frequently affected athletes. Having attended the gym five times a week prior to becoming pregnant, I attributed it to having flexible bones! This dysfunction caused intense pain in the buttocks and pubic area, which also radiated down my legs. The pain was worse when I had been sitting for protracted periods at my computer, after which I would find walking quite unbearable and I began moving with the grace and agility of a lame, overweight duck.
Whenever I mentioned the pain to someone, the reply would inevitably be, "Well, you're not as young as you used to be." Nobody's as young as they used to be, because time never stands still, which serves to highlight the pointlessness of that statement.
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 gas and air, ("I love this stuff," he slurred, eyes rolling back in his head) and I was hanging over the bed in pain.
"You're getting through this stuff rather quickly," remarked the midwife on one of her check-up visits.
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 young child, after a twelve-year break, has been a breeze. Now, at almost three years of age, Lauren is still being breastfed, so apart from my bust, which still enters the room half an hour before the rest of my body, all my other vital organs have resumed their original and rightful positions. OK, I admit that my abdomen resembles a lump of dough that rolls over the top of my jeans when I try and zip them up, but this has less to do with age and more to do with my penchant for chocolate!
*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's 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.
NB. Despite a past article in the Daily Telegraph and a piece on the BBC news saying that I suffered from complications throughout pregnancy, this is absolutely not true. The sickness and general aches and pains were something from which I suffered throughout all of my pregnancies and were not regarded as "complications".