“So, why exactly are you here?”


That’s exactly what a doctor said to me today, after talking with me for about ten minutes.

“You’re healthy, your genes are sound, you’ve got that Restless Leg thing going on… but … I have to be honest here, I was hoping for something more interesting.”

He said that last bit with a small grin, letting me know he was kidding but also trying to reassure me.

I was there for… pre-conceptual counseling.

As in, “the sort of appointment one might make when one is thinking about getting pregnant.”

No, really.

As some of you might remember, I had a fairly significant Baby Blip in 2009. While it eventually sort of tapered, it’s been cropping up pretty regularly. This most recent bout has lasted since before Christmas and hasn’t let up much.  Evidently, hitting the ol’ snooze bar on the biological alarm clock is no longer working. While it’s not yet a shriek, it’s certainly a continual buzzzzzz in the head.

At Mike’s large family gathering, I got to meet this little guy, Kannon:

For reasons I don’t fully understand, he took a liking to me. Well, perhaps more correctly, to my camera. Later, he fell asleep in my arms, and it was kind of awesome.

I haven’t ever given kids a fair shake. They actually somewhat scared me, but mostly, I just wasn’t very interested in them. I wasn’t a very good babysitter in my teens, and I haven’t spent much time around them since then. Being at the library has exposed me to all manner and sort of child. Turns out, they’re kind of fun.

I put off talking to Mike about it. He’s young. He doesn’t feel the same pressure of time I do, and I wanted to be relatively sure it wasn’t just another passing phase. In fact, I even talked to his mom about it before him – testing the waters, as it were (for the record, she is definitely Pro-Grandchild/ren.)

Last week, I talked to my gynecologist about maybe, sort of, kind of, possibly thinking about Having Babies. She was a new doctor – my long-time gyn has sadly departed the practice. The new woman seemed quasi-alarmed. After seeing I’m 40 and that I’m on a benzodiazepine, she immediately (and I do mean without hesitation) set me up a referral to a pre-conceptual doctor for genetic counseling. Plus a blood test for Rubella stuffs, since Mike and I are not married.

I got lucky and the doctor had an opening today. Waiting in his office, I had no idea what to expect – “genetic counseling?” It sounded like something out of GATTACA.

Glancing around the offices for clone vats, I saw none. No scary monster-sized needles, no weirdo tentacle babies. No mutant-sounding moans emanating from distant labs.

The doctor came in, sat down, and asked what he could do for me. “Um,” I began, eloquent as ever. “I’m forty and I’m thinking about having a baby and my gynecologist seemed alarmed.” He sort of smiled and pulled out a chart of chromosomal abnormalities.

He showed me what Down Syndrome chromosomes look like. He showed me a chart that graphed incidence of DS in fetuses. It was essentially flat in the twenties and early thirties, with a gradual incline from mid-thirties to mid-forties. At my age, the percentage read 2.2. It rises relatively steadily until about age 45, when the graph spiked up and quickly rose to 20% at age 49.

He wrote down some numbers. In a nutshell, the incidence works out to be about 17 babies out of 1000. “Is that a number that worries you?”

“Not really…”

We moved on to preeclampsia. He explained what it is, what the implications are, and noted the incidence is higher the older a woman is. I think he wrote down a number that was in the area of 5 out of 1000. “Is that a number you’re concerned about?”

“Not really…”

Next up: Gestational Diabetes. Low incidence, not horrific consequences. “It’s not real diabetes, it will go away. Basically, it just makes the baby grow faster and you might have complications from a vaginal birth, or you might have to have a Cesarian. A c-section is definitely not the worst thing to ever happen to a person. Are you worried about gestational diabetes?”

“Not really…”

“Ok, so why exactly are you here, then?” A smile.

I outlined my concerns about RLS and the medications I’m taking. Triazolam is considered to be safe during pregnancy. There are no human studies on ropinirole, and he couldn’t make a very educated guess. “You’ll have to weigh that out, I imagine. But consider this: Nature, via evolution, has protected the fetus very well. Reproduction is the most important function we have (evolutionarily speaking,) so it’s got to work most of the time. Recently, I had a woman in her first trimester diagnosed with breast cancer. She wanted to abort, because she ‘knew’ she couldn’t have chemotherapy while she was pregnant. ‘Why not?’ I asked her. ‘I can’t even have a coffee, how could I possibly have chemo?’ I told her she could have coffee, and indeed, that the chemo wouldn’t affect the baby. The placenta is an amazing thing.”

He continued on about how there is an elaborate mythology surrounding what pregnant women can and cannot do, what they can and cannot ingest, the decisions they can and cannot make. While he allowed for situational details, he seemed to dismiss much of it as unnecessary stress and hype.

He has a very pragmatic, down-to-earth, sensible manner about him.

I talked very briefly about how I did not want to pass RLS to my child. He asked, “do you resent your dad for passing it on to you?”

“Of course not! But it’s not about resentment – it’s about not wanting to inflict this personal hell on another human being.”

“Here’s the thing. Life is always going to suck a little, right? Maybe the restless leg is the worst thing that kid will have to deal with. Maybe your partner’s genes will cross it out and your kids won’t have it. That’s another thing you’ll have to weigh out. Pre-conceptive counseling is the hardest part of this job, because it’s a personal decision only you can make. I can give you tools and information, but you have to make the choice.”

We talked about how twinning increases with age at conception. We talked about two fatal chromosomal disorders I’d never heard of, but which are vanishingly rare. He talked for a moment about his own emotional experience as a parent, the highest of highs, the lowest of lows.

We talked about how the body doesn’t recover as quickly at my age and older, about how energy diminishes. We talked about how being overweight can complicate all manner of health aspects, and I saw him noting my size and shape in quick, darting glances, but I saw little if any judgment in his eyes.

At the end of our twenty-ish minute session, he said, “have I said what you wanted to hear? Have I helped at all? Because I don’t feel very useful here.”

I was a little let down. In truth, I was hoping for more concrete … I don’t know. Recommendations, I suppose, which is just silly, since this is a decision only Mike and I can make.

Speaking of the prospective father, we seem to be largely on the same page in terms of general thoughts and concerns.

Yesterday, as I was cleaning up the office/sewing room, I came across a portion of my stash devoted to pretty adorable baby-oriented fabrics I bought on impulse last winter. They’re so stinking cute!

I can’t believe this is me, saying that.

I know several women my age and older who have recently had babies, or who are currently pregnant. I know of one 43-year-old woman who became pregnant nine months after giving birth (ten months after losing her oldest son to a drug overdose and beating) who lost her baby toward the end of the first trimester.

The doctor said he recently delivered twins to a woman who is 51, and a healthy baby to a woman who is 55.


As I admitted to the doctor, I am probably over-thinking things, but I want to be responsible. I want to be informed.

So I’ve been informed. Now we just have to think and decide.


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10 responses to “So, why exactly are you here?”

  1. Has the world changed so drastically that, should this whole thing come to pass, giving Mike a slap on the shoulder and an “atta boy” would be considered bad form?

  2. Michigan Heather

    Honey, all I can say is, good luck making this decision! I am happy for you whatever you decide!!

  3. Nancy

    I am 54, raised an only child and there is absolutely no way in hell I would have a child (natural or adopted) at this point. That ship has sailed a couple of years ago. However, I’m not 40 as you are. One thing you didn’t bring up were your new duties relating to your mother. Having to take care of a mother and a child makes you the #1 Caretaker.

    All I can say is good luck in whatever you choose!

  4. Mel

    I’ve been making little nudges at David about adopting over the past year. He may disagree about the little part, but it’s something I’ve mulled for a long time and, even without the biological concerns, options become more limited once we’re both past the 45 year mark. As the eldest of four, I’m well aware of the amount of work, and the lifestyle shift, that even one child will entail. That said, my hospital administrator (who has 8!) said to me, “There’s never a good time!” So if it’s something you want, then don’t overanalyze – make it happen.

  5. Yep, it all seems like hype and paranoia until your kid’s the kid that comes out with lifelong challenges.

    I can’t tell you what to do because if I did, you wouldn’t listen anyway. And I certainly can’t tell you that had I known what I knew now, if I knew how hard life would be for him, for me, and what he would go through that I wouldn’t have had my kid because he is a person, I love him dearly, and I could never imagine life without him so I could never and would never say that.

    But when the doctor asked you if those numbers bother you, I would ask yourself if the numbers didn’t really bother you because you thought the odds were in your favor and too low to get worked up about, or if they didn’t really bother you because if your child came out with a defect, Downs, needing lifelong medical care, if you got sick, and on and on, you’d deal with just fine because whatever child you have and whatever could happen, you can handle.

    Usually, people think the first, when what they should really be considering is the second.

    The dirty little secret behind “you can handle anything” is that, no, not everyone can handle everything. It’s nice to think that you can. It’s nice to think everyone can, but that’s simply not the case.

    As someone who spun the wheel and rolled the dice and came up with something I never even remotely anticipated, who became a type of parent who’s duties go far beyond anything I could have imagined, as someone who didn’t think about what I would do if I gave birth to child with a debilitating, potentially deadly, extremely expensive condition that makes me pretty much a parent for the rest of my life with requisite obligations that will likely not end at adulthood, my advance is to think long and hard about the second.

  6. -B

    Stand back people! She’s about to reproduce. Do not look into the blast!

  7. Erin D.

    Thanks, everyone, for the thoughts and comments. Dwalters, I reckon that would be an appropriate response. 😉

    Heather – thanks, sweetie. I know you understand where I’m coming from on so much of this.

    Nancy – I can’t imagine having a newborn/toddler/young kids in my fifties, either. Jinkies. And indeed, you raise a good point about caring for Mom, which I’m going to write about today.

    Jen – Indeed. The reality behind the numbers is also something I have considered. I have a friend with a little boy who has Down’s Syndrome, and I remember very clearly the emails we exchanged at the time of his (now-ex-)wife’s positive pre-natal test for it. It’s definitely something I’m considering, to the degree I’m able – I don’t think anyone can truly prepare him- or herself for the reality. I read your blog post on CHD today, and have other thoughts I’ll wrap into my next post, as well. Thanks very much for the comments here.

  8. Erin D.

    Oh yes, and Bounce – I’m fairly sure the blast radius will be about 1000km, and will instantly vaporize anyone within it.

  9. Erin D.

    Oh, and Mel, too! I hope you guys can find the right birth mother and child to help accommodate your desires. 🙂 Were you thinking of trying stateside, or internationally?

  10. Bonnie

    We deliver lots of healthy babies with older women. My boss worked with the Amish and can recall delivering babies with moms who were in their early 50s. We recently had a homebirth with a mom who was in her mid 40s, and planning to have more babies. Totally doable!

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