Tuesday, January 15, 2013

The Gap in American Motherhood: or How I Survived The Amnio

The gap in American motherhood is greatly widening. If we aren't pummeled by the media with Jamie Lynn Spears, or Bristol Palin's teen pregnancies and subsequent motherhood stories, or watching the ratings rocket on the MTV show aptly named 16 and Pregnant, then we are seeing in the medical marketplace everything from IVF testing to cutsie terms like embies for embryos, and baby product manufacturers unable to keep up with the high demand for strollers and carrying devices for twins and triplets. Motherhood is skewing younger and older than ever, and I cant help but make the layman economic assumption that it is the indication of the great financial divide in our current economic crisis in the US. The teenagers are given less education and less money, so they are having more sex, and their parents, the 40 somethings that had them at twenty are so busy trying to save their jobs and put away retirement money, theyre never home long enough to coach their daughters and sons ab out the dangers of teen sex without birth control and condoms. In the middle of this mix are the new twenty-something-thirty somethings that are watching the great divide with horror in their hearts and solving the problem by not dealing with commitment or pregnancy at all and flying off to Costa Rica to sip fantastic drinks poolside and watch Lady Gaga videos on their IPhones.

As a 40 year old mom with a baby and a 5 year old, I champion the belated entry to motherhood. I was self-absorbed right about up to when I decided to get pregnant (and it was not emotional but rather something large on the top of the to do list). I was the person who glared at the harried mom with the crying baby on the plane for interrupting my ever-pressing journal entry about why I was mad at my mother for the one-hundredth time. Now I am a mom-mom. Devoted and tired and extended and elated. And besides not being the spring chicken I used to be at twenty-five, I am here to relegate what I believe is the only other downside to late motherhood: Amniocentesis. Off we go, old and conceiving kids with eggs and sperm all crusty and mutated from sloshing around inside us for too long, subjected to decades of X-Ray machines from travel or every time we microwaved at about abdomen level. Bad eating habits of Huevos Rancheros after a night of countless gin gimlets and Dunhill ci garettes. Eggs and sperm infused with the stress of our ambitious years as artists and believers and fighters. Going back to old school, how about all those McDonalds happy meals we ingested after we had our first periods and all the times we breathed in and out as we pumped gas into our cars. Power lines above our heads, and our rental apartments situated right between two cellular phone towers. The subway roaring right underneath our feet sending vibrations into our bones and our nerves and our uteruses. How about all those Tampax tampons inserted, rumored to cause abnormal hemorrhaging that translates to "egg damage". What did all this stuff do to our embryos? Apparently it really messed with the chances of having a kid with Down's Syndrome. So many of us choose to know if we are going to have a kid with some kind of awful disease that will make their lifetime on this earth potentially unbearable. Say what you want pro-lifers, but kids born with an Trisomy 18/13 barely li ve past 2 months.

I had gone on a few chat boards to see what other women in my position had thought about the amnio experience. Few talked about it. They said it would be quick and painless, and that was what it was. Many spoke about their discoveries that they had a baby with chromosome abnormalities and that they had to terminate the pregnancy. The emotion was not present, and in no way could one expect it to be on a chat board where people use terms like LOL or smiley faces created as such :) or "I had to terminate the pregnancy" :(. LOL to those of you going in for yours!" Yikes! But I was convinced that as long as my baby was not abnormal at the end of the testing, the actual experience would be fine.

The high end doctors office furnishings wanted to assure the high risk pregnancy patients that these number one doctors were rich because of the numerous times unborn babies were safely placed in their able hands for invasive testing. The waiting room was designed from a San Francisco show room out of a glossy brochure; love seat chairs, tasseled floor lamps, Kandinsky original prints and nature photos of seagulls and their shadows across a seamless pond. The check-in counter was dust free and sleek Italian marble, complimented by understated blown glass Dale Chihuly knock-off lighting sconces in the walls illuminating #1 Doctor of the Year in Physician Magazine. This was placed right by the sign in sheet so you couldn't help but feel as you handed over your insurance card to be copied that you were in the best hands in the business of invasive needle fluid extraction.

The ultrasound technician could not stop complimenting the perfection of our baby's skeletal makeup, head circumference, movement and formed limbs. I believe there was even an "I think she's sucking her thumb!" after the confirmation it was a girl. I stopped listening to him, or rather stopped trying to fully decipher what he was saying through his thick Indian accent because all I could think was "I have a perfect baby and someone is going to come in here any minute now and stick a needle into the amniotic sac, puncture it, take fluid, just to ensure that the baby is as perfect as this fully trained technician has already told me." When the technician left with a wide smile, a handshake and what I thought was a Congrats (although my husband heard it as the instruction to Keep my feet in the straps), I said to my husband in a shaky voice.

"Maybe we don't need to do this. I mean, the guy raved about our baby."

"I know but were here now," said my husband.

A nurse entered the room and sat beside the bed on a swivel chair. She logged into the computer and quickly introduced herself as Nan or Sandra or Laura. I was in twinkle land at this point. I confirmed my birth date and my name labeling a vial.

"It's kind of nice to have someone younger than 50 in here for a change," she said. When I am really nervous and questioning my own judgment, I look for any opening to be chatty. Here was my chance.

"I have to admit, I thought I was old to be having a baby until I saw a woman checking in with a walker. That bird had to be pushing 55!" I said.

I looked to my husband who had narrowed his eyes at me. He gave my leg what could be construed as consoling but we both know it was a warning squeeze.

"You're telling me," the nurse fueled me. "I don't know how half of them do it. I had a woman in here the other day, 55 having twins!"

We both shook our heads, but the nurse could not know at all what I was thinking. My husband knew what I was thinking... that this was all wrong. That I was young and my baby had ten fingers and toes, and I should bolt.

"The doctor will be right in," the nurse said, giving me no time to state my case.

She left and I was limp with distress.

We waited there for what was the longest ten minutes of my life. They had abandoned me there, my pregnant belly exposed, covered in a clear cold glop, in Scandinavian temperatures.

"Go find out what the hell is taking them so long!" I commanded my husband. "Now! Before I pull out of this!"

He left to find out what was happening and came back with the ever complimentary fountain of youth nurse who was shaking her head about some kind of snaffu which is NOT what you want to hear about when your embryo is about to be invaded by a 12 inch needle.

"I'm sorry, we just had the rooms fill up so quick. He will be right in." She breezed out and on the air of her exit, the doctor breezed in. He looked like a guy that I would buy bonds from at Merrill Lynch in Red Bank, NJ. He would definitely have a box at Giants Stadium and he went to most benefit concerts at Madison Square Garden and was probably friends of friends of Carol Alt and Howard Stern's wife. He pulled on surgical gloves and extracted a labeled tube from a test tube holder. He handed it to me.

"This is you? That is your birthday?"

I verified with what I think was 'Glub'.

"Okay, I am going to need you to relax and breath. There will be some cramping when I put the needle in but you need to just breath through it and stay relaxed. It takes about 30 seconds."

I nodded in agreement and met my husband's eyes. We were doing this. We were invading the cozy home of our loving perfect baby.

The needle went in with a click and my whole life affirming vessel tightened. So tight, so tight that I let out a couple 'Hehns" and tried to calm down. It hurt. It hurt because it was invading my large overstretched baby-carrying abdomen. He pulled the needle out, and that was it.

He shook my hand and left.

I was worn out. I was scared. I was exhausted. How were we to know the baby was okay? I was expected to walk around now for the rest of the pregnancy before I saw my doctor without any confirmation the baby wasnt nicked by the needle? No way. A new technician came in to clean up. I implored her.

"Um, excuse me, I just had my baby's embryo invaded and I desperately want to make sure there is a heart beat. Can you help me? Please?"

She looked from my belly to the ultrasound machine.

"I don't really know how to work this, but how hard can it be."

She found the gel. I took it from her and squirted it quickly in a blobby mass onto my belly. I was frightened we would get caught. I wouldn't see my baby's heartbeat, and she would get fired. She fired up the machine and took the sensor knob and rolled it around my belly. We found my girl. We found a heartbeat.

I was relieved.

"Thank you so much."

"No problem," she said with a smile.

I cleaned the new mass of clear glop off my belly with the blue surgical gown. My husband helped me as I swayed putting on my pants. I hobbled to the door and then down the hall and that is when the clog of hot emotion lodged in my throat and cut off my oxygen supply. I fell against the hall wall.

"I need to go to the bathroom," I rasped to my husband.

I plumeted into the ladies room and lurched for the square edge of the top-of-the-line Kohler sink, the floor spinning beneath my feet. I saw quick and rapid cuts to black mixed with hallucinogenic stars. I lowered myself down onto the open mouth of the toilet by way of the stainless steel toilet paper dispenser. I could feel my husband waiting outside the door, silent, not wanting to be imposing. I knew that I wasn't going to be able to fully freak out in this tiled orderly space so I had to get out, through the lobby, onto the elevator, and into the car. So I opened the door and wobbled with determination into the hallway, sniffling, gasping down the clog, my eye on the etched smoked glass double doors leading to the bank of silent gliding elevators. I had to keep it together in solidarity for the high risk moms that waited in the lobby as I walked by, a few looked up at me, searching my face, and I know that they thought they knew what happened, but they could never kno w. It's one of those unexplainable emotions. I made it to the main lobby when I lost it on my husband. He held me as he guided me to the car. I sobbed a large wet mass onto his dress shirt and we made it to the car, as I wailed and wailed. I was exhausted. The only plus side was I was supposed to be off my feet for the rest of the day, and let me tell you, as the mother of a 4 year old who does most of the domestic stuff around the house, this was going to be a good time for Kim. I was going to soak this up, order my husband around, drink wine, refuse to do any playing or cleaning or arranging. Feet up, new library book, preserve the perfect baby.

Then you wait. Two endless long hideous weeks. During this time you panic about any kind of leaking which is really brutal because as a very pregnant person you are always leaking. I spent a fair amount of time during this two weeks smelling my underwear for a clear liquid versus pee. I mean, this may seem extreme, but you have been given documentation that Vaginal leakage of a tablespoon or more of watery fluid may indicate a small hole in the amniotic membrane. Hello? Baby, hole, leaking fluid? Not a trio of fun word associations. I did even actually consider when I leaked how to measure the liquid with a tablespoon but then logistically it just couldnt be done.

I didnt mention a couple steps here in this whole charade. There was the First Trimester blood work screening. Before the screening, with the First Trimester cut off, I had a 1 in 106 chance of having a baby with Trisomy 18/13 and a 1 in 197 chance of having a baby with Down syndrome. After the screening, I had a 1 in 3,921 chance of having a baby with Trisomy and 1 in 703 chance of a baby with Downs. I had been elated and waved the letter in Helvetica font perfectly imprinted from a laser printer onto the finest watermarked paper like the flag of victory in my ob/gyns face until I saw she was nonplused.

You still should do the amnio, on my recommendation, She outlined some perfectly educated reasonable reason backed by vast experience for why I should and I left with my little flag crumpled in my damp nervous palm. There was also the Genetic counseling appointment that happens for an hour before the amnio where they verify there are no birth defects on either side of the parents families. This to me was the first implanted seed of doubt as to whether we should be going through with the amnio. But we were there by recommendation of our ob/gyn and felt we needed to power through. The genetic testing gal was pert and thin and unmarried and childless and had an urban on the move feeling about her. Surely in that black leather valise she carried were her round trip tickets to Cabo with her boyfriend of five years. She made me feel like I had really made a grave error not having a career of more stability aside from independent movie producing before deciding to give all my fre e time to motherhood at 40 when every year that then passed I would become less and less employable. I made the promise to myself right then and there to at least not allow arm flab. This was followed by a blood draw for research for a new plasma marker so my daughter or the daughters of my friends wont have to experience what I was about to experience today. Without even experiencing it yet, I was daunted and for that potential (as well as a $25 Target gift card hey diapers are expensive), I let them take several vials of blood from me. This in reflection was probably a bad idea on no food and the emotional impact of the procedure I was about to endure. But it was for my daughters future!

When I received the call that my unborn child did not have any chromosome abnormalities, I already knew in my heart it was okay. I had moved on, and besides, I was already so in love with her what would I do? I didnt want to think about it any more. I was on my way to the park with my husband on a beautiful sunny day and our 4 year old with freshly picked flowers clutched in her little alive hands. I hung up the phone.

Were in the clear, I said to my husband.

Oh that is so great! He was relieved.

I squinted in the sun at the blue cloudless sky.

Think about the people that dont get a call like that. Were lucky.

Yes, my husband said, Yes we are.





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