In the American birth industry (oy ve, it is an industry) a woman who gives birth over the age of 34 is considered “advanced maternal age.” Some statistics say that 20% of babies are now born to women over 40.
So there are a lot of “us.”
I first encountered “AMA” after the horrible appointment in February 2014 when I was told my baby had no heartbeat. My doctor wanted me to schedule a D&C that day, but since I was experiencing no miscarriage symptoms, I chose to wait.
Note: I do not regret this at all. Based on research, it was very possible that my tilted uterus was obscuring the view of the fetus and things were fine. However, God “helped” me out in that 5 days later, I began experiencing pretty severe symptoms along with another ultrasound that showed the fetus was shrinking. I inevitably had a D&C, but I would have never rushed to one.
Anyway, when she sent me away with follow-up paperwork that day, I had to look up everything it had said: “Threatened AB” (which means threatened abortion – potential miscarriage), “AMA.” I am not sure what my age had to do with anything since I had never had a miscarriage nor had any pregnancy complications, but alas. I was labeled.
It became clear to me early in my subsequent pregnancy with Jack exactly what AMA meant. You want to know my unprofessional summation?
It’s a marketing scheme. Surprise! We are in ‘murica, where one of the most natural processes on Earth has been turned into a sanitized and overly-scrutinized-by-insurance choose-your-own-adventure with very little adventure unless women happen to know they can take ownership of their own stories (that’s another post). And being AMA did not mean a darn thing in terms of my pre-natal care or experience, other than I was offered and encouraged to have optional genetic testing done, including an amniocentesis, to determine whether my baby had any genetic defects… even though there was no history in my or my husband’s family to put us at risk for anything other than Celiac disease, dry skin, and chronic stubbornness.
I declined all the tests.
Please understand my heart. I understand and empathize with why these tests are valuable to some people. I have heard the song “I Will Carry You.” I personally know people who experienced the tragic outcome of trisomy 13 or 18 or have had babies born who needed immediate critical care. But I also know people who did everything preventative in their power, tests, precautions, and were still surprised by a diagnosis in their child that was devastating. And even when we are “prepared” with knowledge, what can we really do in instances of tragedy?
So my heart here was… We are going to get the child we are meant to get. He or she might be in perfect health or might have something severely wrong. Either way, we will care for that child with all the love and resources we can. We would not terminate a pregnancy based on genetic testing because basically, all of them have more than a small chance of being wrong.
Thankfully (and I thank God daily), Jack progressed beautifully. I had a bonus ultrasound at 16 weeks which I thought was only going to tell us his gender (he was, ahem, All Boy), but when the tech took us through indications and markers that I didn’t even know existed and showed us that we essentially had nothing to worry about, my exhale turned into tears pretty quickly.
In a previous post, I mentioned how I compartmentalize my fears. Yeah. I had done that. And I didn’t realize how scared I was that my age or some other factor was adverse affecting my baby until I was told that he was fine.
So what good was it to be AMA? Well, here are my thoughts:
A few weeks before my due date, I felt like the oldest woman in the world!
– as a 37 year old with 2 previous births, a miscarriage, and having raised 2 step kids from puberty to adulthood, I had…well, the wisdom of experience. I don’t ever consider myself wise, but at this point in life, I do consider myself experienced. So when other expecting mothers (and I was blessed to be around a lot of them while pregnant with Jack) had concerns and questions, I was able to be That Mom… the Titus Mom…not the voice of expertise, but the voice of experience and encouragement.
– I was very clear about what I did not want. I did not want any interventions I didn’t need. I didn’t want to gain unnecessary weight. I didn’t want my baby to have bottles or a schedule. I didn’t want to fuss with things that didn’t matter or try to take care of anyone outside my immediate family. These were all things I did differently when my girls were born… I had an unnecessarily clinical aftermath of Kaity’s birth (and probably an unnecessary C-section, but that is also another post), I had a hard time losing weight, I didn’t know enough about breastfeeding and gave up for the wrong reasons, and I tried much too hard to take care of more than what or whom I needed to.
– I also knew what I wanted. A gentle C-section (thank God this was a readily available process at our local hospital and with my preferred doctor). On-demand, relaxed breastfeeding. Not too many visitors (I lost on this one a little, but only because our baby is so loved).
– I knew what to expect. This mattered on so many levels. I knew what to ask for during all the pre and post operation procedures. (Rod got to be with me during most of my pre-op, not because I was nervous, but because it is boring! If only I had asked for this when I was getting my D&C..)! I knew how to cope with the surgical pain. But more importantly… I knew time was going to fly. I knew Jack would look like a different person in a week. I knew those blurry, mostly-sleepless first nights would not last forever. I knew it was just as important to take pictures with my heart and mind as it was with my camera. And so I savored every single moment. And I still am.
I can espouse on and on about the privilege of being a “last time mom.” I guess that’s a more applicable and less smart-aleck way of reusing the term Advanced Maternal Age. Even though my hair is graying and 40 is only a year and a half away, I don’t feel advanced about much of anything. The longer we are raising kids, the more questions parenting brings. That is why it is important to be a community that shares with love and encouragement. I hope as a mama and stepmom and grandma (this still makes me smile and shake my head), that is what I will always do.