My biggest fear about having a baby at 46

At my first prenatal appointment, I see the baby for the first time. Just a vague form on the sonogram, a white blob of light in a sea of murky gray, it is still an embryo in the fishlike stage, with no hands or limbs, just a visibly beating heart.

The doctor uses a pregnancy wheel to calculate the due date: April 22nd. But later, when the embryo is big enough to measure, the date changes to April 12th. Already something of a miracle, this baby I conceived at 46 will be born almost exactly between my two older children’s birthdays.
But April 12th—that’s the day my mother gave birth to my little brother, the baby I couldn’t wait to meet and help take care of. The coincidence seems amazing to me, and I find myself thinking often of that baby, my brother, and that time so long ago.

* * *

I wonder how my mother felt when she discovered she was pregnant with my brother. She certainly had the glow that pregnant women have, and both she and my father seemed happy about the pregnancy, even though this baby, like my baby, had been a surprise, and her pregnancy, like mine, was high-risk. Her risk came not from age—she was only 34—but from the Rh factor, a blood incompatibility between mother and fetus that can harm a developing baby. If, as a child, I was aware of this risk, I did my best to ignore it. I felt as though a giant light was shining on me and my world, and I woke up each morning filled with excitement about the baby coming into our lives. I couldn’t wait to be a big sister, and I was hoping for a boy.

***

A certain wildness swirls through me in the early days of my pregnancy. Fear and anxiety threaten to overwhelm my feelings of hope and confidence. Am I crazy to be going through with this? When I tell my mother I’m pregnant, she reminds me that I am her third child, and “look how that turned out.” Like me, she considers the matching due date a positive omen.
I cling to this optimism. In those first weeks, with the onslaught of pregnancy hormones mixing with the shock of the pregnancy, I am a mess of conflicting emotions: questions about the health and viability of the fetus dampen the euphoria I feel about having been able to produce a life at an age when statistics say it is close to impossible.
My greatest fear is what I perceive to be my greatest risk—a chromosomal defect—even though statistically the risk for a miscarriage is considerably higher. My odds for carrying a baby with any kind of chromosomal problem are roughly 1 in 10, and for miscarriage, a frightening 1 in 2. Intuitively, I feel sure that everything will be okay, but I can’t help but be worried by such grim statistics.
In my 15th week, I go in for an amniocentesis, doing my best to lie still through the unbearably icky feeling of having a needle stuck into the most sacred of places, my womb. The doctor, normally friendly and relaxed, is now extremely serious, speaking in quiet, gentle tones as he performs the procedure, reminding us that even though the baby, a girl, looks perfect on the monitor, the results of the amnio could prove otherwise. Still, that voice inside me insists she is healthy.
Later that night, Kai and I wait together in a heavy, dreadful silence.
Our children sleep upstairs, oblivious to our anxiety. When the phone finally rings, I cannot answer it; the call is too important to risk a misunderstanding due to language. I watch my husband’s face closely as he listens to the doctor, and relief floods through me even before the smile has finished spreading across his face. The blood work, the doctor reports, has shown no chromosomal defects. Our baby is genetically perfect.

* * *
There were no tests to reassure us during my mother’s pregnancy— all we could do was hope and wait. And as her due date loomed closer, I worried more and more that it was all too good to be true. That this beautiful dream of having a baby brother to nurture and love would turn out to be only that. A dream.
Maybe I was tuning into the undercurrent of worry and fear running between my parents, who were certainly aware of the risks of this pregnancy: If, like me, the baby had the same blood type as my mother, he would most likely be born healthy; but if, like my brother and sister, he had a positive blood type, his health would be compromised. My sister needed a blood transfusion at birth and spent her first weeks in an incubator; for a third child with the incompatibility, the problems could be far more severe.
Suddenly my mother was in the hospital and the baby was born, more than a month early.
“There are problems,” my father said. That’s all he told us.
A hush fell over our house. My father spent most of his time at the hospital, and when he came home to eat or sleep, his reports were vague, hardly reassuring. The baby’s weak, but he’s fighting, he would tell us. The doctors and nurses are doing everything they can.
Two days after the baby was born, I was getting ready for school, pretending it was a day like any other, when my sister rushed into the room, breathless with excitement.
“The baby’s dead,” Darcy whispered.
“No. He’s not.” I refused to believe her.
“It’s true. I heard Dad talking to a nurse at the hospital. I listened in on the upstairs phone.”
“I don’t believe you,” I insisted, even though the truth was already taking hold. “They said he was dead?”
“Well, no, they didn’t actually use those words, but I could tell by the way they were talking. Dad said, ‘Well, you did the best you could…’” She shrugged. “What else could that mean?”
Darcy seemed proud of her discovery, thinking more in that moment of her clever detective work than the reality of the news she’d delivered. The baby was dead.
I knew it was true, but I refused to believe it until I heard my father say it. When we went downstairs to breakfast, I waited for him to speak. But the only sound at the breakfast table came from the crunch of our cereal and the clatter of spoons and bowls. My father was the quietest of all, reading the newspaper as he did every day. I watched him closely, or rather, I watched the paper he was hiding behind, waiting for him to put it down and say something.
But all he did was send us off to school with a kiss good-bye. By the time I stepped into my classroom, I’d almost convinced myself that my sister was wrong. She must have been mistaken, misunderstood the phone call some- how. My father would certainly have said something if the baby had died.
Sometime that morning, my teacher called me up to her desk to pick up a quiz. Like most of the kids in my class, I was afraid of her. Snide and condescending to everyone but her favourites, she looked like a witch, with a beehive of black hair and stone-black eyes magnified by cat’s-eye glasses.
But now, as she handed me my quiz, she told me how sorry she was about the baby. Hearing kindness in her voice for the first time that year, I nodded stupidly and mumbled something in response, but inside I was reeling. How could she know anything about the baby, my brother? How could she be talking about him as though he was already dead?
I reminded myself she hadn’t actually used the word died or dead, she had just said she was sorry. I kept telling myself the baby must still be alive—I would feel it inside of me if he had died. I would know it in my heart. My father never would have sent us to school if something so serious had happened.
Walking home, I allowed myself to fantasize once more about holding the baby in my arms, giving him a bottle and taking care of him.
By the time I got home, I’d nearly convinced myself that things might actually be normal. But when I opened the front door to a silent house, I knew they were not normal at all.
“Dana? Is that you?” my father called, his voice even deeper than usual. “Can you come in here, please?”
I set down my lunchbox and hung up my coat. My legs felt heavy, filled with a thick liquid, as I walked to the living room and joined my brother and sister on the couch. My father didn’t say anything for a minute or two, he just looked from one to the other of us with his piercing brown eyes.
“The baby didn’t make it,” he finally said, his voice grave and emotionless. “He died early this morning.” He presented the news as if it had been inevitable, something we simply needed to accept.
“He just wasn’t strong enough. They did everything they could to save him, but…” He let the words trail away and lifted his chin, as though he was trying to put a distance between his head and his heart. We waited for him to say more, but he was silent. And so were we. None of us cried. We did not ask questions. The baby was dead. That was that, and now we needed to move on as a family.
My mother stayed in the hospital for a week. One day soon after she came home, I followed her into the bathroom and asked to see the scar from the caesarean. Maybe I thought it would make the baby seem more real to me, that I would somehow feel closer to him, or maybe I needed evidence that there had actually been a baby in there, that this hadn’t all been a dream. Whatever my reason, I didn’t expect my mother to comply.
But she did. She stood up from the toilet and lifted her nightgown, showing me her naked pelvis. Her pubic hair had been shaved off, and stubble was already growing in. A black-scabbed scar ran horizontally above the stubble, a row of stitches sewn crosswise through the wound. It was an ugly sight, and I was horrified.

* * *
Near the end of my pregnancy, my doctor tells me if the baby isn’t born by April 12th, he wants to induce labor on the following Monday, April 14th. In spite of having a normal, healthy pregnancy, I’m still high-risk, and he doesn’t want to wait too long.
When I relay this news to my mother, she reminds me that April 14th was the day the baby died. Until then I had not even considered this date— his death date. At first, I worry that it might be inviting bad luck to schedule an inducement on that date, but in these final days, I feel pregnant with hope and optimism, with the expectation and excitement one feels when a new child is about to arrive into a family.
Also, by now, the coincidence of dates seems not to matter anymore; everything pales next to the weight of my growing belly and the emotional pull of the impending birth. April 12th passes without incident, and I decide I’m not ready to induce on the 14th, not because my brother died on that day, but because I want to allow my baby to be born in her own time.
But after another week passes with no signs of labour, the doctor refuses to wait any longer. And by now, I’m ready. I go into the hospital to start the induction process, taking a pill every few hours to bring on contractions. Sometime after midnight, labor begins, and early the next morning, I’m wheeled into the delivery room.
Later, when I look back on these final moments, I see myself on all fours, crawling around the room and howling like an animal. In fact, I am lying on a bed, on my side, with one leg bent and lifted high in the air—a strange, anti-gravity position that the midwife has settled on because she seems afraid to ask me to move. But the howling and screaming are entirely real. The pain is worse than it was for my first two children, and when the midwife announces that I am only six centimeters dilated, I feel I might lose my will. But then my husband reminds me of my son’s birth, how fast things went after exactly this point, and it gives me the strength I need to keep going.
I also find power in my voice. As waves of pain rip through me, I let myself scream with abandon, loudly and deeply—a different sound coming out with each contraction. I yelp rhythmically, blow out through my lips, letting them vibrate loudly, and open my entire throat to push out low, long bellows. Each time, I focus on the sound, travelling with it to its endpoint as though it exists somewhere on the ceiling, on the other side of the room, somewhere far away from the source of the pain—my throbbing, contracting uterus—until the wave recedes and the pain subsides.
Finally, the midwife tells me I can start pushing, even though I am in this awkward sideways position. Through three or four contractions, I push with all my might, until the baby’s head is almost out. Almost, but not quite.
One more push. And finally, the release. A spiraling rush of energy shooting through me and out of my body. I open my eyes and watch the midwife pulling my baby out. Her body is wet and bluish, her eyes are closed, and the umbilical cord is still reaching into me.
I never saw my other children coming out—not with a mirror, not on video—but this time, in this odd position, I see my daughter being pulled from my womb and her still form coming to life. The midwife lays the baby on the bed next to me, and she and I look at each other for the first time. She has blue eyes, is my first thought, and she is looking right at me, her gaze intelligent and intense. As if she has known me forever and as if she, too, has been waiting to see what I look like. Then she does something that takes my breath away: She lifts her hand and reaches out to me, grabbing my index finger with her tiny fingers and holding tight for several seconds.

Author’s Note: After my daughter’s birth, the memories of my brother quickly receded back to whatever place in the heart or mind such memories reside. I will always be grateful for the opportunity I had to relive and remember that very charged and traumatic time: the joy I felt about my mother’s pregnancy, the happy anticipation I floated on in the months leading up to his birth, and the profound sadness and loss I felt after he died.

This is an edited extract from an article that originally appeared at Brain, Child. Want to read more thought-provoking essays? Subscribe to Brain, Child: The Magazine for Thinking Mothers and see why they’ve been receiving awards for literary excellence since 2000.