Monday, 29 June Joanna
I’ve spent the last fortnight tracking down friends who have had amniocentesis. Of all the tests offered during pregnancy, this seems the most invasive, as they puncture the amniotic sac with a needle, and it carries the highest risk of miscarriage. Needless to say if I were two years younger I wouldn’t have to think about it, relying instead on various blood tests. But at thirty-six, though I have no contra-indicators, I am automatically down on the chart as ‘high risk’ and now stand a 1/150 chance of having a Down’s syndrome baby. Another disadvantage to geriatric motherhood.
‘Have you had a chance to think about amniocentesis?’ asks my new doctor, Dr Levy, gently, as we sit in the cubicle, trying to decipher the latest blurry photo from the twelve-week sonogram.
‘Oh God, is it really necessary?’ I grumble. ‘It sounds awful and I feel fine.’
‘Well, it’s entirely up to you,’ he says smoothly. ‘We would advise you to have it, but it’s your choice. There’s only one thing you need to think about seriously. Would a handicapped baby be deleterious to your lifestyle?’
Peter flashes me a look of alarm.
‘If it wouldn’t,’ Levy continues improbably, ‘then there’s no need to have amnio, though you might want to have one just so you know. Some people like to know in advance, so they can prepare themselves.’
Prepare themselves? Ye gods, how exactly?
‘But it sounds so risky,’ I mumble.
He shrugs. ‘It’s not without risk and we go through that with you beforehand. Nationally the rate of miscarriage from amniocentesis is around 1/350. Anecdotally at Beth Israel, the hospital we are affiliated to, I can tell you it’s a lot less.’
‘How many have you done yourself?’ demands Peter.
‘About a thousand.’
‘And how many have gone wrong?’
He puts his hands in his white pockets. ‘Two.’
‘What happened?’ Peter persists.
‘Well, one was an older mother, she was forty-two; and the other, she was about thirty-two, but there were other problems … Look, you don’t have to make your mind up now. Take a week or so and call me back. We do it at fifteen weeks, so if there is something wrong …’ He tails off, but we get the message.
I call friends in England. None of them has had amnio, not even Louisa, who’s now at the same stage and same age.
‘They said it was up to me,’ she says dreamily, ‘and I didn’t feel like disturbing it.’
Regardless of age, an informal survey of my American friends turns up that they have all had amnio, some simply to find out the sex. ‘It’s fine,’ urges Joyce, a brisk TV producer, sporting a floral sarong over her six-month belly. ‘Besides, don’t you want to know what sex it is?’
‘Oh, John forced me,’ cries Lisa, another friend, earnestly. ‘He needed to know if it was a boy or a girl so he could prepare himself.’
They’re incredulous when I tell them I don’t want to know until the birth. ‘It’s like a magical riddle,’ I say, as they laugh and swap uncomprehending glances.
Flora does at least admit she was terrified of miscarrying during the procedure. ‘Make sure you have a doctor with steady hands,’ she e-mails. I try to recall Levy’s hands, they seem plump and creamy, I don’t recall them shaking.
Monday, 29 June Peter
Joanna has insisted that I accompany her to the obstetrician to check him out. I am there to give her a second opinion. He seems a bit young, in his late thirties, with an odd guffaw. His spiel is a dizzying recitation of the odds. This business is more like the tote than the practice of medicine. Now that Joanna is thirty-six, the odds of her having a ‘normal’ baby have declined to 150:1. The odds of amnio going wrong are 350:1. In the 1000 that’s he’s done, he’s lost two babies, so his own personal odds stand at 500:1.
Dr Levy is evidently the bookmaker of obstetricians. I wonder if he takes side bets on his births.
As we leave he tells us that he will be away for the next two weeks.
‘I’m going on vacation,’ he beams.
‘Where to?’ I enquire pleasantly.
‘Las Vegas.’
It figures.
Tuesday, 30 June Joanna
My mother, now valiantly trying to adjust to the idea of a grandchild out of wedlock, advises me to have every test available. I call my proxy mother-in-law, a doctor in Zimbabwe. She advises me to ignore the test, stressing she had Georgina, Peter’s younger sister, at forty-one and was fine. ‘If everything’s fine then my motto is “leave well alone”,’ she counsels firmly.
‘But even if there is something wrong, I’ll still love it,’ I say, suddenly feeling weepy.
‘I wouldn’t be sentimental about having a Down’s child,’ she says quickly.
I remember something Professor Jack Scarisbrick, head of the Society for the Protection of the Unborn Child, once told me during an interview. A long-standing advocate of pro-choice, I had gone to interrogate him for the Guardian during the last attempt to reduce the limit on the abortion bill in 1996.
‘People with Down’s syndrome bring much joy,’ he said, as we sat in his office surrounded by macabre plastic foetuses representing the various stages of embryonic development. They never murder or steal, they are loving and friendly and it’s good to have people among us like that. They bring out the best in us.’
At the time I wrote his comments down, dismissing him as naive. Now I’m pregnant, I can see his point. What if it does have Down’s syndrome? And do we want to know in advance? Now I’ve seen it on the sonogram, could I really face a termination? What if this is my last chance and I’m too old to get pregnant again? Is this my choice, a Down’s child or nothing at all? I pull out the blurry photo for the nth time and scan it for signs that something might be wrong. Pointless. I can’t make out anything.
Eyelids are starting to form. The ears are developing internally and externally. The finger buds are visible and the toe buds will appear at the end of the week. The elbows have appeared, but the arms will not lengthen considerably. The spinal cord is evident, and vertebrae and ribs are beginning to grow. Muscles and two layers of skin are forming.
BabySoon.com
Thursday, 2 July Peter
Since our visit to Dr Levy I find I have become mildly obsessed with odds and the science of chance. I have been doing my own calculations. If the national figure for amnios that go wrong is 1:350 and he’s had two go wrong in the last 1000 tests, then by my reckoning he’s due for another blooper by 1050.
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