An Open Letter to My Younger Sister Doctors
Take it from an “elderly gravida” obstetrician, wait but don’t wait too long.
You see, I just had my second baby, she is four months old, and as I sit here and soak in all of her chubby sweetness, a part of my heart aches. A piece of my heart yearns to have just one more, to be able to experience all this one more time.
I grieve the finality of the tubal ligation I chose to have at the time of my second cesarean section. I grieve the finality of my age on my reproductive chances, and the finality of not having just one more baby. Even if my tubal were to fail (I can’t say I haven’t wished for it to happen a time or two), and I got pregnant tomorrow, I would be hovering around 43 years old when I gave birth, which doesn’t just make me an elderly gravida, I would be a SUPER elderly gravida (I came up with that distinction myself).
I know all too well what that age means. My risks for a child with a chromosomal abnormality would be somewhere on the order of 1 in 33. I would be at a significantly higher risk for miscarriage. If I made it past the first trimester, I would be at incredibly high risk for preterm labor, gestational diabetes, preeclampsia, and complications from a third cesarean section. If I had a successful pregnancy and delivery of a healthy baby, I would be 61 years old when that baby goes to college. If that baby waited until she established her career before having children of her own, I would be in my upper 80’s, and barring any significant advancements in anti-aging, I would be unable to help her in the way that my parents have helped me with my children.
Unfortunately, I waited just a little too long. I was taught to wait.
Wait until you finish your education, wait until you find the right man, wait until you have established your career.
So, that is what I did. I waited until I completed four years of college, four years of medical school and four years of residency. I waited until I found the right man and married, which was at age 28. I waited until I started my first job as an attending in a private practice, but this is where I waited too long. I heard the remarks of my senior partners, belittling doctor moms and their role in medicine. I heard their thoughts on maternity leave and how it affected the practice’s bottom line. I heard the comments that the group almost didn’t consider hiring another female physician because the last two got pregnant and left the group after they had their babies.
So, I decided to wait. I chose to wait until I proved myself to my colleagues. I thought that if I could prove my worth then they would be more willing to accept me as a doctor mom. I waited until I proved myself to my patients because I began to believe that once I became a doctor mom I would no longer be as dedicated to them. I slaved away my early 30’s in private practice. I worked 80 to 100 hours a week. And then, I woke up. I realized that I would never have a family if I continued down this path. So, I left private practice and became an Ob/Gyn hospitalist. However, despite this career move, I continued to wait. I waited until my husband was comfortably on his way to starting on a new career path. I waited until I was well established in my new job.
Then, one day, I realized that time was passing me by, and my fertility was at stake. I was 37, and I had waited long enough.
I got pregnant with my first child without any difficulty. I delivered the week before my 38th birthday by cesarean section due to arrest of dilation. The arrival of my first baby hit me like a hurricane with all the fury and unpredictable changes of a newborn. It was a steep learning curve, but I was completely content at the time. Then, about two years later I decided that my son needed a sibling. So, at the age of forty, I embarked on the quest to pregnancy. Unfortunately, this time around I didn’t get pregnant right away. After about 9 months of trying with no success I finally (with feet dragging) headed over to my local reproductive endocrinologist’s office (I know, I waited too long to seek treatment). After a round of IVF with no success, we gave up. I was staring down my 41st birthday, so I knew my chances were slim to begin with and we couldn’t afford to try again. Then, we received a surprise one month before my 41st birthday, I was pregnant! A tiny miracle. I was blessed with a healthy beautiful baby girl 4 months ago.
