Ten Weeks

Notes from June 4 Prenatal Exam

1. I am permitted (and encouraged) to read my chart on every visit. This was really surprising and gratifying.
2. I spent 50 of the 60 minutes of the exam in my own clothes, just talking to the midwife, KM.
3. I am permitted to do the following activities: ride my bike, swim, work out the ellipse and treadmill and work out with free weights and the weight machines.
4. When I told KM about my history or depression, she wrote out a list of names of counselors near my place of work and requested that I develop a relationship with a therapist to aid me with my pregnancy and postpartum depression issues. She does not expect me to go every week or even every other week, but wants me to have the appropriate interventions in place in case I become severely depressed at any point.
5. She found my friend B's suggestion that I take a prenatal yoga class as a tool for controlling the depression and anxiety “absolutely brilliant” and is almost requiring me to take the class.
6. I can't say that I had a flood of motherly emotion upon hearing the heartbeat via the Doppler. It just confirmed the “walking science experiment” feeling I have been experiencing the past few weeks.
7. My GP is the medical director of the center. As such, she will be routinely reviewing my chart. Talk about continuity of care.
8. I have ideal nipples for nursing. I'm acutely aware of how much information I am giving away with that statement, but I found this to be the most hilarious part of the visit.
9. I can ditch the foul prenatal vitamins and take one Flinstone's chewable a day instead. I can even ditch the chewable, but that would entail watching my diet more closely then I care to think about.
10. I have to be very careful about the fish I eat.
11. I felt 10 pounds lighter walking out of the office. The fact that I have been cleared for regular activity after being told I could not do any other exercise other than walk (by the nurse practitioner at my GP's office) has been a contributing factor to the depression and anxiety I am feeling. More so, I felt like they were caring for me as a person and not just as a vessel.

Genetic counseling, ultrasound and blood work (ugh) scheduled for June 15th. Which leads me into part 2 of this post.

I've been thinking a lot of the murder of Dr. George Tiller in the past ten days. I can't help thinking about it. The further I advance in this pregnancy, the more strenuously pro-choice I find myself coming. Primary because the decisions I am making are no longer in the abstract. I am no longer thinking about abortion as a theory, but as a necessary truth I may be forced to explore.

I find myself thinking in relentlessly, ruthlessly pragmatic tones, separating my emotions from what I might be seeing on the ultrasound and in test results in a couple of weeks. I find myself deeply examining my conscience, trying to parse out a complicated formula that will allow me to base decisions on what is instead of what might be.

On June 15th I will have a blood test called a Quad Screen and an nuchal fold ultrasound. The results of these tests will be used, along with my age and genetic history, to calculate the risk that the alien inside me is carrying markers for Trisomy 18 Syndrome, also known as Edward's Syndrome. Trisomy 18 causes severe developmental complications and 50% of the babies diagnosed carried to term are stillborn. Less than 10% survive past the first year.

These tests will not be able to tell me how specifically the alien will be affected, only the risk.

These tests are done between the 11th and 13th week of pregnancy. If the risk returns as high, I will be forced to make a painful decision.

[A] Wait until between the 15th and 18th week to have an amniocentesis to confirm whether the risk is real and learn the specific genetic abnormalities the alien may be manifesting. Test results take three weeks, which would put me in the 18th to 21st week range, right on the cusp of legality (24 weeks) for terminating a pregnancy. There is only 1 clinic in Pittsburgh who will terminate so late in the second trimester. Late termination is NOT the pleasant experience anti-choice paint it out to be. It takes multiple visits to a clinic and it painful. There are no clinics (to my knowledge) in Pennsylvania that will perform a third trimester termination, I would have to prove medical necessity and travel out of state to have the procedure done.

[B] Terminate early into the second trimester, without waiting to have the amnio done, taking the risk that I am terminating a healthy pregnancy. Still not a pleasant experience, but can be done in most clinics in a single visit. I'm also taking the risk of being disowned/ostracized by some family and friends for this decision.

[C] Do nothing and hope for the best. Risk the possibility of having no control over the medical decisions if the alien is born with defects that are incompatible with life.

The murder of George Tiller, the harassment of doctors, employees and patients at the clinics, all of these things have the cumulative affect of restricting women even further, and, ironically, putting women in the position of choosing [B] in situations where the fetus could be healthy as a way of avoiding making decision [A] further in pregnancy.

I think about these things. I think about how angry I get when I listen to someone who paints themselves as “pro-life” belittle women who have abortions because of mental health issues as women who just don't want to take care of a baby, as if the increased hormonal levels, the sickness, the bewildering sense that you are less than the fetus you are carrying, the fear of loss of job and support systems are a temporary state. Because that is ME they are talking about. That is ME who is trying so hard to get up every morning and get through the day.