From November 2015

From Certain to Ambivalent back to Certain: An Interview with Liz

An elementary school teacher and part-time unit coordinator in a birthing unit, Liz is 38 and 14 weeks pregnant at the time of the interview. Liz immigrated to the U.S. from England when she was six and she became a U.S. citizen at the age of 36.

MS: Have you always known you wanted kids?

Liz: I always knew that I wanted kids and then I started to doubt that I wanted kids. I always wanted kids. When I was six someone asked me what I wanted to do for a living and I said that I wanted to be a mom.  But then, years went by and I was single and I think I was pretty depressed about being single and then

around 30 I was like, maybe I just won’t be a mom and that’ll be fine.

And all of my friends were having kids and whenever I hung out with them it felt very overwhelming and I thought, oh maybe not, maybe I don’t want that.

MS: So you went from certain to ambivalent and then you met Jeff?

We had been dating maybe a month, and he said one morning, do you want kids and I said, yeah. And that sort of surprised me too. And I said, does that make you nervous? And he said, yeah.  But it was my gut response.

Liz: When you were younger you envisioned yourself having kids, when did you think you would start?

Probably my mid-twenties. My mother had her kids when she was 24, 26, 30 and then I started to be those ages and I thought, I could not have a kid. Even if I had been in a relationship, I don’t feel like I was capable of having a kid at that point.

MS: What do you think is different?

Liz: My mom met my dad when she was 15. It’s just generationally different. They got married and had kids. And, I think that because of the internet and travel being cheaper, we have a million other things to do, whereas marrying young doesn’t happen as much.

MS: Do you think there are any drawbacks to waiting until you are over 35 to have kids?

I think the drawbacks to having kids later probably measure out to the same as having them earlier. You have less time with them more than likely. My kids will have less time with me than I have with my parents.

Hopefully, I’ll be a more patient and better parent than I would have been ten years ago.

I think I have more empathy than I used to. As a teacher, I am more able to put myself in another parents’ shoes and look for the best in kids rather than just reacting to them.

MS: How has teaching impacted your perception of parenting?

Liz: I think that teaching and seeing so many parents and families makes me realize that for 95% of people everyone is trying to do what’s best for their kids. I can’t always figure out how that works in their minds.

MS: Do you think your age has affected your pregnancy in any way?

Liz: I doesn’t seem to have. I’ve been to the maternal-fetal medicine specialist because my mom had problems and because I am advanced maternal age, and they said, everything looks really good. I can’t complain about anything in my pregnancy except for the nerves. I haven’t felt sick; I haven’t thrown up. I feel fine.

MS: What is making you feel nervous?

Liz: I know that this baby needs another ten weeks of gestation. It’s just that unknown. Every ache pain, cramp, everything I put in my mouth, can I eat that, can I not?

MS: Do you think you would’ve been as nervous if you were younger?

Liz: Yes. All my lab results are good. I just think until this child comes out and both of us are responsible for it, I’m the only one responsible for it. I wanted a sip of wine the other day and our doctor said no, and I said to him, it’s not about the alcohol, it’s about feeling normal. I feel fine, but I never feel normal anymore because every single thing I put in my body, every action I do, I think about this baby.

MS: Do you think that’s healthy?

Liz: No. I do think that because the American College of Gynecologists wants to cover their asses they are doing a lot of telling you you can’t have certain things so I then look up, well does Europe do that? If Europe and America agree, then I won’t eat it, but smoked salmon, England eats, so I’m going for it.

MS: How has working in a birthing unit impacted your perception of pregnancy and delivery?

Liz: I switched to a midwife recently and I was talking to the nurse when making the appointments and she said I had to have a doctor to go along with my midwife and she said this particular doctor is very blunt and then this other doctor will talk to you for hours. And I said, who has the lowest C-section rate? That was my deciding factor because, when a woman has been in labor for hours and the red sox game is coming on, I’ve seen doctors make the call to do a C-section.

MS: If you could give your 25 year old self advice about pregnancy and motherhood, what would you say?

Liz: Vanity speaking, I now show and most people at 14 weeks don’t show. I read that because my core was not solidly in shape, that there’s no muscles holding in my uterus. I would tell myself to be in good shape. The better shape you are in, the better your recovery will be.

MS: Sometimes there’s friction between mothers and non-mothers, have you ever experienced this tension?

Liz: So many of my friends have kids and I always tried to be very understanding. I always really liked babies and I would go over and help out. I think I had a hard time when I was a non-mom not by choice. I had a particular friend who, it was right around when my dad died, and she found out that she was having a second boy and she told me about the “grief” she was experiencing, from this planned, health pregnancy!–because she was having a boy instead of a girl, and I had a really hard time forgiving that. She and I had talked very openly about how much I did want kids and it wasn’t in the cards. So for her to use the word grief, I was so taken aback.

MS: Do you think it’s a trend of moms to be insensitive to nonmoms?

Liz: I was just at a cocktail party with a woman who told me she was trying to get pregnant and had done six rounds of IVF, and everyone who came into our conversation and just found out I was pregnant would try to talk about it, and I would try to steer the conversation to anything else.  I was not feeling guilty but feeling this poor woman does not need to hear about all of these things when she is going through this.

MS: Do you think being pregnant at an advanced maternal age helped you develop the sensitivity to steer the conversation that way?

Liz: Yes, knowing the feeling of longing to have kids and not being in a position to have them. Those conversations are not where you want to be. I didn’t always want to hear the pregnancy talk from my friends with their big bellies, but I listened.

Who Decides?

From the editors: Visual artist and writer Joyce Hayden has contributed one of her definition collages and an excerpt from her memoir. Continue the conversation with Joyce in the comments!

"Buganjimo" is a Chinese verb, part of a series of definition collages I am working on. This piece uses images of gratitude, expansion, and compassion: a wide open sky, an egg, a butterfly, a woman tethered to a flying raven, a series of Milagros, to promote personal growth and movement.
“Buganjimo” is a Chinese verb, part of a series of definition collages I am working on. This piece uses images of gratitude, expansion, and compassion: a wide open sky, an egg, a butterfly, a woman tethered to a flying raven, a series of Milagros, to promote personal growth and movement.


“You two should have a baby,” my roommate Mia said. “Then you can stay home and write your children’s books” [my dream at the time…writing children’s books, not having a baby]. The possibility thrilled me. For about five seconds. Until I remembered who I was partnered with. I was 25, in love for the first time, with the first guy I’d ever had a second date with. I was never the girl who dreamed of white weddings and picket fences. Never the girl who imagined a houseful of toddler laughter and diaper changes.


My classmate, Laurie Gates, was standing beside me. We were in my living room, looking at family pictures hanging on the wall. The one of the little blond boy. My mother was answering Laurie’s question. I was 10 years old. Fourth grade. That was THE MOMENT when I finally knew what “dead” meant. The blonde boy in the frame was never coming back. My brother, who I thought was just missing, was never coming home.


The first time I met him, I couldn’t stop smiling. He looked at me, then immediately ran to his room, bringing back a book. Rushing towards me, he shouted, “Read! Read!” He jumped into my lap and, as I turned the pages, I never wanted him to leave. The boy was David Mason, the son of Kevin’s friends, Billy and Lorraine. For six months, I longed to have a baby. Longed for Mia’s wish for me to come true. Longed to dance around the living room with a baby in my arms. For six months, I made the argument, both in my head and aloud, how a baby would improve our lives. I was 28, the perfect age, I reasoned. I was met with one of two responses: “Not now” or silence.


Standing in the shower one Monday morning, I let the hot water scald me. I daydreamed about different ways “out.” I was twelve years old, trying to choose between pills, a razor blade, or a bullet. I knew I couldn’t survive one more weekend at Uncle Bob’s house. Couldn’t take one more encounter of his hands on my body. In the shower I came to a realization: I could never have a child. Because parents cannot keep their children safe. As the water tumbled over my hair and face, I imagined a big red house, deep in the woods. A line of smoke rising from the chimney. The house was full of runaways….of kids who needed a safe place to live. I saw myself as the caretaker of this house. And there was only one rule: any kid who made it here, could never be taken away by any adult for any reason.


I laid on my back in the cold June water of Lake Sunapee. Tears trickled down the side of my face, as the sun dappled the leaves above me in green and yellow. “I do not want this I do not want this I do not want this,” I sobbed. I knew in my gut that I was pregnant. At 30 years old, any desire I had for a child had vanished. I was in a position I promised myself I would never experience: having to consider an abortion. Although I had always believed in a woman’s right to choose, I did not want to have to make the decision myself. I pulled my body from the water and sat on the private dock. Perpetual bruises glared on my biceps, to the point that at work, I had to wear long sleeves to hide the marks. My memory recalled the crash of wine bottles and house plants thrown as I ducked. It was a surprise to me that I hadn’t yet been hospitalized with Shaken Baby Syndrome. On the morning when I awoke in a pool of thick dark blood, I cried with pity. I cried with relief.


Though I’ve been called a spinster, by my mother; although many people assume I am gay; although I’ve been asked repeatedly by colleagues, students, friends’ friends, doctors, and strangers how many children I have, the one thing I don’t have is regret. Once I reached 50, I knew that was a poison that could swallow me whole. Looking back, I believe that if I’d found a more loving partner, one I trusted would hold a job and offer emotional support to both myself and a child, then I might have made a different choice. But I didn’t believe that guy existed for me; I didn’t even understand, until I was 40 something, that while nothing is promised, there are steps parents can take to maximize their child’s safety in the world. Nonetheless, I feel blessed I found safety for myself.

Hayden headshotRecently retired English Instructor, Joyce Hayden, spends her days hiking, writing, and creating art.  She travels the country exhibiting her work in galleries, leading gratitude painting workshops, and working on her memoir, The Out of Body Girl.  You can follow her on Facebook and her website YesRiskJoy.


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If Not Kids, then Something Substantial: Interview with Melissa

Melissa is a 42-year-old middle-school math teacher with two dogs. She regularly takes her husky, Takoda, to a youth detention center to provide pet therapy, and she spends her summers traveling.

MS: Do you want kids?

Melissa: So, I never say “no,” but I guess I never say “yes, definitely.”  I always thought that I would.

I never thought, “I’m never going to have kids” until recently. I said it out loud for the first time the other day to my friend.  I was surprised that it came out so naturally.

I just had a birthday, and you hear all the time that after a certain age, don’t even think about it. Even if I met someone tomorrow, having kids would still be years off.

MS: What do you think made you say it out loud? Do you think it was turning 42?

Melissa: I don’t know if it was the age or the thought that I’m never meeting anyone. Never. Ever.

MS: Can you separate having kids from meeting someone?


I thought about having one on my own, but I just think my life would change too much, and I don’t know if I have the support system for it.

So much of my time is spent making money, and I would have to give that up plus put money in. Kids cost a lot when you don’t have a built in baby sitter.

MS: You have a lot of time to meet someone. Do you feel like you are not going to meet anyone because you are past childbearing years?

Melissa: I think when I meet people casually, as soon as they find out how old I am, it changes their point of view. There are men who have an idea what a good age is for a mate, whether they want kids or not. That’s my experience.

Men don’t have to worry about running out of time.

The other thing is: I don’t feel like I can’t have a baby.  I don’t feel like my body is old. I feel healthy and young. But my body inside could tell me something totally different.

MS: What about when you see celebrities having children in their late forties?

Melissa: Then, I think, “Oh, maybe I can.”

MS: Would you consider adoption?

Melissa: I’ve thought about fostering. So much would have to change. I don’t think my brain has fully wrapped around time for me to rush into doing anything.

MS:  Do you think you could be happy if you met someone and didn’t have kids?

Melissa: Yeah, I definitely think so. That’s the only time I get upset. I just teared up a little bit. What if I do meet someone, and he really wants kids and it can’t happen. Or, if I really want kids because I love the person that much.

MS: When you were little did you envision yourself having kids?

Melissa: Yes, I’ve always said. “when I have kids…”

MS: If you fell in love with a guy who didn’t want kids, would you pursue a relationship with him?

Melissa: If he told me right off the bat, I would still date him. And if I fell in love with him, and he said let’s go travel all the time, that would be fine with me. I would need something of substance to take that space other than the normal get up have breakfast, go to work, then have dinner.

I would need something to take the place of kids.

We could buy a bigger house with a lot of land to foster dogs. Do something more giving. I foster dogs. Not only do I have my own two dogs, but I hold dogs and take care of them until they can be adopted. That would fill that need.

MS: What do you think are the advantages of not having kids?

Melissa: I can do anything, for the most part. I have to make sure someone can come and let my dogs out. So, I can’ be totally spontaneous.

Little things: my house doesn’t have to be spotless all the time. I can nap in the middle of the day. I napped yesterday, and I thought, so many people can’t do this because they have kids. I don’t have to think about being frivolous with my money. I can spend it on whatever I want to. I suppose these are little things compared to being a mom.

But, sometimes I listen to the radio in the morning and all the people do is complain about their kids. I see the misery that my parents went through, and I don’t know. I know there are so many good things, but there’s so much sacrifice. And you’re glad to do it once you become a mother, or at least you do it.

My friend has fertility issues, and she was at a party and a woman with three kids turned to her and said, “you are so lucky you don’t have kids.” My friend said to me when she was telling me the story: “lucky” is when you have a healthy child. If you don’t have kids, you either chose not to or you are unlucky.

MS: If you could tell moms how to be more sensitive and kind to people who are not moms, what would you tell us?

Melissa: Being a mother requires sacrifice but for most people who are mothers it’s something they chose to do. Don’t judge me because I didn’t follow the same path as you.

MS: Has anyone said anything insensitive?

Melissa: If people ask if I have kids when they meet me and I say “no,” they respond “Oh” and say something to the effect of: “What do you do with your time then? What makes your life important?”

I also hear it from my students, “Oh, you don’t have kids. Oh. Really?” I say, “no, I have fur babies.”

melissa's dogsMS: Do you feel like having dogs scratches the mom itch at all?

Melissa: A little bit. I have to nurture them. I have to make sure they are good dogs for their society. But I can leave them home for hours without someone taking care of them. When I’m working I have to make sure someone comes and walks them and lets them out. And the financial part of taking care of dogs is a fraction of taking care of kids but it is still vets and good food. When my dog had one little rash, we were in for hundreds of dollars. I guess I get worried and nervous. They are like babies because they can’t take care of themselves. So it helps it a little bit.

MS: What about teaching?

Melissa: Teaching makes me understand why I’m okay not having kids.

MS: Are there things you’d have to give up if you had kids that you’d be sad to give up?

Melissa: Well, I go out all the time. But, then I ask myself: if I had a significant other, would I want to stay out so late?

MS: If you could give your 22-year-old self a message what would it be?

Melissa: I’ve had so many relationships that I didn’t fully commit to thinking there’s something better, and  I don’t think I ever let myself see if the relationship was working. I would tell myself to be more open minded and give the relationship a chance to work.

MS: If you could give advice to a 30-year-old woman who didn’t know if she wanted kids, what would you say?

Melissa: I would advise someone to not have kids just because society tells them to. That’s the wrong reason. You need to do it because you want to and because you think you’ll be able to give the best life possible. I see it all the time: house, marriage, kids. Sometimes I don’t think people actually sit back and think, maybe we don’t want kids, and if we don’t it’s okay.

I never made up my mind either way.

My Pregnancy Choices and the Economist Inside My Head

From the Editors: This essay was submitted by Hillary Sackett-Brian. Continue the conversation with Hillary in the comments.

I recently read an article in The Atlantic titled, “Thinking About Pregnancy Like an Economist” and it reminded me how much my own economic brain has weighed in on my decision whether or not to have children.

As a child I played “house” with my friends and younger sisters, imagining the wonderful husband and cherub-faced babies I had in my future. Even as a teenager, those who knew me wouldn’t have predicted that I would stray far from that path.

My journey took a sharp turn in college, when I came out as a lesbian the summer after my freshman year. My mother insisted it was just a phase. I vehemently denied it, but secretly felt a sense of loss, wondering if this meant I was giving up the fantasy life I had dreamed of as a child. I worried my new identity would prevent me from becoming the wife and mother I always thought I’d be.

I grew to know myself better over the next four years, as many do during college. I moved to the Midwest for graduate school and started dating a straight cis-gendered male, as if confirming for my mother that my foray into lesbianism was indeed just a phase. He had no interest in having children. He was a proud member of what I soon learned to be called the “zero population growth movement” (ZPG) and I, too, now in love, was soon convinced of its principles. According to those in the movement, a demographic balance where the population neither grows nor declines is an ideal to which the whole world should aspire in the interest of pursuing long-term environmental sustainability. (American sociologist and demographer Kingsley Davis is credited with coining the term).

I was in the thick of my Ph.D. program in resource economics, and I endeavored to apply what I was learning to my real life. The overarching goal of resource economists is to better understand the role of natural resources in the economy in order to develop methods of managing those resources to ensure their availability to future generations. So, naturally, the zero population growth movement intrigued me.

Essentially, followers of ZPG recognize three ways to achieve this goal:

  • voluntarily limit births
  • enlist coercive family planning policies (many will cite China’s “one child policy”)
  • do nothing and let nature limit population growth through famine, disease, and war

Sounds scary right? So, I thought I should “do the right thing” and voluntarily have no children. After all, I was born into a situation of privilege – unlike many women without the financial, physical, or political means to access contraception and other family planning services. They would not be able to make this voluntary choice, so it was my responsibility to share the burden.

I carried the torch of the ZPG movement even when that relationship ended.

In Spring of 2011 I met the woman who would become my wife. She had dreamed of having children her whole life and told me many times over the first year of our relationship what an amazing mother she thought I would be. But I continued to beat the drum of ZPG, now adding even more economic flair to the narrative.

In a lesbian relationship conceiving a baby is no small expense. The methods available can cost anywhere from hundreds, to tens of thousands of dollars each try. I posed this to my partner, “Think about all the things we could do with that money instead.” We could save, travel more, invest in our hobbies, live for ourselves and be perfectly happy. Or so 25-year-old me thought.

After a couple years, I had convinced my wife of the storyline, and she no longer pushed the baby plan. Then, in 2014 everyone I knew (or at least it seemed) started having babies. It wasn’t until my younger sister gave birth to my nephew that year that it really hit me. “I want this”. But now it was me who had to convince my wife that having a baby was a good idea. I was flip-flopping and she wondered why. Except this time I didn’t have any economic storyline to provide. I could no longer employ cost-benefit analysis as to why we SHOULD have a baby, it was just a FEELING.

Ugh, feelings. I was confused and conflicted with these things I hadn’t felt since childhood. I even felt guilty for wanting something that I knew I couldn’t reason through. When I try to explain WHY I want to have a child, all the reasons sound narcissistic at best. But, here we are…(maybe?) back on the baby plan. And boy, does it involve a great deal of planning.

Every day I tell my students that every decision involves costs and benefits, and only by carefully and intentionally weighing those costs and benefits can we hope to make good decisions. I do think that approaching my pregnancy planning with an economic eye will help me, but I think there may be more wiggle room than I was previously willing to admit. But one thing that I can agree with in The Atlantic article is this: “It became clear quickly that I’d have to come up with my own framework–to structure the decisions on my own.” So here I am, with economic tool box in hand, accepting that as methodical as I may plan to be, sometimes I might just have to wing it.

Hillary Sackett  headshotHillary Sackett-Brian is an Assistant Professor of Economics at Westfield State University where she teaches Environmental and Natural Resource Economics among other courses. She lives in Brattleboro, VT with her wife Rachel, three dogs (Gunner, Duke, and Raisin) and two cats (Grover and Gatsby). In her spare time she enjoys trail running, garage-saling, and coffee drinking. Follow her on Twitter @HillarySackett.

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A Doula’s Wisdom: Interview with Sarah Thayer

From the Editors: We recently interviewed Sarah Thayer, a certified and trained birth doula who is now a nursing student with plans to become a nurse midwife. With eleven years experience working with pregnant and laboring women, she offers us an observer’s perspective on pregnancy over 35. 

MS: Can you describe your role as a women’s health care professional?

Sarah: I worked as a certified and trained birth doula from 2003 until 2014. I am also a licensed massage therapist and have been licensed in the state of Connecticut since 2004. In my massage practice I see both men and women but have specialized training in pregnancy massage. I have an undergraduate degree from Central Connecticut State University in sociology. I am a nursing student at Capital Community College in Hartford, CT and will graduate with an associates degree in nursing in 2017. Upon receiving my RN license, I intend to continue to graduate school to become a nurse midwife with a clinical doctorate degree.

As a birth doula I worked with women and their families to help them have their own best birth experience. Birth doula’s do not provide clinical care, but rather help their clients during pregnancy, labor, birth, and the immediate postpartum to have a positive birth experience. This is different for every woman and family. This element made my job endlessly interesting.

Primarily I listen to women. I try to understand how I can best support each mother and family in a way that empowers her to make her own best choices. Because I am familiar with the policies of hospitals and different medical practices, I can give referrals, when asked, to providers and facilities that may be a good match for the goals of an expectant mother. There isn’t a wrong way to have a baby, but knowing all of your options and picking the provider and place to birth that is in alignment with your goals is the first step to a positive birth experience.

The over all arc of my work with families includes informational support in pregnancy, connecting women and families to community resources, 24/7 on call availability from 37 weeks of pregnancy through birth, continuous labor support with guaranteed back up doula support in the event of emergency or illness, immediate postpartum support, and a postpartum follow up visit in the first 6 weeks after the birth.

MS: From our perspective, there seems to be some fear mongering when it comes to tests,for women having geriatric pregnancies. Can you share your perspective on that?

Sarah: We have the ability to know more about fetal development because of new genetic tests and advances in technology. I think it can be difficult for patients to navigate understanding what the tests are, what the purpose of them is, what the results mean and don’t mean, and if they have to undergo all the screenings that they are sent for. For example, some screenings simply say that there may be an abnormality that may indicate that further testing is needed to see if there is, in fact, something not developing normally. Further testing could reveal everything is progressing perfectly fine, but more invasive tests, like amniocentesis, come with risks of their own like infection or miscarriage.  It can be a roller coaster for women who feel anxious and frightened while waiting for results when, in fact, everything is fine.

It is true that there is a higher increase in fetal genetic abnormalities when a mother is over 35. It is also true that there are higher risks of miscarriage and other complications when a mother is over 35. I think that women need to soul search a little bit and make informed decisions about the purpose of testing. Is there a family history of congenital abnormalities that warrants exploration? Does the mother have a history of recurrent miscarriage that would indicate genetic testing? Is the woman thinking she may end a pregnancy that has markers of genetic abnormalities, or is that not a choice that she is considering? Is this a woman that finds comfort in more information rather than less? I think one of the problems is that the medical system doesn’t always do a great job of educating patients about which tests are mandatory and which tests are optional and what the pros/cons of a test are. In general, the medical establishment functions in a “More is Better”, mentality without the shared decision making between patients and providers which would empower patients to decide which tests are most valuable to this woman in this pregnancy. Again, this is where provider choice is extremely important. Pregnant women should never hesitate to leave a practice where she doesn’t feel listened to or where she isn’t given informed consent of every test or procedure that is entered into.

I think pregnancy can feel so overwhelming that women forget that they can ask questions or change providers at any time. Women should learn to ask “what is the benefit of x, what is the risk of x”? and “is there any reason why I can not do x?”.

MS: If a woman is deciding /trying to get pregnant for the first time over 35, what health-related considerations do you advise?

Sarah: In my present roles as doula, massage therapist, and nursing student I am unable to give medical or health related advice. That said, my best non medical advice is to think about the type of care you want to receive, how you want to experience pregnancy, what kind of birth experience you think you want. Ask other women about their doctor and midwife recommendations. Women generally like to share their birth stories, so ask them! What did they like about a doctor, midwife, or hospital/birthcenter/home birth experience? Midwifery care is different from OB care. Hospitals that look very similar from the outside may have vastly different policies on the inside that impact patient satisfaction and health outcomes for mother and baby.

Living an active, healthy and balanced life is a great way to start a pregnancy. Common knowledge like being at a healthy weight, eating a balanced diet full of fruits, veggies, whole grains; these are great things to do for general well being. Everyone’s experience of pregnancy is different. Some people just feel awful the whole time, while others glow and adore every aspect of pregnancy. Most of us fall somewhere in between with highs and lows across the full 40 weeks.

MS: In your role as a doula, did you find significant differences in pregnancies of women over 35 vs. those not over 35?

Sarah: There are differences between a pregnancy in your 20’s and early 30’s vs. over 35. Again, I am harping on the point of choosing the right provider again. Some providers view pregnancy as a normal physiological event that only requires intervention once there is a deviation from normal. Other providers see pregnancy as inherently risky that requires constant vigilance to avoid complications. Healthy women, age 35 and older often have normal boring pregnancies. Finding a provider who views pregnancy as a normal process is the first step to having lower interventions. Women over 35 are more likely to be offered higher level screenings that may not be necessary or helpful if the results are not something that you need.

Sometimes women who are over 35 may have had history of pregnancy losses, fertility difficulties, or complicated fertility treatments to become pregnant. Even women who have had hormone therapy, IVF or IUI to become pregnant can have a low tech, low intervention pregnancy. It can be difficult to change gears from frequent progesterone shots and ultrasounds to monthly appointments with no tests at all. We bring all of our life experiences, hopes and dreams right with us to pregnancy and birth. Our journey to pregnancy certainly shapes our experience. Someone who has tried for a long time with losses and disappointments along the way will have a different pregnancy than someone who conceived the first try. A complicated conception doesn’t mean a hard pregnancy and birth, nor does an easy conception promise a care free & easy pregnancy and birth. I do think that the harder the journey to pregnancy the more difficult it can be for expectant families to decline higher levels of screening which may or may not be needed. More information does not always illicit better outcomes; it can create anxiety where it doesn’t need to be experienced

MS: As a doula, nursing student, and mother yourself, what do you believe a woman should think about when deciding whether or not to have a baby when she reaches 35 + ?

Sarah: Deciding to have a baby is deeply personal. Pregnancy, childbirth, and motherhood are nearly ubiquitous roles for American women in their 30’s; so much so that my friends without children can be made to feel like outsiders as women. I wholly respect the decision to have or not have children. In my opinion there often isn’t a ‘perfect time’ to have a baby. Physiologically, a woman’s fertility does start to decline in her 30’s and significantly declines at 40 and beyond. If a woman is 35 and knows she would like to have a baby but isn’t ready or hasn’t found the right partner, harvesting and storing eggs is an option, although a pricey one. There are better IVF outcomes with younger eggs than older ones. So if a woman has the means and wants some more time, this can be a decent option.

If you are 35 or older, you shouldn’t let the whole ‘geriatric’ pregnancy label dissuade you. Consult with your MD or midwife about your plans to get pregnant and ask questions about how long it should take if you are coming off of hormonal contraception. There are ways to track ovulation to make sure your cycles are the appropriate length while also determining the best window for conception.

There are many things to consider when starting a family and every woman’s priorities are different. Motherhood and parenthood is a rollercoaster that impacts every single area of who you are as a person. Once a new baby enter’s a family their entire lives are totally changed. You learn to know yourself as a mother, your partner as a father/mother, and what was amazing and or horrible about your own childhood and parents. The desire to have children is great and biological. No one really knows what they are doing, but overwhelmingly we parents get a lot right and some wrong along the way.

MS: How can an older woman best prepare for pregnancy, birth, and/or motherhood?

Its really hard to prepare for something so unknown. My best advice is to have community. Read books, listen to the stories of women and mothers you aspire to be like, and attend childbirth classes that empower you to make your own best choice. Dream with your partner about how you will parent together and get through the big scary fears we all have, and go for it! My oldest child is 11 and there wasn’t quite the deluge of information on the internet when I was pregnant and home with a newborn. I distinctly remember being at home with a 2 week old baby, pouring through a baby manual, and coming to the realization that no one really knows what the hell they are doing. As parents we are all winging it to some degree. There is something comforting about this because it allows you to let go and get in touch with your instincts. Since then I have had clients show me elaborate graphs generated from Apps that show the number of feedings, diaper changes, burps, etc over the course of a day, week, month. This would not have been helpful to me. Read encouraging things, and not frightening things. There is no shortage of internet advice, child raising books, or anecdotal information that will undermine the power of your presence and your expertise about what your own child needs. Once you have read the facts about something, make an informed decision, follow your gut, and don’t look back.

My first baby what what we call a ‘high needs baby’ who wanted to be in arms and nurse constantly. I learned quickly to try my best to have a short memory, to not calculate how much sleep was accomplished or lost. Be in the moment. Try to find the joy in right now, or the hard in the moment with the knowledge that this too shall pass. In my mothering of older children now, I have to remind myself of the same lessons. Enjoy right now and let tomorrow worry about itself. That joyful/annoying stage is fleeting and will be different next week.

MS: Describe a doula’s role and how a doula can be important to a geriatric pregnancy.

Sarah: A doula provides physical, emotional, and educational supports to women and their families during pregnancy, childbirth, and the postpartum period. One of the things that can be a pro and con of a ‘geriatric pregnancy’ is that there is more life experience for expectant families. Older women who have careers and are used to being in charge of things can be really broadsided by how little control we actually have in pregnancy, birth, and the early days of mothering. Older women are used to be being competent and knowledgable about things, and suddenly they find themselves having no idea what to do. It is an uncomfortable yet completely normal part of the experience. Having an experienced doula to listen to you and normalize something that feels foreign can be very useful. Doulas are supportive of dads and partners too. Partners do not have to feel like the experience is solely riding on his shoulders. Birth is extremely intense for loved ones as well. They want to be helpful but often don’t want to do the wrong thing. The doula is like your birth consultant. She knows what is most important to you and will help you achieve it. The doula will let your partner be at his or her best. The birth partner should be there to love you and experience this with you. The doula can remind the partner to eat, take breaks, show how to rub the laboring mom’s back etc. Older couples often see the value in this type of service because it is like having expert comfort advice right at your finger tips. Doulas also have a knack for placing a cool cloth on your neck or feeding you ice chips without you needing to ask.

MS:  Anything else you’d like to share with our readers?

Sarah: You have options. Just because you have been seeing the same OB/GYN for 20 years doesn’t mean that they are the best fit for your care during pregnancy and birth. Your birth experience is something you will remember for your entire life. I have heard the most beautiful and appalling birth stories from elderly women who can recall very specific details about their births. Women remember.

Talk about your fears! Don’t hide them and foster them without the care of others. If you are being kept awake at night because of fear of childbirth, talk to your care provider and get connected with people who can share their positive stories. Our bodies are structured to do this. Look around at all the people around us and know that a mother somewhere birthed that person. There would be far fewer people on the planet if childbirth were always as horrible and scary as the worst story you have heard.

Lastly, ignore the cultural hazing of pregnant women. People scare pregnant women. You will never hear more awful birth and death stories or parenting nightmares as when you are pregnant. Unfortunately, women who are hurting often don’t have a place to share their pain about births that have gone wrong and a lot of that sharing lands at the feet of pregnant women. Its okay to not listen to that. More importantly, find positive and realistic stories rather than the worst case scenario tales.