Tuesday, February 28, 2012

On prenatal testing and abortion

There is a lot of stuff floating around these days regarding prenatal testing and, as always happens, almost in the same sentence, about abortion. Especially abortion and Down Syndrome.

Just read all of these Time Health articles: this onethis one and this one. It's on CBS. There's been something on the Huffington Post. It's even sort of a campaign issue in the US presidential elections.

Of course there are the pro-life people, who almost always bring up and force in religion, and then there are the pro-choice people, who talk about the woman's right to choose what to do with her own body.

Now, I have never covered up the fact that I am strongly pro choice. As long as the choice is the woman's/ the couple's, not the surrounding community's, and definitely not the treating doctor's.

Legalizing abortion and maintaining the already gained advances is one of my pet causes. Pro-lifers tend to give me the serious creeps and regardless of what awesome literature they have or don't have standing on their bookshelves (usually my major point of final judgement of any person) they will always primarily be judged by their patronizing view regarding what could very well at some point be my body. A body that not even the Viking has any say over.

"But? What? Back up a minute here lady," you might be saying to yourself right at this very minute, "You just knowingly had a kid with Down Syndrome, didn't you?"

Yes I did. I knew that my baby had Down Syndrome already when I was 13 weeks pregnant with her, and that she had some sort of chromosomal glitch (either an extra one or one missing, was our initial information) going on when I was 12 weeks pregnant with her.

I had a CVS (chorionic villus sampling) test done. I wanted to know exactly what the glitch was so that I could make an informed decision on whether to continue my pregnancy, and also in order to prepare for the future. Had the results said Trisomy 13 or 18, I would have had an abortion. It would have been my right to not bring someone into the world whose short life would have been filled with only pain and suffering (before those become staples of life that is - for my own mother this apparently happened around the time I hit puberty). Had I been in this same situation, -13 weeks pregnant with a child with Down Syndrome - when I had just started university and was together with 'the one before the right one', I would have had an abortion. Had I been in this situation in a parallel universe where I had no chance of education, no resources, an absentee husband, and seven other children to take care of, I hope I would have been smart enough to have an abortion. Had I been one of those people appalled by the fact that my child was going to have a disability and not be in every way superior (if that was ever even possible, right?) to everyone else - an heir to my queen of the world, I hope I would have had an abortion. had I been pregnant with a typical child, but by accident and at the wrong place in my life, I would have had an abortion. It would have been my right. In a lot of the world.  

But I was me. In 2011. Pregnant with my first child. Long time married to my best friend and quite possibly the most wonderful man in the world (regardless of the fact that he's still unable to pronounce 'vegetable' and sucks at keeping secrets from me, even about presents he's bought for me). Educated and informed. Pretty well off. And most importantly, able to devote almost every single second of my life, every day now and in the future, to bringing up my child into happy and healthy adulthood and making sure all is well with her.

It didn't matter that she had Down Syndrome. She wasn't going to suffer. Her heart and other organs checked out. There was essentially nothing else different about her compared to any other baby than her karyotype showing one extra 21st chromosome.

And there still isn't - nearly 5 months after she was born. Partly, because, well, there just isn't (it's only one chromosome [and identical to the other two 21st] out of a total of 47, ya'll), and partly because we've aggressively worked with her in developing her muscle tone, reflexes, nervous system, and abilities since she was three weeks old, something we'll keep doing for as long as she needs it.

We have high hopes for her and we'll do our best to make her kind, smart, understanding, witty, responsible, and fun. She'll probably also be stubborn, rebellious, smart mouthed, and obnoxious, but that's all on us.

I, as well as the recent research, strongly believe that nurture, and not so much nature, will determine how she'll be. Let's hope we measure up.

So you see, it all comes down to specific situations. We even have a plan for her should both of us, her parents, die in a blazing inferno/ horrifying car crash/ a freak skiing accident/ Agatha Christie novel, which will never ever leave her drifting, whatever the circumstances (yes, we're aggressively amassing extraordinary people and a large fortune). It seems to me that instead of making blanket statements and decisions about the legality and ethic qualities of prenatal testing and abortion, let's make it so that everyone is able to make the best choice for them while they have the best and newest information regarding their situation, and no one there who considers bringing up a child with Down Syndrome 'an insurmountable task' or a condition 'not viable with life' as some completely misinformed assholes medical practitioners out there seem to be thinking.

The biggest minus of motherhood so far has been the jello they force on you at the hospital.

Tuesday, February 21, 2012

If this was a mommy blog this post would be called 'The Birth Story' or some such crap-o-la

It's a long one, this story. But in a nutshell, it's one with a happier ending than any of us dared to expect:  The babe came out in grand, bloody style and screamed. And all was good with the world.

We already knew she had Down Syndrome, but that was the least of our worries in that operating room.

Still is, in our life.

The babe's now a little more than four months old and as parents I and the Viking (that's the Danish husband of a longish duration to this one, a slightly off-kilter Finn, who has been out of her depth for quite some time and kind of likes it that way, all in one mother of a tangle) are still counting seconds. And we know it.

But before we were counting seconds of parenthood we were desperately counting days and weeks. Of the pregnancy, that is. And here's how it all went down.

The Birth Story (do not dare to imagine anything cutesy here, since that's not how this bunch rolls. Like at all):

Ever since puberty, I had been told that getting pregnant for me was going to be the discreet affair between I, the Viking (at that point referred to as the generic husband, since the Viking himself wasn't even in the country when I hit puberty), the doctor, some powerful medications, hormones, possible surgical intervention, and several visits to the hospital. I had severe PCOS, you see. Something that the medical establishment had decided meant that I was going to be on the pill (as a way of regulating my menstrual cycle) until one day I'd decide it was time and make a series of appointments at the gynecologist's to score some hormonal injections and maybe a petri dish or a few, have Viking ejaculate in a number of cups, and go about my day scheduling in the creation of life (if we were to be one of the few lucky ones), or something in that vein.

We'd always said we'd adopt when the time was right. We'd be the perfect multicultural family for any child, from any background.

But then I took charge. I changed the way I was living - I trimmed away the meds and brought in nutrition and natural supplements - and a year later emerged victorious with a regular menstrual cycle and ovaries clean of the previously ubiquitous cysts. But the doctors were doubtful.

What the hell. We decided to give it a shot anyway. Au natural. And it took. 16 store-bought pregnancy tests and one blood test later we dared to be certain.

I was with child. (Again, don't you dare ooh, or even aah, we're cooler than that...)

Then my last remaining grandfather died, and off I went, by myself, all the way to Europe, with a terminal-change at joy of all joys Heathrow, to his funeral, to the cold and dark (at that time of year) Finland. And promptly had a threatened miscarriage. Hospital instead of funeral.

But she stuck it out. We decided on a Finnish name for her and breathed a sigh of relief.

Until I returned home to Mexico and fainted while I was brushing my teeth.

Which was when they discovered the hematoma and the tear in the placenta. Right after they diagnosed me with neurocardiogenic syncope driven completely out of whack by the pregnancy hormones.

Gatorade and bed rest. We began to search for a Danish and a Mexican name for her.

We just knew we were expecting a little girl.

The night before the 12-week scan we had prepared for the worst. What if there was no heartbeat. What if the development had stalled. What if the hematoma and the tear had been too severe.

What if.

It was an indescribable joy to see our baby dancing around on the ultrasound screen. And dancing she was. Twisting and turning. There was no question there was a heartbeat, her size was right. Everything was good. My doctor asked in another doctor to look at the screen. "Mexico?" was all I thought of that.

We sat in the doctor's office. The doctor took out some of the pictures he had printed out during the scan.
"So this is the fetus. This is the face and this is the neck," he said and we nodded. I thought he was being a weeee bit patronizing.
"Here is a little too much fluid in the neck," he continued, "and there's a fluid filled... a cyst on the neck of the fetus, which we can operate later on, of course."
The doctor stared at us.
"What exactly are you telling us," I said, "Is something wrong?"
"This could be nothing," he said in his accented English, "I am going to send you to the clinica materno fetal to do a better ultrasound. To do a better test. To calculate your risks."

And there it was.

Within a span of two weeks we went from doubting whether we were pregnant, to our chances of having a baby with Down syndrome being 1 in 2 and only slightly less for other chromosomal abnormalities as calculated from the results of the level II ultrasound, to receiving the preliminary results of the transvaginal CVS test, which clearly indicated that I had been right all along.

We were expecting a girl.

This little life had Down Syndrome, which made the pregnancy more risky. But she'd already dug her heels in when my uterus attempted to extricate her, held on tighter when the placenta tore and bled into the uterine lining, and she'd avoided the needle they stuck in through my vagina, right next to her tiny skull in order to harvest some of the placental cells for the CVS.

She wouldn't be dissuaded from experiencing the world.

"Like mother, like daughter," said the Viking and smiled (only he said it in Danish, which makes it much less of a horrifying cliche).

Even when the placenta began to measure off the maturation charts, and we, as well as the doctor, started referring to it as the 'Zombie-placenta (it just kept chugging on even when it should by all accounts have been completely lifeless), our babe just kept on growing. And kicking. And one particular Saturday undertaking something that felt like she had hired a work crew to demolish a particularly uncomfortable corner of her habitation.

There was constant monitoring and countless scares, when the umbilical flows weren't quite right, or the bones of the scull looked a little too attached, or the cerebral artery measurement took a dive, or the bowels started showing calcifications, or when the edema wouldn't clear, or when all of a sudden I could't feel her kicking.

Every week was going to be the last week I was pregnant.

The Viking gave me shots of steroids to mature Babe's lungs.

week by week.

When she reached a kilo in the womb, we were elated.

Day by day.

When we made it to 30 weeks, we could do nothing but cry in the hospital elevator.

By day.

When my pregnancy reached the magical 34 weeks, we didn't know which rooftop to shout it from and decided on the phone, the internet, and the hospital parking lot.

By week 35 she wasn't significantly growing anymore and the doctor recommended what he described as a normal course of action in Down Syndrome pregnancies: I would attempt to eek out as many days as possible until we reached week 37 and then he would induce labor. To diminish the risk of stillbirth.

We agreed. We were so close.

And then the oxygen in her brain started slipping. Inducing labor would no longer be an option. We began to plan for a c-section.

On a Tuesday, during the 36th week of my pregnancy, I got up early, took a shower, moisturized, put on make-up, blow-dried my hair and went for a brunch at my friends house, preceding an appointment at the clinica materno fetal for yet another level II ultra.

I chatted with the people at the brunch and found myself telling them that I was maybe going to have my baby that day.

So I did.

At exactly 7pm that night I heard that precious scream and finally took that breath I felt I had been holding for the past seven months.

For a few seconds all was well with the world. Our daughter was alive and well. In the NICU, but not in any real danger. I'd had my baby, we were out of the woods, right?

And then it hit me. I. Had. A. Baby.


Right then and there I realized one thing: It wasn't ever ' Fuck, I have a child with Down Syndrome', instead it was 'Fuck, I have a child.'  

And it kind of still is.

I had never understood what responsibility felt like before that day.

Or love.