ARTICLES

If You're Over 35, You're Over-age

Slings and Arrows Aimed at Big-Family Moms

By Robert Kumpel

Sue Wise, 43, is the mother of nine children. A navy wife for 21 years, Wise lives in Tierrasanta, but has been stationed in Virginia, Washington, South Carolina, Ohio, and Hawaii. Her most recent child, a boy, was born two weeks prior to this interview. "He wakes up every two hours at night."

Wise decided to have her child delivered by a midwife at Balboa Naval Hospital. Her prenatal care was given at a midwife clinic at Miramar. "I noticed a change in the way way older women, especially over 35, are treated. Pregnancy is considered more of a disease. I was offered the same diagnostic testing that I was offered in my previous two pregnancies over 35, which I was able to turn down -- those were not pregnancies that were delivered in military hospitals. I was offered an amniocentesis, which is pretty risky. I've heard some horror stories about babies being poked by the needle and they end up dying, just to find out if they have down's syndrome. There's another test, called the triple test--it used to be called the AFP test or the fetal protein test -- but that has a 50 percent accuracy rate. I've always turned that down, too, because my sister had one and was told that she would probably have a down's syndrome baby. My sister-in-law took it and was also told that and they both had normal, healthy babies. So I turned them both down. I told the midwife that the AFP test wasn't too accurate. She said, 'It's got a 60 percent accuracy rate now.' I told her that that was still not high enough. It's just a blood test, but I still didn't want it. Who needs the worry from false positives? And even if we found out that the baby had a problem., it wouldn't change the end result -- we would still raise it. I think these diagnostic tests probably tend to cause a lot of unnecessary abortions.

"When I refused the test, the midwife pushed it. She said, 'Are you sure? Because you can start the grieving process early.' To her, it was almost certain that I would have a baby with down's because of my age. I told her that we would deal with that when the time comes. Well, they contract out with UCSD for high-risk diagnostic things. Two nights later, I got a phone call at home from someone at UCSD saying, 'If you have your ultrasound and they find out that it's abnormal, would you be willing to have more in-depth testing done here at UCSD?' I really resented the fact that I was called at home in the evening by a person I had never met before, pushing diagnostic testing. I just said to her, 'W e will cross that bridge when we come to it.' That was all I heard."

An anonymous, pro-life UCSD physician defended the policy of diagnostic testing. "Testing AFP isn't just to determine if there's something wrong with the baby so they can abort it. Pro-life people should get the test so they can see if something is wrong that's correctable and plan for a Caesarian and surgery, if necessary, to help the baby survive at birth. If surgery is necessary, you would want a surgical team ready when the baby is born."

Nonetheless, Wise was insulted. "She was nice and they obviously think that they are doing you a favor, but they're clueless. If you're over 35, you're over-age to them. I have a neighbor who told me, 'I was high-risk during my last pregnancy.' When I asked her what the problem was, she said, 'I was over 35.' I started laughing, because whoever told her that, it was ridiculous. This is my third baby since I've been 35, and I've never been put in a high-risk program, not even this time. I delivered with a midwife and they don't take high-risk people.

"I was asked at 28 weeks, 'What kind of birth control are you going to use after the baby's born?' For all the others, that was asked at the six-week post-partum check up. I said, 'Why are you asking me this? I've never been asked this before I even gave birth.' She said, 'Oh, this is how we do things now.' I told her that our babies had all been spaced through breast-feeding, so she put 'lactation-spacing' in my record. Then she put down 'NFP' though I didn't even mention that. We haven't really ever used it. That was what the midwife who delivered our baby read in my chart.

"Twenty minutes after I gave birth, she said to me, 'If you have unprotected sex in the next few months, you need to come into the emergency room and they'll give you a morning-after pill.' That's an abortifacient! But it was midnight, I was exhausted, and I didn't feel like arguing with her, even though I realize d she was completely ignorant.

"I looked in her face when she said this to me, and she looked cheerful and she really thought she was helping me. She said, 'Whenever I read someone's chart and it shows that they're going to use a barrier method or NFP, I always tell them about the morning-after pill.' I didn't say anything. My husband was there too and he was pretty disgusted.

"It's just constant and relentless. I feel sorry for people who are younger who are told stuff like this and don't have the confidence to dismiss it or argue or stand up for themselves and their faith. They get intimidated, and they think, 'Well, these are the health-care professionals, and they must know what's best.'

"There was a civilian doctor who was a backup for the midwife, and I saw him once. He asked me if I wanted to get my tubes tied at delivery. After I said no, he asked if I thought my husband would like a vasectomy. I'm afraid I got a little prickly and was very definite in turning that down as well. He looked at me and said, 'I have to ask you these questions, because people expect a perfect outcome, and if they don't get it, they sue.' So I think a lot of it is driven by the attorneys. All this does is make people end up doing things that they shouldn't just because they're offered. In fact, my husband pointed out a month ago that the free weekly military newspapers have big ads that read, 'Have you been harmed by the navy hospital? Call this attorney.'"

Delivering with a midwife had other problems for Wise. "I wanted to meet my midwife before giving birth, so each time I went for a checkup, I saw a different midwife, in order to meet as many as possible. As it turned out, I never met the midwife who delivered my baby, but that happens in military hospitals. Since they didn't know me, I was asked the same questions every time: 'Oh, you didn't have an amnio, huh?' Each new midwife didn't have time to read my chart, but that civilian doctor was the only one who offered sterilization."

This was not the first instance of medical professionals showing hostility to Wise. "When I had my third child in Charleston, I went to a six-week (post partum) checkup, but after that, I just stopped going to them. I realized that it was all about birth control, and I was tired of being shot down.

"The doctor, whom I had never met before, said, 'What? You wrote down NFP on your chart? Do you want to be back here a year from now with another baby?' He was very scathing. It was total, undisguised contempt. I was only 26, and I really wish now that I had the courage of my convictions then, but I was insecure about standing up to authority figures. I wish I had told him 'If I am here a year from now, I won't leave the baby on your doorstep!'

"It's amazing. Why is this stranger losing sleep over how many children I have? Then he said, 'Well, you must have hit it off with your delivery doctor.' I asked why he thought that, because I had never even met the doctor who delivered our baby before delivery -- he just happened to be on call. He said, 'He and his wife teach NFP, and they're both Catholic too.' It was in a sneering tone. I didn't know that about him, but I wish I had. And here was another doctor who considered it a mark against him.

"After that, I quit going to my six-week checkups for my next several children. For my seventh, I had a family-practice doctor who helped me deliver at a Catholic hospital in Westerville, Ohio. Everything was fine, but I told her, 'I don't go to my six-week checkup because it's all birth-control propaganda. I just wanted to let you know that now.' She said, 'I can just put it in your charts that you don't want us to bring up that issue.' After she wrote that down, I went to that six-week checkup. That was fine, but I was old enough to be more assertive and confident.

"But for my sixth, delivered at a Catholic hospital in Norfolk, Virginia, I chose a group practice out of the yellow pages. It was a typical navy move where we went three thousand miles and didn't know anyone in town. I was seven months pregnant when I found the practice. It was six doctors who delivered at that hospital, because it was right near their medical offices. I saw probably four of the doctors before delivery. But one doctor I hadn't met was on call when I was post-partum. He was a young doctor, not very friendly. He walked into the room and said, "I want you to make arrangements with your husband to go out to dinner a week after you get home, and I want you to discuss birth control with your husband over dinner.' I guess he thought that I had too many kids. If you have a personality that is more feminine and not strident, they must think your husband is keeping you barefoot and pregnant.

"I tried to treat it as a joke. I laughed and said, 'I can think of better things to talk about over dinner.' He didn't laugh -- he just got angry. When I realized that he was dead serious about this and really thought it was his mission to get me on some sort of birth control, or sterilized, I said, 'That would be totally against our religious beliefs.' He asked what religion I was and I said, 'Catholic!' When he realized he was getting nowhere with me, he just got up and stomped out of the room. That was another six-week checkup I missed. I just didn't want to be harassed anymore, and I felt fine and healthy. I knew the checkup would just be to discuss birth control.

"With my latest, I will be going to the six-week checkup. They asked me at 28 weeks, so it's already in my chart. Besides, I want to ask about some other things."

Kathy Kuebler, 43, of Encinitas is also a mother of nine. Her last two children are identical twin boys, Tommy and Jimmy, both born with down's syndrome and cleft palate. She began to notice medical people pressuring her when she was expecting her seventh child, now three years old.

"When I had an the ultrasound, the person who did the test sat my husband and me down and talked about our age and our chances of having a down's syndrome baby and that we should have an AFP test. If that's positive, they'd want to do an amniocentesis. I told him I didn't believe in abortion so I wouldn't even start down that path. They were trying to talk us into being tested because my chances were higher, with us being over 40."

Kuebler is not timid about telling doctors where she stands. "I just ask doctors right off the bat if they perform abortions. When one told me that he did them at another facility, I said, 'Then I can't have you as my obstetrician.' I put up a pretty good defense, because I'm kind of outspoken, whereas young people who aren't sure about how many children they would want could be easily affected by what people are saying about the size of their family -- unless they have the Catholic faith as a strong force in their lives.

"For the most part, my pediatrician has been supportive. I've had doctors ask me if we're going to have any more or if I want my tubes tied. It's almost a standard question that is asked, even when a woman has even just two kids. They automatically start asking, 'Are you sure you want to have another one?' And that's when you deliver! Prenatally, when you're delivering, that's the best time to have your tubes tied, especially when you have a c-section, so they want you to consider that.

"Of course, when you're pregnant you don't feel much like carrying another baby, especially in your ninth month, but I don't feel that's a question that should be asked every woman. Any woman who is not Catholic might think that's an option anyway. A friend of mine who has a down's syndrome baby is Catholic and she knew ahead of time she was going to have a down's syndrome baby. They were pressuring her to abort. They thought the baby was going to have a lot of medical problems, and they kept asking her, 'Are you sure you want to carry this baby?' Actually, they never even called it a baby. They said, 'Do you want to terminate the pregnancy?'

"My twin boys have down's syndrome. We knew ahead of time that they had cleft palates. That was diagnosed with an ultrasound at 21 weeks. They sent me to UCSD for a 3-D ultrasound to see if the palate was involved and that's when they saw that both twins had a full cleft lip and palate. They couldn't see how far back it went, but they could see it was down to the gumline. At that time, nobody asked me if I wanted to abort. If they had known they had down's syndrome, that probably would have been offered to me, even though I told everyone that I was pro-life and that all children with any defects were souls created by God.

"Anyway, when the twins were diagnosed at UCSD, there were four specialists in the room and I felt like I was a piece of meat and the babies were just an object to be studied. I felt like I was treated very coldly and I left there crying. It was like they weren't even babies."

Instead of weakening her resolve, these incidents have made Kuebler more determined. "It's not hard anymore. I've realized that society doesn't believe in having more than one or two children. When I had four, I'd get comments in the grocery store like, 'Are you going to have any more?' or 'Oh my God! How do you handle it?' and other negative questions. I've gotten past that. I just very happily say, 'Oh, it's wonderful to have so many children. I feel so blessed.' When people ask me if I'm going to have anymore, I say, 'Why should I stop now? It gets better and better!' I try to ask them a question back rather than search for an answer. Another friend of mine is often asked, 'Are all of these your children?' and she says, 'Why no, they're God's. I just get to take care of them for a while.'"

One of the few who has stuck with Kuebler throughout most of her pregnancies has been her obstetrician. "I've kept the same obstetrician, Dr. Lawrence Eisenhauer, for the last five babies I've had, and he knows how I feel about contraceptives. He did ask me why I believe in natural family planning and I don't use contraceptives. When I distinguished between the two -- that one is a natural course of watching your cycle, requiring the virtue of chastity and the other is just selfishness and not letting God into the relationship, he said that he appreciated my honesty and he was trying to learn from that. I really like him and he's a Christian. He's never said, 'Are you sure you want to have any more?' I had five children in less than five years and there was none of this negative stuff. When I came in and told him I thought I was pregnant with twins, he did the ultrasound and started to laugh and said, 'You're the first person I've ever seen who had so many kids who is thrilled to be having twins on her eighth pregnancy.' He doesn't do abortions, which is very important to me."

Like Wise, Kuebler believes younger women are intimidated during prenatal treatment. "If you're not going to have the AFP test, you have to sign a form and that only started in the last few years. They used to just ask and you didn't have to sign a form if you turned it down. I think that makes new mothers feel like they're doing something wrong. When you sign a waiver, it's like you're taking things into your own hands. It's almost like the medical field forces you to have that test to check for down's syndrome. I believe it can also test for spina bifida, but there are so many false positives with that test that many women can go and have the amniocentesis, which is dangerous for the fetus. I have a friend that had her AFP come back very high, so she went ahead and had an amniocentesis and the test came back that the baby was perfectly normal.

"I wish I hadn't known Tommy and Jimmy had cleft lip and cleft palate. At the time I thought it was wonderful, but my whole pregnancy was an anxiety about how severe it might be....Would they have breathing problems? Would they have hearing problems? Would they be able to nurse? I prayed for them and thought about them daily and every time I thought of them, I pictured them as two people with something wrong with them. I don't think that's the way to carry your child.

"I think the down's syndrome is a blessing, because there is so much negativism about down's syndrome. Once we held them and loved them, it didn't matter where they came from or what their genetics were. They are my husband's and my babies and we love them exactly like all the others. We see them as precious souls, and in the last two years we've really seen what gifts they are. They are so loving, patient, and non-demanding. But if you know about this stuff ahead of time, there's a prejudice there already. You're biased one way or another about how this child is going to be and who they're going to be and what your life is going to be like -- and you don't know what your life is going to be like. When you hold that baby for the very first time, nothing else matters. Tommy and Jimmy could never have existed except as down's syndrome babies. At conception, that's who they were. But every time in the doctor's waiting room, I see ads in magazines about contraceptives and responsibility. The whole attitude out there is not to have children and that they're a burden. People come up to me and say, 'Oh my God, how can you handle nine kids? I can't even handle my two.' And they say it right in front of their children! I can't believe that they'd do that because what's the message to the child? If you view your child as a gift from God, you can't be disappointed in anything about them.

"As we deal with more doctors and go through helping ourselves, we're less afraid of the unknown, and even the doctor doesn't know what's going to happen. Of the nine children I've had, each delivery has been completely different. It could be the same doctor each time, but your lives and your delivery are still in God's hands. I've realized that I don't have to rely on that doctor as much as on God."

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