Geriatric Woman has Child
As odd as it sounds, this is really how I felt when on 1 June this year at the age of 37 I gave birth to our gorgeous son Julian. Particularly when I kept over hearing various hospital staff whispering to each other “yes … her … can you believe it … she has CF and she’s 37 …. AND she’s just had a baby”!
I have always wanted to have a child and I remember way back in the mid 90’s when the CF gene was discovered and we were all told by the “ever accurate” news and current affairs media that within 10 years people with CF would be having gene therapy. I remember thinking in response to this news that it would probably be sensible to wait to have children until then, when my lungs would be fixed. I then realized that I would be 35 in 2005. At the age of 25 that seemed way too old to be having a child!!! It is hard to believe then, that at the age of 37 and with gene therapy still way off somewhere on the horizon I have just had a child.
Shortly after I started dating my husband Mike, we had a conversation about having children. Although I had always wanted to have a child, I had decided that as a 34 year old woman with CF I was way too old to be having a child. I told him that as he wanted to have children at some point in the future we should probably end the relationship before it really got started to avoid future heartbreak. The poor man was a little shocked and to his credit suggested that maybe we should cross that bridge if and when we got to it!!
After dating for six months or so, the subject of children came up again and we decided that we should be having an informed discussion rather than just mindlessly speculating. Part of the problem was my strong belief that to responsibly have a child I would need to be pretty certain that I would still be around for the next 20 years to raise them. I was also worried about the likelihood of being fit enough to meet all the physical and emotional demands associated with parenting over the next 20 years. I was fully aware that the statisticians would not give me great odds on this one! Fortunately I had always been pretty diligent in looking after my health. I have jumped on any lung infections as soon as they started to flare up but more importantly have taken a preventative rather than reactive approach to managing my health. I have also made a pretty big effort to incorporate regular exercise into my life. So at the age of 35 with a lung function or around 100% predicted, we decided to start by looking at the published medical research on CF and pregnancy.
I work for a large not-for-profit organization in NSW as their senior social worker. Part of my role is to look at research and to use it to inform how the organizations can improve the support of families. I used these skills to search the literature for relevant published articles on the topic of CF and pregnancy. I printed out numerous abstracts and full articles where I could get them and Mike and I proceeded to work our way through them high-lighting any points relevant to our search. There was quite a lot of research about lung function and pregnancy outcomes which suggested I should have no problems. However the research mainly focused on women aged 18 to 25, there was nothing we could find about women in my age group, with CF, and pregnancy outcomes.
Our next step was to get a referral to a geneticist and obstetrician at RPA. Mike and I made the appointment and in mid 2005 we were having a detailed discussion around the cold hard facts of pregnancy, CF and my age. I felt sorry for the Dr in some way as having swatted up on the research we really grilled him for answers that the research could not give us. The Dr’s opinion was that with my great lung function and my contentious approach to my health I should be OK although we would need to get a wriggle on because of my age. He did however say that if we did decide to get pregnant, I should expect to be hospitalized up to three times during the pregnancy for IV antibiotics and that the baby would probably be induced between 34 and 36 weeks. This news was less than exciting however I thought that if we did go ahead and if I worked really hard at staying well then maybe I could prove him wrong on this one.
Mike and I went home and had a heartfelt discussion about all the various scenarios ranging from us having a fantastic pregnancy and living happily ever after through to him being a sole parent! Not a nice discussion but one that was necessary to have. We also tried to balance out our desire to have a child and the potential short term and long term impact it would have on my health. After much soul searching we decided to go for it. An exciting but also pretty scary decision!
The next step was to go back to the Dr and get Mike tested to see if he was a CF carrier because as bad as it may seem to some people, and although I am so well, I really did not want to knowingly have a child with CF. That however is a whole other discussion way beyond this article that I will leave for another time and place. Fortunately Mike was not a carrier so our prescription from the Dr was to go away and try to get pregnant. As it can be hard for women with CF to get pregnant and because of my age he told us to come back and see him again in 6 months if we had no luck.
Whilst Mike and I had a great 6 months, we didn’t actually have any luck getting pregnant so we headed back to the Dr who sent us off for some tests to rule out any problems in conceiving apart from the CF related ones. All our tests were fine so it looked like it was either CF or being over 35 that was slowing us down. If we wanted to get pregnant sooner rather than later then we may need some help.
In September 2006 we were finally successful in getting pregnant. Now began the really hard and serious work of staying well and healthy. When we first started talking about getting pregnant, Mike and I also started to improve our fitness. We both went to a personal trainer once a week and went for swims or power walks or runs to supplement our training. Once I was pregnant we increased our commitment to maintaining and improving our fitness. Each week I went to two pre-natal aqua aerobics classes, our personal training session and did at least two hour-long power walks. We even bought a heart rate monitor to ensure that my heart rate got up to 150 beats per minute but not over when I was exercising.
I ended up giving up my very busy and rather stressful 4 day-a-week job at 22 weeks when I was diagnosed with gestational diabetes. Mike and I decided that I needed to concentrate on keeping fit and well. The diet I was put on was incredibly strict, much more so than a regular diabetic diet, and being a person who LOVES their food I found it a little hard to get used to. It was also exhausting detoxing off carbohydrates. I found that shopping for the gestational diabetic diet and preparing meals loaded with mostly fresh salads and protein was very time consuming and pretty expensive. The upside to eating so many vegetables was that I ended up just oozing vitamins and minerals and good health. The other benefit of leaving work early was that I had more time to exercise and have a nap if I needed one. I actually think that in many respects I have never been fitter or healthier than when I was pregnant however I have also never worked so hard to be that way either. In the second trimester of my pregnancy my lung function actually improved and went to 105% predicted!
Another factor that I have no doubt helped me to keep so well was the Hypertonic saline that I nebulized for an hour twice a day every day. (It took me so long as my nebulizer was nearing retirement age). For me Hypertonic saline was a wonderful preventative measure as it really helped to keep my lungs clear.
I kept exercising pretty much right up until Julian was born. Mike and I went in the Mothers day 4km walk when I was 36 weeks pregnant and I was still doing my personal training sessions and aqua aerobics at 38 weeks. Ever the glutton for punishment, I was back training 6 weeks after Julian was born and we ran/walked the 14km City To Surf with Julian when he was 10 weeks old and the 4km Bridge Family Fun Run when he was 14 weeks old. I figure that now that he is born the really serious work of staying fit and healthy and keeping my lungs at 105% predicted has begun. Poor Julian, we have been indoctrinating him in the love of a healthy lifestyle from birth!
Looking back on my pregnancy I know that the hard work that I put in to stay well really did pay off . Throughout the pregnancy I was so well that I managed to keep out of hospital and off IV for the entire time. My only hospital admission in fact was to give birth and that was for just 4 days. I did go on two courses of nebulized antibiotics but that was largely from a preventative perspective rather than because I was unwell. Just as exciting was that I even managed to get a delivery day extension and instead of being induced between 34 and 36 weeks our baby got to cook for a little longer and he was born at 39 weeks and 2 days.
Julian was delivered naturally after a 6 hour labour and quite a few lungs full of gas. He was a beautiful healthy baby weighing 3.275kg. Five months and a lot of breast milk later he weighs 7.5kg, my plan is to breastfeed until he is a year old, heaven only knows what he will weigh then! Giving birth was a truly wonderful experience for Mike and I and things just keep on getting better. I love being a mother, and we both treasure our little family. It was without a doubt worth all the hard work and more.
