I sat across from my newly pregnant client and handed her the visit paperwork. "Just make the appointment at the front desk and I'll see you again in four weeks!" I said.
She was delighted to be pregnant. She smiled through the whole visit—yes, she actually glowed. At least, she was glowing until she looked down at the paperwork I handed her and saw her medical diagnoses printed in bold letters at the top—elderly primigravida.
Her shoulder slumped and I could see the joy leave her face as she saw what was written on her chart. "Elderly?" she asked, totally defeated.
"I know," I sighed. "It's awful. The computer generates it automatically. I'm so sorry."
And I watched my elderly patient walk out of the room—all of 36 years old.
If you're unfamiliar, in the world of obstetrics, anyone that is pregnant at the age of 35 or older is considered, well, old. There are a few different terms used to describe this condition: advanced maternal age, geriatric pregnancy, elderly primigravida or multigravida (the last word denotes if this is your first pregnancy or not).
While advanced maternal age is most commonly used now, those other terms are thrown around enough to make an impact—usually the same impact as it had on my client that day.
To put it plainly, it's demoralizing and sexist. It needs to change.
More women are choosing to start or add to their families after they turn 35, and it's time obstetrics catches up.
Listen, there is nothing wrong with being an elderly or geriatric person (it's something I am trying very hard to attain one day). To be classified as elderly is deserving of the utmost respect—when you are an actual elderly person, not when you are 36 (or 42 or 53) years old.
Now, there are some risks that come along with pregnancy in the late 30s and beyond, so I get it. But do we need the label? Our ages are all over our medical charts. A patient arrives in labor, and we check their blood type, their obstetric history, their birth preferences and yes, their age. We then take all the variables into account and work with them to arrive at the best possible plan of care—labels not required, especially because the labels that are given to women are so often unhelpful, and based on societal perception.
Labeling women based on their age is deeply rooted in a culture that views aging in women as a problem. Society tells us we need to dye our grays, lift our boobs and fade wrinkles—no judgment to women that choose to do these things, of course, from the 37-year-old who is not as un-gray as she would appear. It's just that we shouldn't feel like we need to do these things to be accepted. Society makes us believe that aging is the consequence of having a life well-lived, instead of the beautiful and empowering gift that it is.
Labeling women as elderly or geriatric inspires a lack of confidence in the pregnant body—by the provider and the patient. And it joins a long list of "things that are inherently wrong with women's bodies." We're dirty. We're weak. We're overly emotional. And most pertinent here: As we age, we lose our value.
Labeling us based on our age also perpetuates this untenable, unrealistic vision of what a perfect woman is supposed to be and do with her life and her body (a target that is ever changing). If we get pregnant when we're too young we're taboo, if we get pregnant when we're older we're elderly, if we get pregnant when we're single we're ostracized, if we get pregnant by surprise we 'made a mistake,' and on and on and on.
The message has been one of perpetually shaming women for their bodies. The irony of it is that women's bodies are the most powerful things on this earth.
And so to all the women with bodies, here is my note to you:
You are a human being living a human life—that means that you are comprised of any number of variables—your age, your weight, your DNA and a thousand other details that make you YOU. Those details don't define you, they are simply a part of you. When you are pregnant, your provider should take care of you, the pregnant human being in front of them, and not the label they have given you.
I also want you to know that some of the most beautiful, empowered births that I have had the honor of attending have belonged to women 35 and older. It is extremely possible to have a healthy pregnancy and birth. And once that baby comes, I promise that you will have the energy and stamina to chase and raise them.
So here is to all the
elderly geriatric strong, wise and amazing mamas out there. You've (totally) got this.