What I Thought I Knew: A Memoir Read Online Free PDF

insurance company for a referral. I’m afraid there’s nothing else I can do for you. It’s outrageous that your gynecologist did an internal exam when you were five months pregnant. Just unbelievable! Have you spoken to her? I think you should call her. It’s an outrage.”

    “Robin, I was five months pregnant when you examined me.”
    “You weren’t five months pregnant!”
    “You did an internal exam on me six weeks ago. And I just found out Friday—through an emergency CAT scan—that I’m six-and-a-half-months pregnant.”
    “Oh . . . Alice . . . I’m so sorry.”
     
     
    “I’d like a referral for a high-risk obstetrician,” I said to the Oxford telephone agent.
    “What is the nature of the risk?”
    “There are several. I’m forty-four years old, I’m six months pregnant, and I’ve had no prenatal care.”
    “What is the pregnancy risk?”
    “Um . . . advanced maternal age?”
    “Just a moment, please. . . . That’s not a risk factor.”
    “Yes, it is.”
    “There’s no code number for it, so it’s not considered a risk factor.”
    “That’s ridiculous!”
    “We don’t have an age policy regarding high-risk ob-gyn treatment. You said there were other risk factors?”
    “OK. I’m a DES daughter—Di-ethyl-stilbestrol. Because of my DES exposure in utero, my cervix is likely to dilate early, resulting in premature delivery.”
    “Just a moment, please. . . . There’s no code number for DES.”
    “There’s no code for DES, because DES daughters are too old to have babies!”
    “Are there any other risk factors, Ms. Cohen?”
    “Yes. I have a deformed uterus. That has to be on your list. A small, deformed, two-horned, bicornuate uterus.”
    “Could you spell that?”
    “B-i-c-o-r-n-u-a-t-e.”
    “Just a moment, please. . . . There’s no code for that.”
    “Please listen for a minute. I’m forty-four years old; I’ve had no prenatal care for six months; I’ve been given hormones that are dangerous for the fetus every day of the pregnancy; my cervix is likely to dilate early; I have a deformed uterus; and I’ve been told I can’t carry a baby past six months, which was two weeks ago.”
    “According to our codes, none of these qualify you for high-risk obstetric care. Is there anything else I can help you with today, Ms. Cohen?”
     
     
    My sister Madeline came to the rescue with a referral for her friend’s high-risk ob-gyn. Dr. Slotkin agreed to see me, though he didn’t accept Oxford, so I’d have to pay out-of-pocket.
    “Yes, I’m very familiar with DES daughters. If I’d seen you earlier in your pregnancy, I would have put a stitch in your cervix to keep it from dilating, but it’s too late for that. If I put a stitch in now, it would probably cause your cervix to dilate, and that’s exactly what we don’t want. I’d like you to take it easy, Alice, really limit your physical activity.”
    “Can we do an amnio?”
    “Well . . . since it’s too late for an abortion, amniocentesis is pointless, and there is a slight risk involved in the procedure. However, if there is a serious genetic defect—amnio only tests for a few genetic disorders: Down syndrome, cystic fibrosis, the big ones—it might be legal to have a late-term abortion.”
    I shocked myself by wishing for a serious genetic defect so that I could have an abortion and get on with my life. “I want to do amnio right away.”
    He hesitated, then told me a story. “My big brother has Down syndrome. My parents’ lives were turned upside down by the relentless demands of raising Howard. He lives in a state institution now. I don’t know if he’s ever been happy, it’s so hard to tell. . . . Given your advanced maternal age, Alice, you’re at greatly increased risk of genetic defect. I understand why you want amnio, and why you would choose an abortion. I won’t judge you, if this is how it plays out. But let’s hope the baby is healthy.”
    It pinched when the doctor drew amniotic fluid