Pregnant at 48! Are you mad?

When Margaret missed her period, she did not even notice.  After all she was 48 and would soon hit menopause; it was not uncommon to see minimal amounts of blood for some days, but as Rebecca Nalunga writes, her ordeal was just beginning. 

 

Margaret had stopped counting and was already eagerly planning to redecorate her soon-to-be empty nest: her two sons were at university, the eldest in his final year, the other in his first. 

 

In the next month she developed a feverish feeling, a shy cold that disappeared with sunrise and she just could not stand the smell of detergent. When the fever persisted she went to a clinic in the neighborhood for a malaria test. 

 

“The doctor sat across from me, an uncertain smile on his lips and proudly announced: ‘You are pregnant!’

Her first reaction was a blank stare and then a hysterical laugh. “Surely he had given me some other person’s results,” she reasoned. “I looked around the room, its white walls were closing in on me and I felt I could not breathe. As the doctor assured me that the results were indeed mine, he passed me the slip and there across the top was my name neatly written out,” she narrates.

 

The drive home with all the loud hooting of impatient motorists could not quiet the thoughts that ran through her head. How was she going to tell her husband? Her friends? Pregnant? Me? Really? No!

 

She looked at the antenatal card and the pack of prenatal vitamins she had been given to start on immediately and she broke down and cried. Awaiting her husbands’ return, she did not bother looking at the ledger book the housemaid brought in from her boutique to check the day’s sales. 

 

Almost alone

“When I told my husband I was pregnant, he went numb. For three days, he did not speak to me, bypassing me in the house as if I did not exist.

 

I was confused, crying myself to sleep almost every night for a week,” she narrates, her gaze directed towards the polished wooden floor of her plush living room. When Anthony did speak, he blamed her for being careless. How could she have done something as stupid as conceive at that age? Why hadn’t she taken the necessary precautions? Why burden him when he had just retired at 54 to enjoy his farming? 

 

“I apologised to him, kept quiet and decided to soldier on. I found myself a good gynaecologist and began antenatal classes. My stepchildren, who were way older than my own, joined their father in shunning me. Only my two sons were there for me, often driving me to my doctor’s appointments,” she recalls. 

 

Her group of friends with whom she used to meet and socialise scolded her for embarrassing them, with some secretly expressing doubt that her husband was responsible for the pregnancy. She cut them off, rarely left the house and slowly began to prepare a nursery for the baby. 

 

It was painful

Margaret’s pregnancy was characterised by frequent visits to the doctor because she developed severe back and joint aches. After an agonising nine months, she gave birth to a bouncing baby boy, Jonathan, by caesarean section.

 

“The labour was long and much more painful than I remembered it to be. My husband came to the hospital, but only for a few minutes and left. With my sons at school, I only had my sister to lean on,” she continues. 

 

The first few months were hell. Looking after the baby was difficult, but with the cold attitude at home, it was even worse. “When Jonathan cried, my husband scolded me and soon banished me to the guest room with ‘my son’ because ‘some other people, unlike me, had to wake up early to go to work’.”

 

Being a mother late in life was exhausting. Margaret could not cope with Jonathan’s toddler energy, but her elder sons were besotted with him, always buying ill-fitting clothes, toy guns and cars whenever they visited. They played with, bathed and fed him to give their overwhelmed mother a much needed break.

 

Margaret did not breastfeed long because after just two months the breast milk run out. She switched to formula feeds and then to solid foods at six months. 

 

As her baby grew, the love returned. 

“When Jonathan was about six years old, independent and ready for primary school my husband took him to school. I wept tears of joy and from then on, my baby was the darling of the family.

 

My husband wanted to go out and play with him, take him to the beach or to the swimming pool and always insisted on picking him up from school despite the fact that I had a driver and three vehicles at my disposal,” she gently laughs, her gentle smile belying her enduring spirit.

 

Today, Jonathan is in his second year at university and is his parents’ pride. “I cannot describe the love and joy seeing Jonathan gives me. He is a sweet child who has my determination and traits of his father,” Margaret says, a look of contentment on her face, as she scrolls through her phone, showing me photos of a  tall young light-skinned man in shorts at the beach. 

 

She compares raising a child to driving a car: “If you have driven one before, no matter how long you take without practice, it all comes back to you when you sit behind the wheel.”

According to Dr. Keith Mugarura, the health team leader at Compassion International, Uganda, the average age for menopause ranges between 45 and 55 years. “Some women begin early, others begin late that is why a range is provided. Margaret is an example of those who may start late,” he explains. 

 

Pregnancy generally comes with many risks and complications, but they are higher if the mother is above 45.

 

He adds that conception at a late age predisposes a woman to diabetes, kidney problems and cardiovascular risks as well as musculoskeletal strain due to increase in weight exerted on the bones. The woman may give birth naturally, especially if she has other children, but warns that the labour might be long or it might be an assisted delivery where gadgets are used to pull out the baby.

 

According to Mugarura, chances of having an abnormal baby are higher in women above the age of 45. For instance, one in every 30 cases may deliver a child with Down’s Syndrome as compared to one in every 500 cases for women in their 20’s.  

Dangerous conditions like pre-eclampsia (high blood pressure) may develop after 20 weeks, presenting with blurred vision, headaches and stomach ache. But sometimes these signs are absent. 

 

Heavy bleeding in the first two months of the pregnancy may indicate a miscarriage or an ectopic pregnancy where the foetus grows in the fallopian tube. If unchecked it can be fatal. Late term bleeding during the last months is also not a good sign.

 

Mugarura advises that immediately a woman discovers she is pregnant she should seek the services of a gynaecologist for close monitoring and to make a birth plan.

I remember spending a lot of time with my mother as I was growing up. I rarely saw my father, but my elder brothers are my best friends. I felt like an only child, had my own bedroom, television, spotted the latest fashion.

 

I had everything I wanted. I played alone when my parents were away, teaching myself computer applications and the latest video games.

 

Dad and I had our special weekends, playing squash and badminton. My friends’ parents in secondary school looked a lot younger than mine, but thankfully dad has a firm body that quite conceals his age.

 

However, the keen students thought they were my grandparents. It was odd, but having been to boys-only boarding schools all my life, they do not dwell on such trivialities.

 

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According to Jean Nuwagaba, a counsellor at Kyambogo University, parenting depends on how ready one is, no matter how old they are. 

 

“Late fatherhood can bring with it a lot of joy and compassion for the new born because such a man has experienced the love of a child before,” she says.

 

The way a man receives the news that his elderly wife is pregnant depends on how rigid he is. 

Late fatherhood sets off fears of whether or not his wife will make it through childbirth, whether or not he will be able to provide for the child or if the child will even make it through delivery alive. However, when the experience is successful, he usually comes around.

 

The woman, too will be surprised by the discovery that she is expecting and then have to deal with the fear of the unknown, based on her physical incapabilities to go through childbirth safely and the demands of a newborn at an advanced age. To overcome this, Nuwagaba advises that; the couple accepts the extraordinary position in which they find themselves with a positive attitude, as negative emotions trigger stress hormones in the mother. “If a mother is unhappy during a pregnancy she will give birth to a child who is irritable and not easy to soothe,” she explains.

 

It will greatly help to allay the couple’s fear if they attend antenatal sessions together and be reassured of the health of the mother and the baby.

 

Talking to a counsellor will arrest fears of the unknown.

 

They should continue being active on the social scene, as isolation breeds feelings of self-pity.

 

Attending a fellowship will provide spiritual nourishment for the parents and they will come to realise that every child is a gift from God.

 

“When the child is born, their first playmate and caretaker is the mother. From them they receive attachment and it prepares the child socially. However, just because a child is born with a big age gap between his siblings does not mean he cannot socialise with neighbourhood children and relatives within the same age group,” Nuwagaba says. The child can also be taken to a day care when they are of age to learn more about social skills.