ADVANCED MATERNAL AGE

 There is a demographic shift towards later childbearing, and it has become a major health concern. There are numerous associations between advanced maternal age and pregnancy complications. Many women are focusing on their careers and by the time they are on the right path they might have some time to deal with the harsh dating world to find the right man. I was extremely career-oriented in my twenties and felt like I could survive without a child. All I wanted was to be financially independent and not rely on any man to feed me. I immigrated in my late twenties and by the time I was settled in a specialization program, I was about 33 years old. By then I really wanted to settle and have a family. I got married at 35 years old and had a baby at the age of 37.

Women over 35 have decreased fertility which means it may take them a longer time to fall pregnant. They have higher rates of pregnancy failure, miscarriage, and ectopic pregnancy. This is mainly attributed to a progressive decrease in oocyte numbers and their quality. With all this, we also have an increased risk of chromosomal abnormalities such as trisomy 21(down syndrome), trisomy 13, and 18.

Older women are more likely to enter pregnancy with pre-existing hypertension which can cause morbidity in mom and fetus. Gestational hypertension and pre-eclampsia are also more common in this age group, especially if the women are primigravida, having the baby with a new partner or the spacing of the pregnancy is more than seven years. The guidelines suggest that women of advanced maternal age are screened for gestational diabetes at 24 weeks with the oral glucose tolerance test. It is important to counsel women with gestational diabetes and hypertension that even if the blood pressure and the blood sugar are within the normal range six weeks post-partum, they are at increased risk of becoming hypertensive or diabetic in the next five to ten years and they have to keep an eye on it.

The reasons for the underlying trend of older mothers are complex, but decisions about the timing of childbearing may often be dictated by factors beyond the women’s control. Despite all the various evidence for an overall increase in poor outcomes, the absolute numbers experiencing complications are small and most women over 35 have a straightforward pregnancy and birth. At present, there are no effective strategies to reduce the incidence of adverse outcomes such as stillbirth.

 

 

 

 

MY BABY IS TURNING TWO

 I wasn’t always sure if I wanted to be a mom. Now that I have a daughter, I am enjoying every minute of it. There are difficult moments here and there. Some nights when we have a sick child and haven't slept the whole night and still show up at work the next day. Weekends are crazy with a toddler, by the time I am up and showered and dressed baby and myself and prepared breakfast, I feel exhausted and still have a long day ahead.  It has been an overwhelming journey for me and my husband, from trying to conceive to pregnancy loss and all the way to having a happy and healthy girl!

She has been amazing through these two years. She is growing well and is above the growth chart for her age. Her milestones have been reasonable. She atrted sitting at around eight months and started walking around 15 months. She follows instructions. She is still not very vocal and only says a few words. It may be due to the bilingual atmosphere in the household. She enjoys watching Cocomelon, stealing our phones and playing with them, running in the open and splashing in the swimming pool, or playing with the other kids and she is starting to show interest in books. Her favourite books are Peppa Pig stories and the ones with pictures of farm animals. I love it when I set up her toys and books and she goes and grabs the book and starts paging through it.

She doesn’t like me and her daddy arguing, she hates separating from mommy, she doesn’t like her legs being covered with a blanket at night and recently she has no interest in food and loves to say no to everything.

She stays with my mother while I am at work. We are in the same complex and I drop her off every morning there is no stress and I pick her up whenever work is finished. I am planning to put her in crèche next year for three days per week. I think she might go through a hard time separating from me and adjusting to the new place, but in the end, it will be worth it because she can play, make friends, be more stimulated, and learn new skills.

 

 

 

 

 

GRATITUDE

 The day-to-day life may seem boring with the same routine of waking up and going to work. The demanding workplace, and the usual problems, the traffic, back home is the cooking dinner, bathing the baby, and putting her to sleep. We might think that we are not making much progress in life, but there are times when I actually have the time to sit back and reflect on my life journey and I realize that I have come a long way. This happened the other day when I was shortlisting doctors for a medical officer post in our hospital. I realized I was in the job hunting position just a few years ago trying to write my exams and get into the specialisation program.

I have come a long way and tried to enjoy the journey and have fun. The job market for doctors has become very competitive. It is hard to believe that thousands of doctors in South Africa struggle to find a government job after they finish their community service. One of them actually made a touching video on social media to make people aware of the doctor unemployment crisis. A couple of our registrars who also finished specializing are going to be without a job until they figure something out.

As humans, our brain tends to drift towards negativity. We tend to spend a lot of time thinking about the things we don’t have and not wanting what we already have. I was listening to a program where Oprah Winfrey was talking about happiness in life. She pointed out that, during challenging times in her life, she often sits down and starts writing in her gratitude journal. And the one time she wrote seventy-two things that she is grateful about.

I know my workplace is not without problems but I am truly grateful that I have a full-time job that is meaningful and I can support my family. I know I still need more experience regarding surgical procedures, or I still want to do a fellowship but I am happy I have come all this far and specialized in the first place! And I love my job!

This is me about 20 years ago when I just started medical school, preparing for one of my exams. the photographer was my brother running around the house with his new digital camera and capturing every moment