Another Baby at 38: Sorting Through my Big Feelings

As an older mom and a fertility specialist, I really wish getting pregnant was how they show it in the movies – lots and lots of sex and boom! A positive pregnancy test, and everyone is thrilled! But the reality for many, if not most, is quite a different picture.

A woman holding a pregnancy test displaying the text Not Pregnant. Obviously, for my aspiring single and LGBT parents, sex may or may not be happening but is irrelevant to the baby making plans. But even for many heterosexual women, the situation is not as simple. In light of U.S. society suddenly “realizing” – due to increasing visibility of infertility and miscarriage {large thanks to social media here!}, declining fertility rates, increasing average ages of first-time and all birthing moms, and the pandemic baby bust – that there are logistical barriers for even those who would like to have a baby, there have been a lot of recent articles trying to parse out what individual and societal choices would result in more pregnancies. The paternalistic authors wring their hands over what happens when women are out in the world, pursuing advanced education and working outside the home, while the pragmatic feminists point to how difficult working motherhood is, uniquely so here in the U.S. compared to similar countries. I could write a whole post about that latter point, but none of that gets to what happens on a personal level.

While pop culture has started to get somewhat more realistic about the #TTC process, I think many women are still shocked when they get there themselves. So, as an aspiring second-time mom in her late 30s, here’s how it goes down for the obsessive future planner, type A kind of gal {aka me}.

Before I get into it, I want to say that there are many for whom a first or subsequent biological child would be great, but who are also clear that they would be fine with alternatives – child-free or making peace with their current family size, adoption, fostering, and so forth. For others, the grief of not reaching their ideal family size is nearly unbearable. Both of these emotional places are equally valid to me, and to the World Health Organization, who acknowledged infertility as a disease in part because of the data-proven emotional suffering it can cause. In my current situation, I have spent a lot of time wondering where I sit on this spectrum – open-minded or dead-set on the vision of family I’ve always imagined. Frustratingly, probably more toward the latter. And, I know I’m not alone here, but my husband and I are not sitting on the same spot on this spectrum. Hence, I find myself needing to write this post for some catharsis before we actually even start to try – because I am reaching panic mode while a second child is a mere whisper of a thought for him.

So here’s the jumble of thoughts I’m working through. Maybe it will help another mama feel less alone!

Assuming there will be another pregnancy:

There were many aspects of pregnancy and the postpartum that I just assumed I would get to experience again, or to have a do-over. Breastfeeding is a big one. It was tough for me, and I exclusively pumped for my daughter, while finding myself believing that “next time I would get it right”. Sometimes, no matter how okay {or not} you are with being done family-building, you might find yourself mourning certain parts of the process.

Feeling scared:

Risks go up, and pregnancy rates go down as we get older. We all know that to some extent, but many are unaware that trying for pregnancy by age 40 probably carries about a 5-10% chance of pregnancy/month, with a 20-25% chance of miscarriage if you conceive. Wondering what can happen, what your options might be in those moments, and how you – and your marriage – will be able to handle it are all common concerns. I find this one so hard to navigate because there’s just no crystal ball – sometimes it all works out, and sometimes it just won’t.

The whole IVF world:

A big question for women in this context is how far they would go to build their families, and what resources they have. IVF, especially with genetic testing of embryos, can make a big difference for couples in this age range, but does not come cheap. Increasingly, I have patients recognizing this up front, who come in to to freeze eggs or embryos even before a first child, to try to preempt this concern. I froze my own eggs at 34 for this exact reason. Knowing that starting the fertility journey was getting late, largely for family circumstances out of our control, I wanted to help save myself some anxiety for the future. And truly, those frozen eggs have really brought me a great deal of peace of mind. But now as time ticks on, I find myself wondering:: what if those weren’t enough, what if I had to start over now, what if, what if, what if. The loss of control, and again that inability to know what will come, is endlessly anxiety-provoking for a future planner!

What if your kid were to be an only child:

We all come to adulthood with our own experiences – did we have siblings, what was our childhood like, do we get along with them now? Also, where do you live and what are the local trends {Houston is big on larger family sizes, a big shift from NYC, where we were before!}? But I think many people just have strong, deeply-held beliefs on what they envision for their family. You might know that the data says that there is no ideal family size for everyone, that only kids do great when loved, but if you always imagined your kid being part of a sibling duo or trio, it’s a hard pill to swallow. When I imagine my daughter sitting in the backseat by herself on a road trip, splashing around the pool or the beach without a built-in playmate like the one I had, I feel a deep sadness. Despite my time thinking about it, I am no closer to figuring out how to rewire my brain so I don’t choke up imagining these scenarios.

Fear of displacing my daughter:

A mother holding a young girl. And yet. I drafted this post on a plane with my daughter passed out in my lap, her breath hot against my chest. I felt guilty even imagining that another child could ever take this spot, even as I know she will continue to grow – bigger, more independent, needing more of her own space. Since my daughter entered toddlerhood and her presence became more all-encompassing, our pup already has his moments of being a jealous older fur-child. If I were to be pregnant, once he realized it or once the new baby arrived, would he feel anxiety or sadness at being further displaced? How would my daughter react? There does seem to be a bit of guilt, and perhaps insecurity, over how many times you can divide your love, your attention, your time. 

So, while I go round and round, wondering if and when my husband and I might be riding the same wavelength as far as this topic goes, what our journey will look like, and whether I’ll finally get to feel at peace with our family being done {because even I have no aspirations beyond one more healthy pregnancy!}, I know that I’m not alone in feeling the overwhelm of navigating this liminal space of pre-TTC. To those of you hanging out in this space also:: lots of love, grace and good luck. While I might not be doing a great job of convincing my own heart, my head knows this – whatever happens, it will definitely be okay.


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Another Baby at 38: Sorting through my Big feelings. A photograph of a woman holding a pregnancy test displaying the text Not Pregnant. Logo: Houston moms.

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Rashmi Kudesia
Rashmi Kudesia, MD MSc is a board-certified OB/GYN and Reproductive Endocrinology & Infertility specialist who is passionate about improving women's access to evidence-based, honest reproductive health information and care. Aside from her clinical practice seeing patients in Houston and Sugar Land, Rashmi frequently speaks at conferences and community events, and advocates for women's health via media interviews and social media. Originally a Midwesterner, she moved around the East Coast for school and training, including nearly a decade in NYC, where she met her husband, Ashish, a Houston native. After moving to Houston in 2018, she's continued searching for that perfect work-life balance as the family grew quickly, adding their first pup, Bowser {2018}, their first home, and now their first kiddo, Amara {2019}! Right now, she's learning the ropes of being a working mama, but still loves exploring Houston's amazing food scene, checking out the newest museum exhibits, or planning the family's next trip. She's always on the hunt for the city's best iced latte or glass of wine to be savored with a good book. Find her on Facebook and Instagram {@rkudesia}.


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