I went to the doctor with a pain in my head.
An ongoing headache.
She looked in my mouth twice, poking my tongue with an unsweetened paddlepop stick. I looked at the wall, lined with anti-obesity posters, as she took my blood pressure. I hoped she wasn’t going to ask me to weigh myself.
My blood pressure is perfect. I was sent home with a script and instructions to take paracetamol. Come back and see her if the headache deteriorates.
After her observations, she engaged in small talk.
“You still working at the Office?”
“No, I work for the Department now.”
“And things going well otherwise?”
“Yes, I got married in March.”
“Are you planning to have children?”
“We aren’t sure yet.”
“Well make sure you come to get a checkup, three months before you start trying.”
She glanced at my file. 34 years old.
And the small talk became big.
“Don’t leave it too late, there’s a strong risk your baby will be born with a disability.”
I just got married five minutes ago, and now babies are a common discussion topic. It’s been strangers asking nosily, but this time, it was a doctor because of her duty of care.
I smiled meekly, remaining silent. I hoped she’d stumbled across my work sometime. My writing on disability pride. Seen me speak, or perform. Spent time with my people.
But her head was probably in books about the medical model of disability. Diagnoses and grieving for a life lost.
I don’t even think she realised there’s a small chance of me passing on my genetic condition. Because no one seems to want a baby born with that other disability.
A baby could be born with any type of disability. And anyone could acquire a disability at anytime. It’s a life lottery.
And then I wished she had the perspective of disability that I do.
That disability isn’t a tragedy or a burden. Not a life sentence.
That can be a strong, positive part of identity.
That disability is not the worst thing that could happen.
And, did she forget that I too identify as having a disability?
Every woman of child bearing age must get this talk. Women with all sorts of perceptions about and exposure to disability.
I told my husband about the doctors appointment when he arrived home. Mentioned the headache, and we argued about the official term for a medical paddlepop stick. It’s a tongue depressor, he said. I told him about the family planning discussion. He groaned. He also knows disability isn’t the worst thing that could happen. And I loved him so much at that moment.
I just wanted to stop my headache. But now my heart aches from that brief discussion about the risk of having a baby with a disability. The discussion was not about fertility and how much time I have left to maximise my chances of conception. It was about disability.
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I speak from the point of view 1/ as a doctor and 2/ as a woman over the age of 35 trying for a baby.
A woman's fertility does decline from the mid-30's onwards. Many people don't appreciate this. GPs and fertility specialists deal with the consequences of this on a daily basis.
And it is probably true that, having a chronic illness, it might be harder for you to conceive and the pregnancy will be higher risk. This is true of all chronic diseases.
Yes, it might've been hard for you to swallow that discussion, and perhaps it might not been in a way you would have liked it, but she was making a valid point.
Also, we as doctors cannot not discuss things because there is a potential for offence (weight being a good example) – there has been legal action against doctors for not warning people of certain risk, so it seems they are damned if they do, and damned if they don't.
I can totally understand that the discussion might be grating and confronting for you, but it's still worth considering the point she was trying to make.
Have a great day and weekend.
I think it's super common for all women of a certain age with doctors- but that doesn't make it right.
It's definitely something that my sister was spoken to about every time she visited the dr after the age of about 32 as a single women without kids. I think a lot of doctors want to make sure that people realise that it does get harder to conceive with age, despite the raising first time maternal age. It is a real pity that was couched around "risk" of disability rather than fertility though.
When you said you weren't sure, the talk about coming to see her first should have been the end of the conversation. The model of not having kids is so hard for people to understand. I never had this experience. I guess everyone just assumed that I would not have any. funny. I guess the doctor cannot win. I judge them back for judging me.
as i read it, the issue at hand was Dr framed it in 'disability =bad' terms. fertility wasn't addressed, or if it was it was backhanded. You want to address risk? fine. Do it honestly, & fairly so informed choice can me made. 'Don't put it off' esp to a just married person is condesding at best
I totally agree with you that even though a person may not be born with an obvious problem they may develop or already have others. Asthma, short sightedness, a likelihood if developing diabetes, childhoid leukemia. The kust seems endless. Yet later pregnancies do increase the chances of more problems for your chils. No one would wish their child to be burdened with extra doctora visits, hospitalisations, medications. We all want our children to have as mych ease to grow to adulthood as possible. There are already so many other things they will have to deal wirh in life. You should not see the doctors talk as a put down for disabled people but as a wish to protect your child from extra problems in its life.
Take care of yourself Carly <3 It's been a realy hectic last 6 months. You need to breathe and let your whole body rest. As you've mentioned earlier your skin has not been at it's best last months – I personally think that rest is the key, or at least a bit of it. Love//Maria
I'll be reblogging this at some point on my blog – myzania15 at wordpress. I chose to go into Occupational Therapy for various reasons. I knew early on I wanted to work in Paediatrics. More and more, I realise that the things you talk about here – wishing that the health professional (doctor in this case) "had the perspective of disability that I[we] do" – those are my reasons. I have Dandy Walker Syndrome, which is a 1 in 30,000 births disability. I am mildly affected, so I know my experience is "light" compared to others. But. It's still experience.
Thanks for your perspective Claire. I am glad you chose this career so you can help people with true empathy.
I'd prefer it if you didn't reboot, rather just quote and create a link back please?
Sure!
I believe this is the same doctor who took my daughters driving licence away for months cause of dizziness for a while when standing! After months she saw a specialist in neurology even though problems been gone for ages . He called the doctor a twat & said she never should have taken it away at all!
Thank you Claire Keogh
You’ve ruined her life for nearly a year as she has been trapped at home with a baby & depression.
Avoid this doctor😡