Emily felt as nervous as a child on her first day at school as she sat on the bed in the obstetrician's office, swinging her legs beneath her. Daniel looked just as much out of his depth as he sat in the hard plastic seat beside her. There were framed medical certificates on the mint green walls, colorful posters showing the different phases of pregnancy, and the unpleasant smell of antiseptic lingering in the air. Emily realized she was going to have to get used to this environment. Over the next few months, she'd be smelling a whole lot of antiseptic!
The door swung open and in walked the doctor, Rose Arkwright. On first impressions, Emily thought she was dressed very smartly, more like an attorney than a doctor. It was really only the comfortably flat shoes, the white doctor coat, and the stethoscope around her neck that gave her away.
She smiled at them both as she placed her clipboard down beside her computer and took a seat at the desk.
"Mr. and Mrs. Morey?" she asked, addressing them both. "Firstly, may I say congratulations."
She had a warm smile, Emily noted, and she shook each of their hands with a firm, confident grip. Emily got the distinct impression that Doctor Arkwright was an intelligent, no-nonsense kind of person. She felt like she was in very safe hands.
"Thank you," Daniel said, smiling shyly. "We're over the moon."
Emily was glad to hear him say as such. She wasn't entirely sure how he felt since he'd seemed a mixture of shocked and stressed yesterday.
"Shall we get right to it?" Doctor Arkwright said. She flipped over the first piece of paper and looked at Emily. "I'm afraid I'm going to have to take a lot of detailed notes to begin with. Forms, forms, and more forms."
"No problem," Emily said. "Fire away."
"The first thing we need to determine of course is how far along you are. Are your periods usually regular?"
Emily nodded. "My last one was just before our wedding. So it's been about eight weeks."
"So this might be a honeymoon baby?" Doctor Arkwright said with a smile. "How romantic."
Emily blushed.
Doctor Arkwright continued. "The way we work out the due date is to initially take it to be thirty-eighty to forty-two weeks after the end of the last period. So currently we're looking at December eleventh."
Emily and Daniel looked at each other, their eyes wide. So close to Christmas!
"Then when you have your first sonogram and the baby is measured that can be adjusted slightly," the doctor added. "Can you tell me what symptoms of pregnancy you've been having and how long for?"
"She was feeling nauseous and faint," Daniel explained. "From right after the wedding really, wasn't it?" He looked over at Emily for confirmation.
"I thought it was stress," she said. "There was a lot going on in our lives at that point of time."
Doctor Arkwright nodded. "They're the two most common symptoms to have early on. And often confused with stress. No fainting, though? Just feeling woozy?"
"Yes," Emily said.
Doctor Arkwright took notes as she spoke. "Good. It's not dangerous to the baby if you do faint because it's too small at the moment and in a protective sac of fluid. But for you it can obviously be a bit distressing, particularly if you hit something on the way down. Keep an eye on that going forward. It's likely to resolve over the next few weeks but for some women the symptoms do persist. If you're naturally prone to low blood pressure it could continue into the second trimester. So make sure you take it easy. Stand up slowly. Eat regularly. Best to keep a banana in your purse. And a bag of nuts."
"Sure thing," Emily said, nodding, already starting to feel a little overwhelmed. She wished she was taking notes and hoped Daniel was committing to memory all the things she was too overwhelmed to absorb.
"Right, shall we take a look at you?" Doctor Arkwright said, standing.
Emily swung her legs round so she was lying flat on the bed. Daniel stood and hovered beside her. Doctor Arkwright put on some latex gloves.
"I feel like I've been abducted by aliens," Emily said, peering up at her audience.
Daniel laughed.
"Yes, you'll be prodded and poked more in the next few months than ever before in your life," Doctor Arkwright said. "By the end you'll have no qualms about stripping off in front of people. Body hang-ups go completely out the window."
"I look forward to that time," Emily said, feeling her cheeks warming with a blush.
Doctor Arkwright checked Emily's pelvis and abdomen, her hip rotations, and general joint flexibility. She moved her fingers deftly, checking almost every inch of Emily's body. Emily felt she was a lump of dough being kneaded.
"I'll order some blood tests," the doctor explained as she worked. "So we know your type and Rh status. We'll also check for anemia, certain antibodies, and make sure you're immune to all the big viruses like chickenpox, rubella, hepatitis."
Blood tests weren't exactly Emily's favorite things in the world. The thought of having so many tests made her feel increasingly anxious.
"This is your first pregnancy, isn't it, Mrs. Morey?" the doctor asked as she placed a cold stethoscope against Emily's chest.
Emily nodded. "Yes."
"Any prior gynecological problems? Abnormal pap results? Sexually transmitted infections? Anything like that?"
Emily shook her head and wondered whether it would have been better for Daniel not to have come along to this particular appointment. She'd naively thought such delicate questions wouldn't be asked immediately. She was going to have to get used to revealing everything about her body now. Nothing would be off limits!
Doctor Arkwright removed her stethoscope and slung it back around her neck again.
"Now, because of your advanced maternal age," she explained, her attention drawn back to Emily's abdomen, "it's a little more important for you to take the right vitamins, sleep enough, reduce your stress levels to the absolute minimum. They're all things we would recommend to expectant mothers whatever their age, but for you it's that extra bit important."
"Should we be worried?" Daniel asked. "About Emily's age?"
Emily frowned up at him. With her stomach on display and the both of them looking down at her like a specimen it made her feel vulnerable and somewhat at their mercy. She could cope with the doctor referring to her age, but not Daniel!
Doctor Arkwright looked at Daniel briefly and shook her head. "It's far more common for women to leave starting a family until their late thirties these days and the medical world is catching up. It's not as much an issue as it used to be. Really the main hurdle is fertility, which clearly isn't a problem in this case. There is a marginally higher risk of gestational diabetes, blood pressure problems, premature birth. But you're in safe hands."
Emily certainly felt like she was in safe hands. She just wished there wasn't so much testing to be done. It all felt a bit impersonal. Clinical. She didn't like just feeling like a baby-making vessel and would be very glad when this initial assessment was over and done with.
Doctor Arkwright peeled off her gloves. "All done. You're in good shape, so nothing of concern there. Please, take a seat and we'll have a quick look at your medical history."
Emily sat up and gave Daniel a weak smile, not quite ready to forgive him for his comments on her advanced age. She rearranged her clothes and slid her shoes back on, then took a seat. Doctor Arkwright washed her hands and then came and sat in her chair, spinning toward her computer. She took a moment to read the screen.
"You have a good clean bill of health," she said, looking through the data. "Scarlet fever in childhood with no lingering aftereffects. Non-smoker, which pleases me greatly. No particular health conditions. Nothing chronic. No ongoing medication use. A slightly higher alcohol rate than I'd like to see, but you'll be completely quitting that for the next few months anyhoo." She spun back around and looked at Emily.
"We're both quitting," Emily said.
"I didn't think it would be fair otherwise," Daniel said. "Especially since we own a bar with a cocktail waiter who's second to none!"
Doctor Arkwright smiled. Then she laid her forearms against the table and looked across at Emily, her expression serious.
"Now, this might be a little bit of a delicate thing to discuss, but I couldn't help noticing that on your registration forms you ticked the box of family history of mental health problems. If you're comfortable to do so, I'd like you to tell me a little bit more about that history. It's entirely for your benefit, no one's judging here, it's just to make sure we're keeping an eye on the right sort of things while your hormones are changing throughout the pregnancy."
Emily clasped her hands in her lap, feeling instantly uncomfortable. Talking about her chaotic upbringing was her least favorite thing to do, especially to a stranger, even if that stranger was a doctor who'd probably heard it all before and just wanted to help.
Daniel reached over and touched Emily's hand for reassurance. Buoyed by his presence, Emily took a deep breath.
"My father went through a long, long period of depression," Emily said finally, her voice sounding thin. "For dozens of years. It was following my sister's death."
Doctor Arkwright nodded and kept her face neutral as she wrote the information onto her form. "And your mother?"
"My mother?" Emily shook her head. "I don't even know what's wrong with her to be honest with you. It could be something psychiatric. But then again she might just be a difficult person."
"She's not been assessed or diagnosed with anything?"
Emily shook her head. She was feeling very uncomfortable now. Talking about this stuff always made her feel a bit panicky. But Doctor Arkwright added the information to her forms, acting in no way as if Emily's admission was anything to worry about.
"And what about yourself?" she said, gently. "Did you ever experience any problems growing up?"
Emily shrugged. "I don't think so. I mean, I was devastated after Charlotte died. And after my dad…" She stopped speaking to collect her thoughts. After a breath, she started again. "There have been some really trying times in my life. I don't know how well I dealt with them at the time. It took me years to even deal with it all. Then when I started, it came back to me in sort of scary flashbacks."
Daniel's thumb stroked the top of her hand where it was resting. "She would zone out occasionally," he added. "Sort of space out. But it happens a lot less now."
Doctor Arkwright remained very professional as they spoke, absorbing Emily's admissions with nothing more than a sympathetic nod of the head. "It sounds like you may have been experiencing some mild PTSD symptoms," she said.
Emily felt alarmed. It sounded so dramatic. For her, it had just been something she'd gone through, some kind of natural outcome to touching on the memories she'd closed off for so many years.
"Please, don't worry," the doctor reassured her. "It's far more common than people believe, particularly when trauma happens in childhood. When we don't have the language to express our emotions or even label them properly, repression becomes a natural defense mechanism. The important thing to note now is that you may be at a slightly higher risk of pre-or postnatal depression or psychosis. Again, it sounds dramatic but it's very well treated these days, through counseling and medication if necessary. As long as we keep an eye on your symptoms there's absolutely nothing to worry about."
Emily nodded and let out her breath. Doctor Arkwright was very reassuring, but at the same time she felt a sense of unpleasant anticipation for what might be in store for her. These things were never talked of. Not amongst her friends, nor her mother's generation. She couldn't help but feel worried about having a higher chance of experiencing something that was so poorly understood.
Doctor Arkwright smiled and handed a glossy folded slip of paper to Emily. "Here's a pamphlet that details nutrition, vitamins, exercise, travel do's and don'ts, et cetera. Take some time to read it and let me know if you have any questions when we next meet. I'll also give you a prescription for prenatal vitamins, which are very important. We'll book a sonogram for four weeks' time, so you can see your baby."
She turned to the computer and logged in an appointment for a scan. Then she turned back. "That's it for now. I promise the follow-ups won't take quite so long."
She stood and offered her hand to Emily to shake. Emily stood and shook the doctor's hand, and Daniel did the same. It felt like the appointment had gone so quickly and was over in a blur, though they'd been there for such a long time. Emily had no idea how much of what she'd just heard she'd managed to absorb. It felt like basically nothing.
They left the doctor's office and walked together out into the bright day.
"Did you take any of that in?" Emily asked Daniel as they strolled to where the car was parked.
"Not really," he confessed. "There was just so much information."
As they walked, Emily studied his face. He looked stressed and she wondered which bit of the appointment specifically had worried him the most. Her age-related health concerns? Her possibly elevated risk of postnatal depression? Or just the fact that he hadn't committed every single one of the doctor's words to memory?
"It's all in the pamphlet," she reassured him. "We can read it over and over again. Every night before bed, if you want."
She laughed, trying to lighten the mood. Though Daniel nodded, he still looked tense, his gaze somewhat far away. Emily wanted to ask him what was going through his mind, to find out what the issue was for certain, but he seemed to have shut down.
She felt her own excitement begin to fade away as a result. Daniel's attitude seemed to be becoming more at odds with her own. She couldn't see even the smallest flicker of excitement in his eyes. It was just concern, worry, and stress that she saw in his expression.
They got into the truck and drove home in silence.
