Tuesday, December 3, 2013

My Aged Uterus


In January 1996, 17 years and 11 months ago, I was living with my grandparents for the second time in 6 months. My mother had a hysterectomy earlier that year because of pretty serious cramping and bleeding she had with endometriosis and large uterine fibroids.

When my mother told me, I was saddened by the finality of never having that little sister I wanted. Because my father continued working five days a week, my 8-year-old brother and I lived with my grandparents for the summer. It would be the last summer that my grandparents did not have air conditioning. It was installed in the days before we returned home. It was also the summer of the OJ Simpson trial, and we spent many of those sweaty Midwestern summer days lying on the floor in front of the television, low enough so our grandparents could see the trial. It was also the summer we introduced our grandparents to Rugrats.

I returned to the fifth grade just to end up going back to Flint that winter of 1994-95. They took her uterus and cervix but not her ovaries, and one of them had enlarged, concerning for cancer. When my mother told me, I was devastated, crying with the fear of losing her. My father continued working, so back to our grandparents it was. I completed weekly assignments from my public school down in Ypsilanti at my aunt's Islamic School in Flint. I wouldn't have to repeat the fifth grade for my missed days, my mother assured me.

I remember that winter. I called it the tundra winter because it was cold and barely snowed. Temperatures did not venture above 20 Fahrenheit for most of the summer. I remember the cold between my grandparents' house and Grandfather's conversion van, from the van to the school, from the school to the van, and back again. The pathology came back on my mother's ovary and it wasn't cancer. It was a chocolate cyst, a large focus of endometriosis that grew and caused her ovary to torse. My mother, who had opted to keep her ovaries in order to maintain her normal hormones, went into surgical menopause at the age of 41.

A week or so later, I was playing in the TV room of my grandparents' house when I felt a sudden trickle. I went to the bathroom and pulled down my panties to see little spots of brown in the bottom. I knew what a period was. My mother taught me about it when she pulled me out of maturation class in the fourth grade, wanting to present me sex "in the context of God" but still being too afraid to talk about intercourse with me. I knew what a period was because that's what happened to Mommy sometimes on family trips when she'd have to sit on a towel in the car and when she was writhing in pain and vomiting. It was the pads in the bathroom and the smell. This was a little bit of brown. I was confused.

I called Grandmother and asked her what it was. I can't remember her words, but she confirmed my suspicions with a groan, turning her eyes towards the ceiling with a look of "Lord help us, another one fertile!" It was my period!

She gave me a pad and clean panties, and I scurried off to play, excited that I was, like Clair Huxtable told Rudy, "a woman now."

...and then, the next day, I got my first cramps, and it was no longer fun.

My mother lost her ability to ovulate, and I gained mine. My mother lost her ability to bear children as I began my journey to be able to bear my own. I was 10 years old.

Now, 17 years and 11 months later, I am 28 years old. My ovaries have ovulated and my uterus has shed for over 200 cycles. It's coming up on 18 years of menstruation and I'm over halfway done with my reproductive years and the best ones have already passed me by. And I wonder...what was the use of starting to menstruate when I was 10 years old?

I thought about this after reflecting on the teenage girls whose babies I've delivered over times. These girls usually have short labors, breathing well through their contractions and tolerating them without epidurals and then proceed to push their babies out in less than an hour of pushing. And these are first babies, the babies it can take up to two hours to push out. I once had a patient come in at five centimeter dilated, get pushed back to labor and delivery, progress 10 minutes after my exam to complete, and pushed the baby out in one contraction, three pushes.

Sitting next to one of our interns, we reflected on this. "I hate to admit it, but there's something about the teenage body that is made for having babies. It's like, they're not mentally or emotionally ready, but their bodies are ready."

I said, "Maybe that's why we developed patriarchal societies. Because we best reproduce when we are teenage women and therefore need the extra support and protection from men."

She nodded. "You're probably right." After some thought, she said, "You know, I don't know why we haven't yet evolved so that our optimum reproductive years are after we, you know, get ourselves settled, get an education, figure out what we want in life..."

The fact of the matter remains that I am a female physician who completed medical and graduate school at 27, only now have begun to have reasonable marriage prospects, and I have had the ability to bear children for the last 18 years. My reproductive system is old and unused. It will not be as easy for me to get pregnant as it may have been for me 8-10 years ago, when I was in my reproductive prime. The tissue of my cervix is not as pliable and may not dilate as efficiently. My body has been so used to being in the non-pregnant conformation for so long, its no telling if my hips will open wide enough for a large baby head.

My mother had me at 30. My head was too big for her pelvis and she could not push me out. She went to c-section for cephalopelvic disproportion. My head was so big, the pediatrician had to measure it twice. I am going to have a large-headed baby, hehe.

When I was 13 years old, three years into menstruation and already in love with an age-mate of mine, I imagined us getting married. We would get married and have our first baby when I was 20. That baby would be a boy and he would be a junior. We were going to live in Detroit in a brick, one-story house. I was going to call 9-11 and deliver at home and he was going to be my miracle baby, just like this 13-year-old boy was a miracle in my life.

At the same time, I scoffed at the girls in my class who wanted to be teenage mothers, like their moms. At least my aspirations weren't so ridiculous.

I would move away from that boy, never letting him know how I felt, and I would not be having a child at 20. Or 25. And maybe not at 30.

In the end, I don't mourn my lost reproductive time. Instead, I celebrate my privilege, my ability to choose my partner, my ability to attain my education and ability to wait for a time of more security for whoever my baby beans will be. And although at times I feel like that business is atrophying...insha'Allah, it keeps working into your 40s, less efficiently, sometimes making mistakes, but it keeps working. Insha'Allah, I'll have time.

...but 18 years of being able to reproduce is a long time and makes me feel old. Makes my uterus and ovaries feel old. That's 18 years of nausea and vomit inducing cramps. That's 18 years of overdosing on ibuprofen to try not to stay in bed all day in fetal position. That's 18 years of trying not to ruin clothes.

Oh my aged uterus, why do you torment me so?


  1. I started my period when I was 13 years old, I haven't quite reached 11 years yet. Its interesting your observations with teenage mothers, I've always associated teenage births with VVF perhaps due to the documentaries I've watched on child marriages.

    According to the grandmother's periods didn't come so early in the past. In most West African cultures, women got married after their first periods, due to my lack of understanding I imagined there must have been lots of child brides, but apparently the average age when a woman got her first period back in the day was 18.

    1. This is true. Time of menstruation does vary by population. I honestly think I was so young because I was an overweight kid. But menstruation at 18...oh how life would be so different!

      Few births in the US are associated with VVF, including teen births. These are older teens anyway. I have not delivered with a teen mom younger than 15. And, none of the teen pregnancies I see here are the result of child marriages, but sexually active teenagers with their teenage boyfriends, usually. All around a less traumatic thing.