Ovaries

When I’m lying flat, stretched out like a starfish on our king sized bed at night and trying to fall asleep in the cool dim of my bedroom, I imagine I can hear my ovaries crusting over, disintegrating, and blowing in a puff of breeze into the night sky. 

I beg my body for just a little more time. One more month. Maybe three. I’ll do the fertility yoga. I’ll drink the fertili-tea. I’ll get the acupuncture. I’ll take the acrid herbal “uterine health” capsules and pour the rest of my cold brew down the drain. 

At 43, I know that the pregnancy ship has almost certainly sailed. Part of me thinks I could swim out and catch it if I just tried a little harder. I could do the special diet and the supplements of dubious origin. I could lay face down on a table every week and get embroidered with acupuncture needles. I could get up every morning while my family sleeps and do the Yoga for Fertility DVDs. I could take my temperature before rolling out of bed each day and skim my cervix for “egg white consistency” mucus a few times each month. I could probably even get my husband on board with cringy, unsexy, hyper-scheduled sex. I did all of those things and more to conjure forth my daughter. I could do it again.

Photo by Alexander Grigorian on Pexels.com

I don’t really need to entertain this To Do list. The helpfully depressing charts and graphs on every fertility related website all tell me that at 43, I have a 10% chance of conceiving with my own eggs in any given month, and a 50% chance of miscarriage even if I do manage to find one good egg to meet up with one stalwart sperm. IVF at 43 offers similarly low odds of success. My chances are very, very slim. But my grandmother gave birth to her sixth baby when she was 44, so, for the record, geriatric pregnancy is not unprecedented in my family.

I have baby fever, so menopause must be just around the corner. My uterus is clawing at me from the inside in its last sputtering gasps for life, desperate for some assurance of her relevance and evergreen utility. She and I have our toes at the very edge of that fertility cliff, and we both know we’re about to be pushed off. My hormones conspire to wring one more baby out of me in panicky desperation. After years of pregnancy ambivalence, my abdomen cranks into a tight knot as I shove my cart through Target and see the moms with their buzzy broods. A ruffly lemon print onesie inflicts a stab of actual pain in my eyeballs. Every pregnant belly and every mom and baby stroller combo in the neighborhood feels like a personal insult.  

I’ve been almost perfectly content with one child for all six years of her life. The thought of another pregnancy or another screamy, sleepless new baby were not appealing to me at all, even if the idea of a sibling for my one kickass daughter has been pretty tempting. She is a brilliant bright light, and I’d love to give her a partner in crime, and someone to talk smack about her messed up parents with when she’s an adult.  

But another baby? I was pregnant three years ago and miscarried in the first trimester. We weren’t really trying – in that, I was not doing my To Do list of fertility-boosting semi-science or scheduling sex. Somehow, I got pregnant anyway! At 40! And was excited and terrified for about three weeks. When I realized I was miscarrying, I was 70% heartbroken and 30% relieved. I wasn’t most afraid of birth complications or genetic abnormalities or even the increased chance of multiples (I was definitely worried about those things, but vaguely). No, I was saliently terrified that I would gain weight with this second baby and I wouldn’t be able to lose it. When I imagined my post-40 postpartum, I saw the specter of a person who was bigger than I could emotionally or psychologically handle. 

When I lost that pregnancy and I admitted to myself that my fear of weight gain was bigger than my fear of much more dire health risks of “advanced maternal age”; that was my fat-phobic Come To Jesus moment. 

Mentally wrestling with the miscarriage and my warped view of my body and my deep, deep fear of weight gain was the catalyst for my first efforts towards body acceptance. It has not been fast or easy or linear work. I haven’t “arrived”. 

Bet here I am, three years later, ovaries crusting over, exerting real daily effort to appreciate the body that I have no matter what size my stretchy jeans. Today I feel ready to confront that fear of weight gain and just do the whole damn Get Pregnant thing, but it’s too late. If ever you need a cautionary tale for how internalized fat phobia can screw up your actual life, let me be your case study. This body has carried me through a lot, and I’m grateful. The body I have today – my real one, not an imaginary diet-culture-infused smaller one – is pretty great. I wish I had realized that much earlier. 

I was hoping for at least a little shame.

Lest anyone think I am on the cusp of full, healthy self-acceptance, let me give you a peek at some of the miasmic content of my inner life.

My annual physical was today, except I haven’t been so stellar on the “annual” part. I thought I had, but my official records show that the last time I went in for a well visit was in March of 2018. Whoopsy!

In anticipation of today’ visit, I steeled myself for the “I-have-your-best-interests-at-heart” beat down I was expecting from my primary care doctor when she and I got to the part about my current weight. I imagined her concern about the number on the chart, especially relative to the 2018 number, and rehearsed my response to her prescription for weight loss with some subtle fear/shame drizzled over the top for full effect.

In these mental rehearsals of my doctor’s imaginary scolding, I envisioned that I would stack her comments in a neat crisscross pattern, whip out the Queen of Hearts Zippo lighter given to me by a roommate 15 years ago, and ignite the bonfire of food restriction and punishing exercise I planned to enact immediately.

“Well, I have to do it, you know. For my health. Doctor’s orders.”

Photo by Min An on Pexels.com

Here’s the thing though. She didn’t mention it. Not one syllable about my weight. I have an amazing PCP who is actually not perpetuating weight stigma or diet culture, and there I was, disappointed. We got all the way to the end of the check up and I started to panic. Was I not going to get my hall pass back to orthorexia? How was I going to get the validation I wanted to take extreme measures to shrink my body if my doctor wasn’t going to give it to me?

As the appointment was wrapping up, she asked me if I had any health concerns, and I blurted out “This is the biggest I’ve ever been and I’m kind of freaking out about my weight gain. I don’t feel like my eating habits have changed much. I’m afraid I’m going to gain more weight.”

Do you know what she did? Could you even believe me if I told you?

  • She normalized weight gain during a global pandemic. “Many people have put on weight this year. Stress can really contribute to weight gain, even if your diet hasn’t changed.”
  • She normalized people’s bodies changing over time. “As women slide through those last ten years leading up to menopause, our metabolism changes dramatically. Our bodies technically need fewer calories as we come out of our child bearing years. Many women notice weight changes in their 40s.”
  • She validated my concerns about my health. “We’re going to run blood work, and we’ll look at your thyroid and your blood sugar and other markers. Your previous blood work has always come back fine. If we see something amiss this time, we can make adjustments. If you feel like you want to lose weight, we can talk about that.”
  • She carefully advised against dramatic calorie restriction. “Your body needs fewer calories as you age, but it’s difficult to feel satisfied on a restricted diet. Finding exercise or a sport that you enjoy and ramping up your time moving is a more sustainable approach. Eat food you truly enjoy, and try to avoid eating or drinking things out of boredom, or things you don’t actually enjoy eating.”
  • She didn’t even breathe the letters “BMI”. She didn’t print out handouts about weight loss. She didn’t remind me of risk factors for diabetes or cancer or heart disease. She did show me the fitness app she uses for body-weight-resistance strength training “You don’t need any special equipment! And weight training is good for your bones!”.

My doctor did all the things I know so many people want and need their doctor to say to them. She focused on my actual overall health (bloodwork, how I am feeling in this body of mine, my mental health in this train wreck of a year) rather than one number. From what I have been reading, I know this is not the norm. I am thankful for my very English, very proper, very weight-neutral doctor. I am also thrown for a loop. If I’m not motivated by fear and body shame, I guess I’ll just have to be motivated by the endorphins of exercise and the pleasure of eating what I truly enjoy? I am honestly not sure I know how to do that.