April 11, 2013


Your Pregnancy After 35, 3rd Edition. By Glade B. Curtis, M.D., M.P.H., and Judith Schuler, M.S. Da Capo $15.99.

The Shape of the Eye: A Memoir. By George Estreich. Tarcher/Penguin. $16.95.

     Pregnancy after age 35 has risks for women that are different from those faced by younger mothers-to-be. But as women continue to marry later or have children outside marriage at later ages, the number of women needing guidance from a book such as Your Pregnancy After 35 continues to grow. At this rate, there will need to be a book called Your Pregnancy After 40, because pregnancies after that age – once thought to be a barrier for childbirth – are growing even faster than those in women over 35. If the over-40 book is ever written, it is a fair bet than Glade B. Curtis and Judith Schuler will be the ones to write it; or maybe all women really need is an updated and expanded version of the authors’ Your Pregnancy After 35. If so, they have it now – and it is as comprehensive, clear, plainspoken and informative as earlier editions of this book have been for more than 15 years. All the basics about pregnancy are here – helpful for women whose first pregnancy comes after age 35 – along with information on the added risk factors for mother and baby alike at this age, such as a need for a different nutritional focus and some changes in vitamin and mineral supplementation. Women over 35 are more likely than younger women to be in mid-career positions and advancing in the workplace, so Curtis and Schuler also include information on relieving job stress and handling workplace fatigue for those with a higher level of responsibility than younger women typically have. The basics here are worthwhile even for women who have had children before, who may not remember facts such as this or may never have known them: “Fertilization age (ovulatory age)…is 2 weeks shorter than gestational age and dates from the actual date of conception. This is the age of the fetus. In the case of 12 weeks pregnant, the fetus is actually 10 weeks old.”

     One of the most attractive elements of Your Pregnancy After 35 is its inclusion of brief, boxed items that have nothing directly to do with pregnancy but may be helpful to women trying to add yet another element, and a very significant one, to pre-pregnancy schedules already stretched to what feels like the breaking point. For instance, there is a neat bit of advice about making marinated meat by cutting up raw meat, putting it in a plastic freezer bag with marinade, sealing the bag and freezing it – then taking it out to thaw, during which time it marinates automatically. There is another about doubling closet space by raising the height of an existing closet rod by one to two feet, then hanging a new rod two to three feet below it. Some of these “time-saving, energy-saving tips” relate more directly to pregnancy than others, and some boxed items are not labeled with that “time-saving” designation at all: omega-3 fatty acids are good for keeping skin lubricated and reducing inflammation; before taking medicine for a headache or indigestion, try approaches that do not involve medication; understand that inducing labor raises the chance of having an emergency Cesarean section. The overall feeling of this book, despite the considerable amount of medical information packed into it, is of an extended chat with knowledgeable medical professionals who are able to cut through jargon and talk clearly to women without talking down to them. For example, the chapter called “Will You Be a Single Mother?” points out that pregnant singles need not feel “alone” if they seek support from family, friends, and other single moms. Written for women but also invaluable for men who want to understand what their partners are going through in pregnancy and how they can help lessen some of the physical and emotional impacts, Your Pregnancy After 35 is an outstanding resource on everything from specific medical matters to the important financial-planning elements that should go along with pregnancy at this age – or, for that matter, any age.

     One topic covered by Curtis and Schuler with care and concern, and with their usual to-the-point forthrightness, is the importance of specialized testing of fetal cells for older mothers, including genetic testing for chromosomal disorders such as Down Syndrome. Such testing allows women to decide whether to continue a pregnancy and, if so, how to make the necessary adjustments to life after a baby with special needs is born. And what happens if an older mother opts not to have such testing and does give birth to a Down Syndrome baby? That is the underlying story in The Shape of the Eye, in which George Estreich and his wife, Theresa, already parents, have a new daughter, Laura, who is a Down Syndrome child. The parents’ decision to avoid genetic testing because they would not have aborted the fetus anyway is ill-considered – the test would have allowed them to prepare much more comprehensively for raising Laura – but this is a highly personal decision that no reader should gainsay. Estreich’s book is at heart the tale of a family expanding on many levels and in many ways that none of its members ever thought possible until Laura was born. It is a story of difficulty and adjustment, yes, but also a triumphant tale of love conquering – well, not all, but a great many of the difficulties of raising a “special needs” child. In fact, the primary flaw in this (+++) book is that it is so determinedly sincere, so love-soaked, that it frequently seems overdone, as if Estreich is well aware that he is writing not a memoir for himself and his family but an advocacy book of sorts that he hopes will become a blueprint for other families facing issues similar to the ones with which he has dealt. Estreich, a poet, writes in the sort of self-indulgent style that garners prizes from the cognoscenti but may take some getting used to for average readers. “I’ve been fishing since I was eight – an obsession, like baseball, that mystified both of my parents – and I know striped bass, bluefish, flounder, largemouth bass, smallmouth bass, bluegill, pumpkinseed, crappie, bullhead, rainbow trout, brook trout, brown trout, cutthroat trout, bull trout, and mountain whitefish. The juvenile bluefish I used to catch in tidal estuaries were called snapper, and so are the red, glaucous-eyed corpses at the fish counter, marooned on stained ice chips under curved glass.” This sort of style is used to detail Estreich’s background and Theresa’s as well as the details of their life with Laura, including medical issues, home circumstances, IEPs (individualized education programs), and much more. Originally published in 2011, the book now contains an Afterword written as of Laura’s start of sixth grade. “I have a generally dark view of life, and I loathe sentiment and inspiration,” Estreich says in that Afterword, but The Shape of the Eye belies that self-assertion. In fact, the book is at times almost relentlessly upbeat, as if Estreich needs to be positive not only for his family’s sake but also to avoid implying that there are significant downsides, up to and including major depression and serious financial pressures, associated – for many people – with raising a special-needs child. “I wrote this book to begin, or to continue, a conversation,” asserts Estreich in his Afterword; but his motivation seems less straightforward than that. Earlier in the book – and not in reference to this book itself – Estreich writes, “There is nothing lonelier than an experience unshared: the secret, held behind the force fields of memory and language and culture.” That seems closer to what brought Estreich to The Shape of the Eye; that, and his comment a few lines later that “writing is like raising a disabled child: one is always a little bit removed, and a little bit on stage.”

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