“They grow up so fast,” I said, tears in my voice. I’d been there when Wanda gave birth. Seemed like yesterday.
“We want to pop over with something for Dylan before he leaves, okay? You know Leila worships him.”
“Good thing we arranged their marriage when she was born,” I said.
“We’ll have beautiful grandchildren,” Wanda said. “Check your calendar. The six of us haven’t gotten together in ages.”
“Remind Leila that her godmother misses our sleepovers,” I said, handing the phone back.
“Girl, be careful what you wish for. Now that Miss Model is with Ford and is making her own money, she’s getting an attitude.”
“See? You’re tired. She can come live with me, and you can visit anytime.” I was only half joking.
“Only if I get Dylan,” Wanda said. “Especially now that he’s grown and all the hard work is done.” She smiled and went into an exam room, and I did the same.
For the next few hours, I was Lillie Silva, BSN, RN, CNM, a woman who knew what to do and say, who could lose herself in her work.
Stephanie, who was indeed in the sweaty grip of menopause, had tried black cohosh, dong quai, and yoga for her hot flashes. “Lillie, I have to change my pajamas in the middle of the night, I’m so sweaty. I’m going to kill myself if these don’t stop,” she said.
“Oh, don’t do that,” I said with a smile. “I’m glad you tried the other stuff, but let’s go next level. Paxil, ten milligrams. It’s a subtherapeutic dose, and a lot of women say it’s a miracle drug.”
“Then give me the miracle,” Stephanie said. “Oh, Lillie, thank God there’s something.”
I tapped the script into the computer to Steph’s pharmacy. “Call me in a few days and tell me how it’s going.”
Rena and her husband were next, and my heart ached for them. She was a lovely forty-two-year-old woman trying to get pregnant for the first time. Unfortunately, she hadn’t been aware of how much fertility drops each year after thirty and had put it off to focus on her career. James, her husband, had normal sperm count and motility. We’d tried Clomid to no avail. Intrauterine insemination, where sperm was injected right into her uterus, hadn’t worked. Ultrasounds and hysteroscopy had shown nothing abnormal. In vitro was probably next.
Sure enough, they asked, then held hands as I talked about the process of in vitro, the cost, the chances. It wouldn’t be easy or fast . . . fertility drugs, egg retrieval, sperm analysis, blood work, the hope that the sperm would combine with the egg to start a healthy embryo. Their faces fell a little with each fact.
“What are the odds that we’d end up pregnant, say, within a year?” James asked.
I took a deep breath. I hated questions that involved statistics. I myself had bucked those odds, after all. “Obviously, I don’t know. Everyone is different. But my best guess, based on the data, based on the number of eggs we can retrieve, maybe . . . ten percent?”
There was a moment of silence. “Yeah,” Rena said. “That’s what we read on the internet.”
“Listen,” I said. “I know how important having a baby is to you. If you want to try this, I’m right there with you, all the way.”
“Thanks, Lillie,” Rena said. She and her husband exchanged glances. “But we’ve talked about this. Those aren’t great odds, so we’re gonna try foster-to-adoption and not put this old body through any more torture.”
“There are a lot of older kids out there who need parents,” James said. “They don’t have to have our genes to be our kids.”
Tears flooded my eyes. “I agree,” I said. “I think that’s wonderful. I’ll send you a list of some agencies other clients have worked with.” I stood up and hugged them both. Rena sobbed once, and I tightened my grip. I understood the pain of not having your body cooperate with what should have been a natural process.
But I had Dylan, at least.
Annie Blanco, age twenty-four, was seventeen weeks pregnant. “I want natural childbirth,” she said. “No drugs.”
I smiled. “That’s what we always aim for.”
“You delivered my sister’s baby last year. Laura Peters? A boy?”
“Oh, yes! She did such a great job.”
“That’s what I want, too. No pain, just breathing.”
I smiled again. “Well, there will be pain, I can just about promise you that. But it can be absolutely manageable. This is what your body was built for, after all. Unless there’s a reason to intervene, we won’t.”