Babies Having Babies

I can’t remember if I have already written about just how many teens I see in the office. Our practice doesn’t really serve a ton of teens in general but I do think because during my interviews I expressed an interest in them and on my “bio card” that is at our front desk it says under professional interests: “Adolescent health and prenatal care”, they just send’em all my way. 17? Unplanned pregnancy? No secure housing? More afraid of an abortion than of a baby? I got the perfect midwife for you!

And taking care of these teenagers can be very rewarding. Seeing them through their pregnancy, trying to educate and empower them, watching them become mothers and women…But when the majority of the pregnant women you see are these young girls, your ideas get skewed. And I, admittedly, get resentful and angry. These girls probably need me more than most but I often walk into their exam room with a healthy bias, thinking that they have no fucking clue what they are doing. Sometimes I am wrong, and pleasantly surprised. But sometimes, I’m dead on.

I walked into room 17 last Thursday to meet my latest soon-to-be teen mom. Crowded in the small room were three people, no one over 18. The girl I presumed was my pt was sitting hunched on the exam table, her scabbed legs dangling. The boy I predicted was the FOB was sitting on the only chair in the room and another hefty girl was sitting on the stool that I usually use during the exam. I introduced myself to my pt, her boyfriend and then to the girl in my seat.

“Hi” she said. “I’m the Godmother.” I shook her hand and wondered if she was the godmother of the pt or of the unborn. I chose not to ask because I was immediately distracted by trying to figure out if anyone was going to give up their chair for me or if I would hover over everyone the whole time. “You probably need this chair, right?” The Godmother said.

“Yes, thanks.” I said. “I do usually use that one.” The Godmother got up, moved past me and planted herself on the exam room floor, cross-legged, in the corner.

I asked my usual questions about the patient’s last menstrual period, went over her dates, asked her if the pregnancy was planned (it wasn’t) and attempted to have a conversation with her about the responsibilities of parenthood:

“So, was this pregnancy planned?”

“Um, no…”

“And you guys are certain that you are going to keep the pregnancy?”

“Yes.”

“Do you have support?”

“Kind of.”

“Do your parents know?”

“Well, my mom doesn’t know” My patient said. “But I think my dad does, I think my sister might have told him. I’m not sure.”

“How about your parents.” I looked at the FOB.

“Um, no. Not yet.”

“So you both plan on telling your parents?”

“Well…at some point I guess…”

“Are you concerned you won’t have their support if they know you are having a baby?”

“Yes. My mom told me I couldn’t live there if I was pregnant.”

“Do you think that’s just your fear or you really know that to be true?”

“Oh no, it’s definitely true. She wouldn’t want to see me.”

“So, you’re living at home right now?”

“Yes.”

“What about you? Where are you living?” I looked at the FOB again.

“With her.”

“So, you’re both living with your mom.” I look at my patient. “And at some point you think you’ll have to move out. Do you have a plan for that?”

“Oh yeah. We’re gonna get an apartment.”

“So, you have a job?”

“No.”

“So how are you going to pay for the apartment?”

“Well, I’m gonna try to get a job and plus he works for a carpentry company…”

At this point the Godmother, who had been texting up a storm and who has not lifted her head the entire time (here’s hoping she pays more attention when the baby is actually born…) stands up and politely excuses herself to make a phone call. I think she actually said something like, “um, sorry to interrupt. Is it okay if I step outside to make a brief phone call?” As if she’s taken time off from her busy CEO position downtown. Sure, sure I said. Take as long as you need. Really.

The conversation looks pretty much the same each time. Sometimes the dad isn’t involved. Sometimes the pt works at Subway. Sometimes, luckily, there is no Godmother present. But in general, it’s tough to feel hopeful for the lives of everyone involved. Myself included. There’s always a lot of nervous laughter during the exam. My patient on Thursday kept blowing kisses to the FOB while I did her pap. It was…uncomfortable.

We finished up. I gave them the emergency numbers and asked if they had any final questions.

“No.” said the patient.

“Nope.” said the FOB.

“I got one question actually.” Said the Godmother as she was hoisting herself up from the floor. (She had returned to the room just in time to text during the entire PE)

“Sure,” I said. “What’s up?”

“Um, I’m wondering if she can, like, go to 6 flags this summer.”

* * *

Another recent memorable moment with teen parents was while I was on call last Friday. There was a 17 yo in labor and she had her mom and grandmother and aunt with her. Their support was amazing. Holding her legs, wiping her down, encouraging her, telling her how strong she was, sharing their own birth stories…And then there was the FOB. He was 21 and only moderately present throughout the labor and birth. He did take many pictures of my patient’s privates while the baby’s head was making its way through but I think it was more in order to find a place to hide than genuine curiosity and awe.

“Will you be cutting the cord?” I asked him while we were pushing and he was sitting on the couch looking through the pictures he had just taken of his girlfriend’s crotch.

“Yeah.”

“I’ll be cutting it too.” My patient’s mom said looking at him out of the corner of her eye.

“What?” the FOB said. “I’m the father!” he said and pointed his thumb towards his chest.

“Well,” The pt’s mom said still not looking at him, “I’m the other father. So we’re both cutting the cord.”

After the delivery the FOB was thoroughly disgusted by the placenta and verbally convinced us of that by pointing and groaning and talking about it as “that thing”.

I cleaned up, completed all my paperwork and gave a final hug to the new mom. I spotted her boyfriend holding his new son in his arms, just staring into the eyes of the newborn. He was transfixed. I motioned for the pt to look at him so she could witness how much that new little boy was holding his attention. She rolled her eyes.

“Well,” I said, “One last thing I forgot to ask you. Are you planning on having your baby circumcised?”

“What?” The FOB shouted as he stared into his son’s eyes, “Hell yeah we’re having him cut. He not walkin’ around with no elephant trunk. Uh un. Not my kid.”

And just like that, whatever respect or hope I had gained, had vanished. I pulled out a piece of paper from my pocket and wrote down exactly what he had said because, well, it was just too fucking good to not remember forever.

And as I drove home that night and thought about my young patients I heard a song by our dearly deceased Michael Jackson whose music is now being played 24-7 on most every radio station. He sings: If you can’t feed your baby (yeah, yeah), Then don’t have a baby (yeah, yeah), And don’t think maybe (yeah, yeah), If you can’t feel your baby (yeah, yeah)

He may have been a weirdo but he sure did get that right. Hear that kids? If you can’t feed your baby? Then don’t have a baby. Got it?

Today at the office a nurse pulled me aside to tell me she just got off the phone with someone who wants to get prenatal care with our practice.

“I think she’s perfect for you.” The RN said. “She’s 16.”