CHAPTER EIGHT
The exam room at Sunset Harbor Women’s Health was not what Emily expected.
The floors were linoleum, not tile, and the walls wore a faded shade of celery that gave even the cleanest corners a sickly pallor.
On the counter, a lineup of pamphlets—Nutrition in Pregnancy, Advanced Maternal Age, What to Expect—formed a small, rectangular battalion beneath the cabinets, flanked by a pyramid of latex glove boxes.
Emily sat on the vinyl-covered table, at their absolute earliest morning appointment, the paper sheet beneath her already creased and torn in several places, especially where her knees pressed in and out with the nervous rhythm of a marathoner waiting for the starting pistol.
Daniel perched on the single guest chair, his thighs too long for the space, arms folded.
He wore the collared shirt he reserved for bank appointments and funerals, as if respect for the process could buy them better odds at Emily advanced maternal age.
The only other sound in the room was the hum of the wall-mounted air conditioning unit, just loud enough to make a person think, now and then, that someone was standing just behind the closed door, ready to come in.
Emily shifted again, trying to find a posture that didn’t feel both exposed and ridiculous.
The exam gown had no real closure at the back, just two strings that met at her mid-spine and did a half-hearted job of covering her.
Her legs, white with goosebumps, looked foreign to her, as if she’d borrowed them from a mannequin.
The monitor on the rolling cart still displayed the afterimage of her most recent ultrasound, a black-and-white halo, blurred at the edges, punctuated by a flickering blip in the center.
For a full thirty seconds, she let herself watch it, the baby’s heartbeat rendered as a steady strobe.
There was awe in it, a fearsome awe, and something like relief that she couldn’t admit even to herself.
It was real now. Emily wrapped her arms across her middle, hugging the edge of the gown to her ribs, and tried to breathe quietly so Daniel wouldn’t know how close she was to losing it.
“Looks healthy,” Daniel said, not quite a question.
“Textbook,” Emily answered. The ultrasound tech had said this to Emily before she’d now repeated it to Daniel.
The tech was a stone-faced woman who’d offered no small talk and left the probe’s cold gel smeared across Emily’s belly as she printed out the photo and slid it across the paper sheet like a dealer showing a winning hand.
Emily had folded the image into her purse without looking at it again.
Now, as she waited, the certainty of that small, flashing dot seemed less concrete.
Why is the doctor taking so long? Is there something wrong?
The room’s chemical tang—antiseptic, astringent, oddly sweet—climbed up the back of her throat.
She wished she could have had coffee this morning, just something to anchor her, but she’d abstained in case of blood tests.
The door swung open on a rush of air, and Dr. Lieberman entered, a clipboard in one hand and a tablet in the other. Her face was thin, almost severe, but when she smiled, it was with the genuine care of someone who spent her days caring for people who needed her.
“Good morning,” she said, her voice pitched above the air conditioning. “Sorry to keep you waiting.”
“It’s okay,” Daniel said, standing out of reflex and immediately realizing it wasn’t necessary. He sat again, hands braced on his knees.
Emily offered a smile.
Dr. Lieberman consulted the clipboard, eyes flicking from the top sheet to Emily’s chart on the tablet. “So,” she said, “looks like we’ve got some news since the last visit.”
Emily nodded, but the word wouldn’t come.
Lieberman’s gaze softened a shade. “I’ve reviewed your labs and the ultrasound. Everything looks very encouraging.” She glanced at Daniel, then back to Emily. “You’re about seven weeks, right on target. The embryo is developing as expected, and we have a nice, strong heartbeat.”
Emily swallowed. “That’s good.”
“It is.” The doctor pulled a rolling stool closer, perching on its edge. She set the clipboard aside, folding her hands. “But—and this is not a surprise, I’m sure—your age places this pregnancy in a higher risk category. The term we use is ‘advanced maternal age.’”
Daniel’s lips quirked. “Isn’t there a nicer term?”
Lieberman allowed herself a laugh. “Used to be called ‘geriatric pregnancy,’ if you can believe it. We retired that label. No one wants to be about to become a mom while they’re being called a grandma by their doctor.”
Emily felt her mouth twitch, but it wasn’t funny, not really. “Does that mean…” she started, then stopped. She didn’t want to ask, but the question tumbled out anyway. “What are the actual risks?”
The doctor didn’t flinch. “Most people in your situation do just fine. But statistically, there’s a higher incidence of complications: gestational diabetes, hypertension, sometimes more stress on the placenta.
We monitor those closely. The big thing is increased risk for chromosomal anomalies—Down syndrome is the most common one, but there are others.
” She kept her eyes steady, inviting questions.
Daniel’s posture went rigid, and Emily could feel the new density of the air between them. “Is that something we can test for?” he said, practical, already searching for solutions.
“There are screenings,” said Lieberman, “both noninvasive and diagnostic. We’ll walk through all of those today and at your next appointment. I know it’s a lot, and you both have already been through plenty, so let’s take it one step at a time.”
Emily wanted to nod, to play the role of model patient, but her head felt too heavy. The words stacked up like loose blocks: risk, anomaly, complication. She felt Daniel’s hand close over hers. Her pulse thudded so hard she was sure the doctor could hear it across the table.
Lieberman’s tone softened further. “I want you to know, most of the time the risk numbers are less frightening than they sound. They’re statistical, not predictive.
We have excellent tools now to monitor everything, and you have a lot going for you: healthy lifestyle, low blood pressure, no history of metabolic issues.
” She checked her notes. “No personal or family history of clotting disorders, which helps.”
“Can you just… go over the basics?” Emily said. “Like, from the top? I want to know what’s coming.”
Dr. Lieberman nodded. “Absolutely. For now, you’ll have standard prenatal labs.
I’m adding a few extra markers for your age bracket—just precautionary.
In your second trimester, we’ll do more detailed ultrasounds, and if you want, there’s a blood test at ten weeks that can give us a lot of information about chromosomal risks.
” She angled the tablet so Emily could see.
“There’s also amniocentesis and other diagnostic options, but we don’t jump to those unless the screen shows a reason. ”
Emily tried to look at the baby’s heartbeat again, but the monitor had gone to sleep, and now all she could see was her own reflection in the black screen.
Lieberman continued. “Increased risk doesn’t mean guaranteed outcome.
Most women your age have healthy pregnancies and healthy babies.
We’ll keep a close eye, and if we see anything concerning, we’ll talk through options together.
” She paused. “You’ve done this before, but every pregnancy is different.
If at any point you feel off—dizzy, blurry vision, headaches that won’t quit—I want you to call, day or night. ”
The doctor rose from the stool. “I’ll give you two a few minutes. I’ll send in the nurse for your blood work and get you scheduled for a follow-up in two weeks.”
Emily wanted to ask if they could wait on the blood work, maybe come back next week when she felt less like an insect pinned to a specimen tray. Instead, she just nodded.
The door closed behind the doctor, and the nurse came in almost instantly.
The new woman wore a name tag that read “Monica.” She was brisk but gentle and not one for small talk.
Daniel watched the draw with a deliberate neutrality, hands steepled between his knees, while Emily turned her head and stared fixedly at the ceiling’s fluorescent grid.
With every click and snap—the tourniquet, the rubber-capped vials, the needle’s whisper into her vein—she could feel her panic threatening.
“You’re a good stick,” Monica said, removing the needle and pressing a cotton ball to the puncture. “Most folks tense up way more than you just did.”
Emily managed a smile, though she felt a little lightheaded. She glanced at the vials—three of them, each labeled in a looping script—and tried not to think about how easily the body gave up its secrets, when pressed.
“I’ll let you get dressed. Beth will check you out at the front.” The nurse left as quickly as she’d come, closing the door with a muffled thunk.
Daniel helped Emily gather her things. She dressed in silence. As they walked down the hallway, Daniel’s hand found hers again, this time more tentative, as if waiting for permission. Emily took it, and together they made their way toward the exit, the murmur of the clinic fading behind them.
Outside, the parking lot was bright and sterile, the sun too high and sharp for comfort. Emily blinked against it, and for a moment, the world was just noise and light and the faint, persistent echo of her own heartbeat, now actually doubled.
“Are you scared?” she asked Daniel when they climbed into the car, and the question hung in the air, unexpected.
He swallowed. “Yeah. But not of the baby, or what could happen there. Just… not being able to fix it. I’m good at fixing things, but this—” He gestured at the building, at her, at himself. “This I just have to ride out.”
Emily blinked, surprised by his confession.
She started the engine. The radio blared on, the bickering hosts quickly replaced by a song she recognized from high school. Emily let the noise wash over her, the cheap pop chorus filling the space.
She wondered, briefly, how something she wanted so badly could also be the thing that scared her most. Feeling flushed, she rolled down the window and let the salt air fill the car.
Then she put the car in gear and drove them home. There was breakfast to get taken care of at the inn.