Soon after I started practising I worked at Head and Hands, a wonderful clinic and community organization in Montreal where I saw my first maternity patients. One of the first was a 15-year-old girl called Patricia (all names have been changed), and she looked like a recipe for disaster. The father was her boyfriend, Serge, a Caribbean immigrant who was only a few years older at 19. When she contemplated an abortion, he had pressured her into keeping the baby. Her mother, who was also young and single, was furious over her daughter's wild behaviour.
She had not been doing well in school and had been sneaking away to spend time with Serge, often staying out late at night. Now they had an unplanned pregnancy. When she first came to the clinic Patricia was feeling unsupported and insecure, and half-way through her pregnancy it appeared that everything was unfolding in a depressingly familiar scenario. She and her mother were fighting all the time, and Patricia planned to move out the moment she had the baby and was eligible for welfare. She was barely going to school. Meanwhile, Serge had gotten cold feet and disappeared.
Then, slowly, things began to turn around. Patricia's poor relationship with her mother, plus the fact that she was getting too far along in her pregnancy to attend her old high school, prompted a move into a residence and school for pregnant adolescents and young mothers.
With space and distance, Patricia and her mother came to a new understanding. Patricia moved back home, although she continued to attend the smaller and more personalized school. She began to do better - by the time her son, Richard, was born, Patricia was both living at home and working hard at school. Her mother took care of her son, and Patricia herself had changed. No longer wild and a little spacey, she was hard working and responsible. Once the baby was born, Serge began to come around again. Encouraged by his mother and grandmother, he began spending time with his son, taking him out. Serge and Patricia began dating again.
They came together to my clinic for the baby's 18 month check-up. We began talking about what Patricia would do once she finished high school. I suggested a secretarial school; Patricia thought it sounded like a good idea. Two years later she graduated, and immediately found a job. She and Serge were living together upstairs from Patricia's mother. A while later they moved out of the area and I lost touch with them.
Ten years passed and they arrived back in the clinic - Patricia, Serge and a tall, handsome 14-year-old, Richard. Patricia had grown from a pretty, plump 15-year-old with a frizzy ponytail into a beautiful, sophisticated-looking woman. She was pregnant again. This time it was planned. Serge was working as a nurse and Patricia was the indispensable secretary for the head of a government department. They had benefits. They had a half a duplex. They had a grown-up life. They had a future. And this time they were pregnant with twins.
After the twins were born, Serge and I took his new son and daughter upstairs to the nursery. Richard and his grandmother were standing at the elevator door waiting to greet the new babies. As Richard kissed his new little brother and sister, his father smiled warmly, paternally. I touched his arm.
"You know, Serge, 10 years ago I would never believe that this would be happening."
"Well, Dr. Feldman," he replied "sometimes it just works out."