40+ and Expectant

By Vicky Stojanovska

The women of the “Noughties” are not only leaving marriage to their late thirties and forties, but are also putting their biological clocks to the test and delaying motherhood, including first time motherhood for many. Their reasons vary from the financial and social, to waiting for the right guy to come along to make babies with! Whatever the reason, there are certain questions you need to ask your doctor (and yourself) if you find yourself walking down this path in life.

A growing trend?

In the U.K., the Office for National Statistics revealed that 25,976 babies were born to women over the age of 40 in 2009 alone. And a 2006 study titled Factors Influencing Women’s Decisions About Timing of Motherhood revealed that between 1995 and 2003, the mean age of first time mothers in Canada had increased from 28.8 to 29.6 years. In Canada, the proportion of births to mothers over 35 years increased from 8.6% to 14.5% between 1991 and 2000.

“Older age at first childbearing is a broader societal issue that affects population growth and subsequently, a country’s economic growth through low fertility rates,” says University of Calgary’s Dr. Karen Benzies, PhD, one of the study’s main researchers. “On average, first time mothers in Canada are older than those in some other developed countries such as Sweden where the mean age is 28.3 years, and the United States where it is 24.9 years. Canada’s fertility rate is lower than many developed countries at 1.6 children per woman of child bearing age. We need 2.1 children per woman of child bearing age to replace the population. Replacement does not allow for population growth.”

Putting motherhood on hold

While some women choose to delay having children for career purposes, many others simply had not in their younger years found a suitable partner to have a child with. This was the case for Talia, a 43 year old stay at home mother of three year old Ted, who met her husband when they were in their late thirties. “We both wanted to have children and we gave it a go, but I mis-carried our first pregnancy early (at 6 to 8 weeks). We then had a bit of a break and tried again with success.”

Dr. Benzies adds: “In my study, one of the main reasons (for delaying motherhood) was that they had not found a suitable partner with whom they wanted to raise a child. I enjoyed one of the comments: One woman said that they got a dog they year before they planned to have a child, ‘to break them in’ to the idea of routine and being at home.”

Jan Anderson, a 51 year old mother and author of Enhancing Fertility After age 40 and Improve Your Fertility Naturally, believes that it’s just as important to be emotionally and physically ready as it is to find the right person to have children with. “Women who feel under pressure to have children before they are ready might end up feeling resentful and are more likely to immediately hand the child over to a childminder, because they don’t feel ready to take a career break or take an active part in childcare. An unwanted child born to a younger mother is far less likely to fare well than a much-wanted child born to an older mother.”

“It is very presumptuous to assume that all women are going to meet the right partner by the age of 35. Are the fertility experts suggesting that women should find a partner who may not be suitable just to enable them to have a baby during their optimal breeding years? Not all women delay conception in favour of a career – they want to delay conception until they are happily married and can provide a stable family life for their children,” adds Jan.

Benefits to delaying motherhood

After having three children in her mid twenties, Jan gave birth to her fourth child in 1999 at the age of 40. She says that with her last pregnancy, she felt better equipped to face any challenges.

“You can be a great parent at 23 and a great parent at 63. However, I do believe that in our youth we often do not have the patience, life experience, the wisdom and stability that we may have at a later time in our lives. I have a direct comparison, because I had my first child at the age of 22 and my last at the age of 40 in 1999. When I gave birth at 40, I was entering motherhood with a lot more wisdom and experience of life. I am certainly in a better position to educate my daughter. I am more stable – both emotionally and financially – and have a lot more patience than I had when I was younger.”

Dr. Benzies noted in her study that financial stressors and social isolation are typically decreased among older mothers “because they have completed education, were satisfied with career advancement, and had material resources to support optimal child development while at the same time having resources to address their own personal needs, such as gym memberships and spa days.”

Talia agrees: “I guess being older gives you more opportunity to be financially secure, so that’s one less thing to worry about when having children. Some older mothers say they are wiser at 40, but I don’t feel any wiser than the young mothers around me. I’ve learned a lot from them in regards to raising children, particularly those that have been there and done that.”

However, Jan feels a significant difference between motherhood in her early 20s to that at age 40: “When I gave birth to my first son at the age of 22, I was a single parent and not only was I concerned about maintaining an active social life, but I was in a very unsettled phase in my life and certainly didn’t have the emotional strength that I have now. Whilst I loved my son dearly, I feel that I have enjoyed motherhood far more as an older mum. I cherish every single moment of my time with my daughter, Lauren, who is now 11, and miss her dreadfully when she is at school. I spent a great deal of time educating her before she started school, which has paid off because she is, in her teacher’s words, ‘excelling.’ She’s a bright, happy little girl and keeps telling me that I am ‘the best mum in the world.’”

Conception after 40 – a rapid decline

Fertility declines rapidly among North American women after the age of 31 years, says Dr. Benzies. However, she adds: “Some research suggests that the problem is not age itself, but that as women get older, they have more diseases such as diabetes that put the pregnancy at risk. We also need to pay attention to the fact that low fertility is not simply a woman’s problem. As men age, their reproductive system capacity decreases.”

According to the American Congress of Obstetricians and Gynaecologists (ACOG), one reason that women may become less fertile is that ovulation, the release of an egg from one of the ovaries, occurs less often as a woman ages. Another reason may be that an older woman’s eggs are not as easily fertilized as a younger woman’s. Also, problems such as blocked fallopian tubes and endometriosis are more common in older women.

Other health issues

ACOG points out that the risk of complications during pregnancy is higher for older women due to the pressures that pregnancy place on a woman’s body. They are more likely to need to visit the doctor more often, need special tests, and require special care during labor and delivery.

“High blood pressure poses risks to mother and baby, including problems with the placenta and with the growth of the fetus. High blood pressure also may worsen during pregnancy.”

“With increasing age, women also are more likely to have diabetes or to develop gestational diabetes (diabetes that occurs during pregnancy). Women with diabetes are at greater risk for high blood pressure, pregnancy loss, and a condition in which a fetus grows too large (macrosomia),” says the organization.

“Doctors rely on a woman’s medical history, physical exams, and special procedures and tests to detect problems that may arise. In most cases, couples with risk factors have normal, healthy children. But they still need to be well informed and discuss their plans and any known problems with their doctors.”

Jan adds that women should get in touch with their bodies and learn to recognise possible signs of declining fertility, such as irregular periods and other symptoms that might indicate peri-menopause. “Looking at your family history is also a good idea, since genetics plays a part. If your mother had an early menopause, then you are more likely to go through the menopause early and if she had a late menopause, then the chances are that you will be fertile for longer.”

Risk factors- birth defects and older age

Dr. Benzies says that both very young mothers and older mothers are at risk for delivering infants with genetic disorders such as Down Syndrome and congenital malformations. She points out that in one study, the specific risk factors associated with older maternal age are:

• Conception difficulties: 85.3%

• Multiple births (often associated with assisted reproductive technologies): 24%

• Preterm birth: 21.8%

• Low birth weight infant: 11.2%

The ACOG advises that all women are offered screening or testing for genetic problems and they suggest talking to your doctor or genetic counselor regarding the pros and cons of having these tests:

• Amniocentesis. In amniocentesis, a small sample of amniotic fluid (the fluid in the sac that surrounds the fetus) is withdrawn from the mother’s uterus for testing. This procedure can help detect certain birth defects in the fetus during pregnancy, such as Down syndrome or other chromosome problems, and spina bifida. Amniocentesis usually is done at 15–20 weeks of pregnancy.

• Chorionic villus sampling (CVS). With CVS, a small sample of cells is taken from the placenta and tested. CVS detects some of the same chromosome problems as amniocentesis does. This test can be performed earlier in pregnancy than amniocentesis, often at 10–12 weeks of pregnancy.

Advice and words of wisdom

Dr. Benzies advises women over 40 who are planning on falling pregnant to find out about the risks at an earlier age and use this information to make their decision about delaying childbearing. “Annual physician visits should be a time when women are asked about plans to start a family; physicians should counsel women about the risks.”

While she believes that having a committed partner ready to help raise a child together is important, Talia believes it’s also better for those already in a stable relationship to try and have children earlier, if possible: “You have more stamina, you’re more healthy and your parents are still young enough to give you some assistance when you need it. When you are in your 40s the focus is often on conception and pregnancy with less thought about what you and your partner are going to be like in 10 years time with a pre-teen. We didn’t give enough thought to this.”

Jan, on the other hand, isn’t fazed about being sixty when her youngest turns twenty. “My gran was in her late forties when I was born and yet I had a far better relationship with her than I had with my own mother, who was only 23 when I was born. It is the quality of time that is important, not the quantity. I wouldn’t exchange the years I had with my gran for a lifetime with someone with whom I didn’t have a close relationship.”

“Your age doesn’t always necessarily dictate your outlook on life, or your energy levels. I am a very active, healthy person and intend to remain this way for decades to come! I also have a very youthful outlook on life and don’t anticipate this changing. Not only was my grandmother in her sixties when she fostered children, but she looked after my eldest son full-time when he was a baby whilst I went out to work. She had far more vitality than many younger parents I knew at the time and I would not have felt confident leaving my son with anyone else,” says Jan.

So, does being an older mother affect the way children are raised? Jan believes so – on a positive note.

“When I gave birth to Lauren at the age of 40, I was far more prepared. I was in a stable relationship with my partner and was much more settled in my life, professionally, financially and emotionally. I gave up a full time marketing career to combine working from home as a freelance writer with looking after my daughter. She has given me so much joy and I could not even contemplate returning to a mainstream occupation. I feel that I have the best of both worlds.”

“Although all of my children were breastfed for up to a year, I continued to breastfeed my youngest daughter until just before her fourth birthday. I would not have had the time or patience to do this as a younger mum,” she adds.

Situations vary for every woman, but if you’re thinking of having a child and you are in your forties (or approaching), have a talk to your doctor about your options. Weigh up the benefits and any possible risks. Pregnancy and motherhood are an exciting time in a woman’s life and you want to be as best prepared as you possibly can be!

Sources

Dr. Karen Benzies has conducted research into women delaying childbearing and is from the University of Calgary.

The American Congree of Obstetricians and Gynecologists.

Talia had her first and only child at age 40.

Jan anderson is an author on the subject and had three kids in her 20s and her last child at age 40.

Situations vary for every woman, but if you’re thinking of having a child and you are in your forties (or approaching), have a talk to your doctor about your options. Weigh up the benefits and any possible risks. Pregnancy and motherhood are an exciting time in a woman’s life and you want to be as best prepared as you possibly can be!

Being Prepared

Women of all ages should talk to their doctors before trying to get pregnant. This is especially important for women in their 30s and 40s. This will help your doctor find out if you are at risk for certain problems and prevent or treat these problems before they can harm you or your baby.

You also may need certain tests and immunizations before you become pregnant. Your doctor also may suggest some lifestyle changes to help you get ready for pregnancy, such as:

• Eat a healthy diet.

• Try to lose weight, if you are overweight or obese.

• Take a folic acid supplement.

• Exercise regularly.

• Stop smoking, drinking alcohol, and taking illegal drugs.

• Reduce stress.

• Get plenty of rest.

• Make sure your immunizations are up to date.

If you already are pregnant, getting early and regular prenatal care may increase your chances of having a healthy baby. Many problems, if found early, can be prevented or controlled.