Midlife Moms

2/20/2014

Remember when women heard their biological clocks ticking loud and clear at age 30? These days, pregnancy for women in their 30s is hardly unusual, and 40 is no longer considered a closed door as advanced technology and lifestyles have made postponing motherhood a desirable – and less risky option. In the last two decades, births to women in their late 30s have risen 70 percent, and for women over 40 births have increased more than 40 percent. Statistics today show that one in every 12 babies born in the United States is to a woman over the age of 35.

So what is responsible for changing what was labeled a “geriatric” pregnancy in the 1980s to what could accurately be referred to as “commonplace” today? Sociology and medical experts say there are several reasons behind the trend towards pregnancy later in life. Studies show that because women are more educated and more career-oriented than ever before, they may delay having a family until they feel their careers are established. Women are marrying at later ages as well, which contributes to the delay in having children. Experts speculate that a rise in divorces and second marriages is also fueling the trend towards later pregnancy. And on the medical side, advances in reproductive technology have made conception more achievable and pregnancy risks more manageable than ever before.

Ben Darby, MD, ob/gyn with OBG-1 of West Calcasieu Cameron Hospital says that while most women over 35 have uncomplicated pregnancies and healthy babies, it is important for women of this age to be aware of the increased risks facing them and their baby. “Celebrities in their 40s on magazine covers may make pregnancy at a later age look easy, and it can be, but in reality there are some special considerations for pregnancy after age 35,” says Dr. Darby. “Thirty-five is not a magical number that spells ‘doom and gloom’ on the reproductive front, but just the age at which certain risk factors begin to increase. In many cases this increase is slight, but maternal age is something we as physicians give special attention.”

Dr. Darby says even before pregnancy, older moms-to-be often face obstacles. A woman’s fertility declines with age. Unlike men, who have the ability to produce sperm throughout their lives, women are born with all the eggs they’re ever going to have, and the quality of these eggs deteriorates over time. Fertility problems increase after about age 35 and women this age and older are more likely to require reproductive therapy of some kind, which can be emotionally and financially stressful. “We advise our patients over age 35 who are trying to conceive to have preconception counseling to maximize their chances of achieving a pregnancy. If conception does not result after six months of trying, a fertility evaluation may be recommended.”

Once a 35-plus woman is pregnant, thoughts usually turn to pregnancy-related risks for mom and baby. Foremost is the increase in genetic defects such as Down syndrome. “There is a lot of publicity about the increased risk of Down syndrome after the age of 35, as if that were a major turning point for risk. Actually, the risk rises slowly with age, so that at 35, the chance of Down syndrome is slightly less that .5 percent,” explains Dr. Darby. “That means that over 99 percent of babies born to women this age will not have Down syndrome.”

Dr. Darby says there are other risks to consider after age 35, including:
 an increased chance of miscarriage or stillbirth
 high risk of multiple birth, even without fertility drugs
 pregnancy- related complications including gestational diabetes, preeclampsia (high blood pressure), placenta previa, placental abruptions, preterm delivery and intrauterine growth restriction.
 higher rate of caesarean delivery
In addition, the normal health concerns of women in this age range such as uterine fibroids, heart disease, high blood pressure, and diabetes can pose a risk of complications during pregnancy.

"Listing the risks associated with pregnancy after 35 overstates the case for possible complications," stresses Dr. Darby. "Remember, these are just increased risks, not a probable risk, and should in no way dissuade a woman from becoming pregnant at this age if that is her desire. For a healthy older woman who becomes pregnant, the medical risks for her and her baby are minimal. Much depends upon the mother's physical and mental condition before pregnancy. A healthy, fit 40-year-old will likely do better than an unhealthy, overweight 20-year-old smoker. "

There are diagnostic tests and screenings recommended for pregnant women over age 35, and the physicians at OBG-1of West Calcasieu Cameron Hospital recommend a consultation and ultrasound with a perinatologist for all of their patients in this category. "We believe in providing women with all the resources we can offer to ease their mind and increase their chances of having a healthy pregnancy and baby."

With the exception of the increased risk of Down syndrome and the complications that may occur if the baby is premature or low birthweight, pediatricians say babies born to moms over 35 don't face any additional health problems than those born to younger mothers. "However, to a certain degree, older mothers do have a different perspective toward their children," says Albert Richert, Jr., MD, pediatrician with the Pediatric Center of Southwest Louisiana. "If it is their first child, the adjustment to a different lifestyle and the demands a new baby places on their time is more pronounced since they have had a longer period of time either as a single adult or as part of a childless married couple. Older parents do seem to appreciate their babies somewhat differently. It’s not that younger parents don't love and cherish their children, but as an older mother, there seems to be a different feeling present as well."

According to Dr. Richert, advantages of being an older mom can include:
• Less stress with young children
• Often times financially stable

For more information on pregnancy after age 35, call OBG-1 of West Calcasieu Cameron Hospital at (337) 312-1000.