Deciding when to have a baby is one of, if not THE, most important decisions a woman makes in her life. Many factors influence the decision. Over the last few decades, there has been a trend to delay childbearing amongst women in industrialized nations.
In the United States, the mean age at first birth has risen to 25.6 years in 2011 from 21.4 years in 1970. We aren’t just seeing women delivering their first baby in their early 30s; we are seeing increased numbers of women choosing to have their first birth in their late 30s and after age 40. The availability of contraception, the increased ability of women to have professional and executive careers, and advances in assisted reproductive technology contribute to this trend.
I often have women who are ready to conceive in their late 30s and early 40s come to me with many questions. Is it too late? What are the risks to my health? Will the baby be healthy? Will I be the oldest mom on the soccer field? Will I need extra testing? These are all good questions. Although we don’t have absolute answers for all of the questions, we do have good scientific research to guide our counseling for our prospective moms and help them maximize the health and experience of their pregnancies.
Many women know that as they get older, it is harder to conceive and there is a greater chance of becoming pregnant with a baby with a chromosomal or genetic abnormality, like Down’s Syndrome. However, there are lesser known risks to both mom and baby. For instance, a woman over 35 is 2-3 times more likely to develop gestational diabetes than a woman under 35. We also discuss the increasing risks of poor fetal growth, premature delivery and high blood pressure disorders with advancing maternal age.
All of these risks can sound very scary to a prospective mom who has reached the exciting point in her life when she is thinking the time is right for a baby. When we talk about each risk, we also talk about how we are going to prepare for each risk. We talk about what screening tests we have to detect abnormalities, how we will monitor the baby’s growth and her blood pressure trends. As we care for more and more women giving birth in their late 30s and 40s, we become more and more knowledgeable about how to care for them.
As a brand new mom myself, I am keenly aware of both the excitement and the fear that comes with pregnancy, birth, and parenthood. For me, timing was key to having a baby. I chose to finish my professional training, establish my practice and find a husband to share the experience with; this meant I faced having a baby at age 37. I never planned on being 37 with my first pregnancy! I was excited, and very nervous. I discussed with my doctor all the same issues that I discuss with my older moms, and ultimately, I had a wonderful experience and now a healthy 8-month old daughter. I also now have a greater appreciation for the unique experiences of women who chose to have children later in life.
Rosanna Gray-Swain, MD, is a board-certified physician at West End OB/GYN. She is on staff at Barnes-Jewish Hospital.