Older mothers

Mom After 35

Are you an older mom?

As a woman who fell pregnant when I was over 35, I certainly never thought of myself as “older” until I called to book in for my 12-week ultrasound and after a few preliminary questions the receptionist asked “Aren’t you going to have a CVS?” As if it was just a matter of course and everyone has one. Naturally, I asked if I should be and her response was “Well, you are older, you are in the higher risk category because of your age”. I later found out that CVS, otherwise known as Chorionic Villus Sampling, is a test carried out during pregnancy to check whether your baby has any disorders like Down’s Syndrome or other rare inherited disorders, where your gynaecologist sees fit.

That didn’t bother me half as much as being “older”. I’m 37 and will be 38 by the time my baby arrives and, yes, this does put me into a higher risk category of having a baby with genetic problems. I think I knew this but because I’ve had two healthy children I really didn’t think it was something that I needed to consider, but apparently it is. So I’ve done some research and thought it would be useful information for any woman considering having a baby after the age of 35.

Recent figures show that the numbers of “older mothers” (35-39 years) are on the increase. The number of women having children during this period of their lives has doubled in the last 20 years. The same applies for “really old moms” (40+).

However, in Kenya, first time moms are still much younger, but worldwide there is a general trend towards having babies later in life with the average age of first-time moms being 30-31years.

In general, society has changed significantly in the last 20-30 years with women taking on different roles in their relationships, the workplace, government, education and of course at home. Life expectancy has increased and where 40 used to be considered middle-aged and “old” - a time when you had your mid-life crisis – it is now thought of as the prime of your life.

Here are a few, although definitely not exhaustive, reasons why some women are waiting until later to start their families:

• They wait longer to meet and commit to their life partner.
• More and more women are engaging in tertiary education and then wanting to use their qualifications in the work force.
• They are more likely to have opportunities at work and have career aspirations.
• They feel the need to be financially secure before taking the leap into parenthood, and that is easier said than done in our current economic environment.
• More women are opting to set and achieve their own personal goals before taking the step towards becoming a mom.

For those of us that have delayed entering motherhood - we have to be aware that our fertility reduces with our passing years. Our peak fertility is during our late teens through to our mid-20s, with fertility dropping rapidly after 35 and another sharp decline after the age of 37. This means that your likelihood of falling pregnant after 35 is quite reduced (although definitely not impossible). It’s no surprise that the 35 year + age group are the biggest users of Assisted Reproductive Technology (ART) otherwise named fertility treatment.

It’s really quite strange to realise, now that you are ready to have a child, it is not as easy as it was made out to be. Once you are 35 there are increased risks that you have to take into consideration: 

• It might take longer to get pregnant.  You're born with a limited number of eggs. As you reach your early 30s, your eggs might decline in quality — and you might ovulate less frequently, even if you're still having regular periods. An older woman's eggs also aren't fertilised as easily as a younger woman's eggs. This doesn’t mean you can’t get pregnant – it will only take you a bit longer. If you're older than 35 and haven't been able to conceive for six months, consider asking your healthcare provider for advice.
• You're more likely to have a multiple pregnancy. The chance of having twins increases with age. The use of assisted reproductive technologies — such as in vitro fertilisation — also can play a role. Since these procedures typically enhance ovulation, they're more likely to result in twins or other multiples.
• You're more likely to develop gestational diabetes. This type of diabetes occurs only during pregnancy, and it's more common as women get older. It is essential that you maintain tight control of your blood sugar through a healthy diet, physical activity and other lifestyle measures. Left untreated, gestational diabetes can cause a baby to grow too large — which increases the risk of injuries during delivery.
• You're more likely to develop high blood pressure during pregnancy. Some studies suggest that high blood pressure that develops during pregnancy — before 20 weeks (chronic hypertension), after 20 weeks (gestational hypertension) or after 20 weeks and accompanied by protein in the urine (preeclampsia) — might be more common in older women. Your healthcare provider will carefully monitor your blood pressure and your baby's growth and development. You might need to take medication or deliver your baby before your due date to avoid complications.
• You might need a C-section. Older mothers have a higher risk of pregnancy-related complications that might lead to a C-section delivery, such as placenta preavia — a condition in which the placenta blocks the cervix. Labour problems tend to be more common in first-time mothers who are older than 35.
• The risk of chromosome abnormalities is higher. Babies born to older mothers have a higher risk of certain chromosome problems, such as Down’s syndrome.
• The risk of miscarriage is higher. This is perhaps due to the higher likelihood of chromosomal abnormalities. 

Of course, the advances made in recent years to medical technology and tests allow “older” mothers to have much safer pregnancies than in the past. In fact, the higher level of routine testing for genetic problems in “older” mothers is probably the reason why around 80% of all Down syndrome births are to mothers who are under 35 years of age instead of the higher risk group (35+). So, if there are all these hurdles and risks to be overcome, why are more and more women waiting until later to have their babies? Does the media play a role in our decision-making? Possibly. The media certainly doesn’t report that celebrities have suffered their second miscarriage or that they have suffered pregnancy complications related to their age. 

We only see the stars who had the perfect pregnancy, perfect baby and have returned to their fabulous pre-pregnancy shape within days of giving birth all to the acclaim of “at the age of 39”. Does this fill us with a false hope of being able to achieve the same thing? Here are a few older celebrity mothers:

• Geena Davis – First child at 46
• Janet Jackson -Pregnant at  50 
• Madonna – First child at 38
• Melanie Griffith – Second child at 39
• Sarah Jessica Parker – First child at 37
• Bette Midler – First child at 41
• Julia Roberts – Twins at 37
• Elle Macpherson – Second child at 41
• Courtney Cox – First child at 40
• Susan Sarandon – Third child at 45 

Certainly, there is the option of using ART in your quest for a baby, but this is definitely not the answer for everyone. This can take you on a rollercoaster ride all of its own and really deserves to be spoken about in another article. 

So what are the main differences faced by us as ‘older’ moms during pregnancy:

• We’re more likely to be faced with making a decision about the continuation of our pregnancy, based on information gained from routine testing for pregnant women 35 plus.
• We’re usually highly motivated to become parents, especially if this is a first child and not likely to leave anything to chance.
• We’re more likely to be undergoing some form of assisted reproduction.
• We might not bounce back as well as when we were younger. This is similar to when you used to party all of Friday night and then get back up to do it all again on Saturday night – those were the days.
• It may possibly cause the end of, or at least stall, your career.
• The reality is you’ll be an older mom when your child starts and finishes school.
• Family support might be less as Grandparents may not be able to offer the same physical support, since they are also older by then.
• Your “freedom” will not return until much later in your life. 

Benefits of being an older mother:

• You’ll be more likely to afford babysitting, so that you can take a well-earned break.
• Because you may be more financially secure, you won’t have to compromise on baby’s equipment.
• You would have had the opportunity to travel (child-free) and really enjoy your life to the fullest - and maybe you won’t miss it for a while.
• You would have achieved a number of your personal goals already.
• With age comes a greater confidence in oneself; this can still be shaken once you have a baby, but it will help you to be proactive as a parent.
• You are older and (hopefully) wiser and have broadened your knowledge, making you a wiser teacher to your child.
• You’ll probably be having babies at the same time as some of your younger friends and develop a wonderful support network.
• Your patience may be greater as you’ve had longer to learn self-control.
• You can learn from the mistakes and successes of others who did it all before you.
• If the baby has been long in the coming – you will really appreciate your baby more.
• Friends and family who have been through it all before would have done a lot of research that you can draw on, so now you can find a childcare group in your area by just checking out their shortlist. 

Our fertility, or lack of it, is something we fail to talk about with our friends for fear of upsetting each other. And it does hurt when someone flippantly asks “Are you ever going to have a baby?” It’s pretty hard to say “I’d love to” after yet another failed attempt or another miscarriage. 

Healthy you for a healthy pregnancy

Taking good care of yourself is the best way to take care of your baby:

• Make a preconception appointment. Meet with your healthcare provider before you conceive to make sure your body is prepared for the task ahead. They will assess your overall health and discuss lifestyle changes that might improve your chances for conception, a healthy pregnancy and baby.
• Seek regular prenatal care. During pregnancy, regular prenatal visits help your healthcare provider monitor your health and your baby's health. Mention any signs or symptoms that concern you, even if they seem silly or unimportant.
• Eat a healthy diet. During pregnancy, you'll need more folic acid, calcium, iron, protein and other essential nutrients.
• Gain weight wisely. Gaining the right amount of weight can support your baby's health — and makes it easier to shed those extra kilos after delivery. A weight gain of about 11 to 16 kilograms is often recommended for women who have a healthy weight before pregnancy. Work with your health care provider to determine what's right for you.
• Stay physically active. Unless your healthcare provider says otherwise, pregnancy can be a great time to get active. Get your healthcare provider's approval before starting or continuing an exercise programme, especially if you have any underlying conditions.
• Avoid risky substances. Alcohol, tobacco and illicit drugs are off-limits during pregnancy. Clear any medications or supplements with your healthcare provider ahead of time.
• Learn about prenatal testing for chromosomal abnormalities. Although most prenatal tests simply confirm that a baby is healthy, it's important to prepare for other possibilities. 

Further Reading

Older Mothers: Conception, Pregnancy and Birth After 35 - Julia Beeryman, Karen Thorpe; Kate Windridge

The Essential Over 35 Pregnancy Guide [Kindle Edition] - Ellen Lavin

Not Too Late: Having a Baby After 35 - Gill Thorn

For more information see Motherhood or Parenting.