A baby is a blessing at any point in life, but it can be even more special — and even more scary — if a mom has to wait until later in life to bring a little one into the world.
There are many reasons why women wait these days. Since women have entered the workforce in higher numbers, the average age at which women give birth has been on the rise. People are waiting to get married and some are waiting to get pregnant until they are more established in their careers.
Now about 15 percent of mothers who give birth each year are over 35. That number was 11 percent in 2002, and 8 percent in 1990. In increasing numbers, many of those mothers are giving birth to their first child, making the current average age of first birth 26.
That has its advantages — parents in their 30s have more money and more stability than teen parents. And after mom and dad have accomplished goals in education and their career, they are often happy to settle down and expand their families.
But it also can have its disadvantages, from fertility to birth defects to pregnancy complications. The term "advanced maternal age" has been around since the 1950s to describe women who give birth after 35. Sometimes, it is referred to as a geriatric pregnancy — and yes, that is insulting, but it's also interesting to think that just a few generations ago 35-year-olds were preparing to be grandmothers, not mothers.
More and more of us fit the geriatric mother category these days. In fact betwee, 1985 and 2012, first-year birth rates increased six times for women ages 35 to 39, while it quadrupled for women ages 40 to 44.
Here are 15 harsh truths to being a geriatric mom.
The biggest obstacle to becoming a mom after 35 is a natural decline in fertility. Doctors go back to a 1986 study where womn of all ages were given articial insemination once a month for a year or until they got pregnant. Nearly three-quarters of the women 30 or younger were pregnant by the end of that year, hile the rate was 62 percent for the women aged 31 to 34, and just over half for woman over 34.
Notice that the women 35 and older still got pregnant half of the time. That's still a pretty major possibility, although as she ages a woman has fewer eggs, and her overall health could be lower than it was in her 20s.
Because fertility decreases as women age and because the risks of the pregnancy go up over time, doctors recommend that women who have been trying to get pregnant for 6 months without success consider getting help.
While women may have a harder time getting pregnant after 35, if they do, they may be blessed with more than one baby. The likelihood of conceiving multiples increases with age.
Twins are three times more likely to be born in women over 35, especially if they have had previous pregnancies. There are a couple of reason for that. The first is naturally occurring because later in her reproductive life a woman is more likely to release more than one egg during ovulation. Multiples also can happen more for older moms because of the increased use of fertility treatments, some of which increase egg release while in IVF sometimes more than one egg is implanted to increase chances.
Multiples come with their own risks in pregnancy and delivery on top of the risks that come with being a geriatric mom. That can make the next nine months a tricky time, but for a woman who has waited for a baby, the extra blessing may more than make up for it.
Unfortunately, when a geriatric mom gets pregnant, she often has a harder time carrying the baby to term. The rate of miscarriage goes up with age. which can be especially heartbreaking if a mother worked extra hard to conceive and feels the clock ticking on her fertility.
While all miscarriages are devastating, the numbers are pretty scary for a woman of advanced maternal age. Less than 9 percent of pregnancies for 22-year-olds end in miscarriage, while the number doubles to 18 percent for a 30-year-old mom. It more than doubles again by the time a mom reaches 40, reaching about 40 percent. And by 48, it's doubled once again to the heartbreaking number of 84 percent.
Doctors believe that the high number of miscarriages for older moms is related to the low quality of the older eggs. Research has found that moms who use donor eggs — younger donor eggs — are more likely to have successful pregnancies, so there is hope. Medical technologies could not only help a geriatric mom conceive but increase the viability of the pregnancy.
12 Down Syndrome
The risk of having a baby with a chromosomal abnormality increases in a mother of advanced maternal age. The statistics for Down syndrome, which is where a baby has an extra copy of the 21st chromosome, show the big difference in the risk for a woman in her 20s versus in her 30s or 40s.
At age 25, Down syndrome is fairly uncommon, occurring in 1 in 1,340 births but at age 30, that increases to 1 in 940. At 35, you are more than twice as likely to have a baby with the condition, with a likelihood of 1 in 353. At age 40, that goes up to 1 in 85 and 1 in 35 at the age of 45.
The extra chromosome causes problems with the development of the baby's brain and body. That can include development disabilities, vision problems, hearing loss and congenital heart defects. Sometimes other issues such as blood disorders, thyroid problems and other conditions can also occur for a baby with Down syndrome. While your baby may have a tougher time in life, Down syndrome isn't fatal, as long as the heart issues are corrected. Many babies survive and thrive into adulthood.
There can be signs of chromosomal or genetic defects in an ultrasound. But for women of advanced maternal age, doctors will likely recommend an amniocentesis to get a clearer picture of what is going on inside the womb. The procedure is quick, although it is a little painful and can have major side effects, but some doctors believe it could provide some answers for women concerned about the health of their babies.
To perform the procedure, the doctor will start with an ultrasound to check the baby's position and make sure that he isn't in the path of the needle. Then, the doctor will use a long needle to get a sample of amniotic fluid from the uterus. The fluid contains cells from the baby, which can give an idea of the chromosomal makeup. It is 90 percent accurate for most abnormalities and 99 percent accurate for Down syndrome. If other issues run in your family, the doctor may want a more extensive genetic work-up, as well.
While the procedure is over quicky, doctors recommend that the woman rest for a day or two afterward. The potential is there for bleeding, fluid leaking or cramping. It could even cause the onset of contractions, which isn't good because the procedure is usually performed between 15 and 18 weeks, long before the baby is ready. Because of the risks, some parents decide to forego the testing and embrace the baby, no matter the situation.
10 Birth Defects
While research may give older women pause about getting pregnant past 40, a new study out of the University of Adelaide in Australia says that women have help getting pregnant have fewer birth defects than women who get conceive naturally. The study looked at babies conceived naturally as well as those conceived through in vitro fertilization and through intracytoplasmic sperm injection.
While the rates of birth defects are higher in mothers who are older overall, the number of children born with birth defects who were conceived with help actually went down as the mother aged.
The researchers determined that a need for greater study is in place, but moms shouldn't have to worry as much about going through fertility treatments in their 40s. Women who conceive naturally may still have issues, but that isn't the case for every mom.
While researchers are still trying to determine a cause for autism, studies ahve confirmed a link to maternal — and paternal — age and an increased likelihood of children who are diagnosed on the spectrum. The likelihood increases with both extremes of the age spectrum, from an increased rate for teen moms to a higher rate for the children of geriatric moms.
The rate of diagnosis is up 15 percent for children whose mothers had them in their 40s compared to those in the 20s. The rate is also higher when the father is older — as much as 28 percent higher for dads in their 40s and 66 percent higher for children born to dads in their 50s. If both parents are older, that is also an increased risk, and if one of the parents is older and the other is 10 or more years younger, that also could mean a higher likelihood for autism.
Researchers are still trying to piece together the puzzle on autism, although the latest findings on parental age is helping. Further studies will help, but for now, mothers of advanced maternal age need to be aware of the possibility since early diagnosis and therapies can help a little one on the autism spectrum have the best prognosis as possible.
There is some good news for moms expecting babies later in life. Their little miracles may be off the charts in IQ. Scientific studies actually back it up.
According to 2015 research from the London School of Economics, first-born babies born to moms in their 30s score higher on intelligence tests on average than first-born kids born to younger moms. Doctors aren't sure if that is because of the pregancy or because an older mom may be more likely to work with her children on developmental milestones, but it shows that the late-in-life babies do have a leg up on the competition in at least one avenue.
Moms who have babies later in life are often more educated than moms who have babies young, so they may have some genetic predisposition. It isn't clear why, but a smart mom won't question the why and will just praise her child for who they are.
Some more good news could be found in a Swedish study that determined that there are some fitness advantages to being born to a geriatric mom. According to a study released earlier this year of 1.5 million Swedish adults, those born to moms in their late 30s or 40s were found to be taller and more physically fit.
Other research has shown an increase in obesity in babies born to moms in their 40s, but the new study contradicted that, showing that even in families where babies were born to the mother in her 20s and then in her 40s, there were definite advantages to the younger sibling.
With all of the other risks that can come from pregnancy at advanced maternal age, the researchers said that parents shouldn't intentionally delay their family plans because of the research, but it could give hope to women who are worried about later pregnancy.
Some more bad news for geriatric moms came recently, when an American Psychological Association study determined that the daughters of women who give birth after 30 are more likely to go through depression later in life.
The University of Western Australia research that followed young girls until they reached the age of 23 found that the women who were born to older moms experienced more stress. The rate increased for moms aged 30-34 when they gave birth, compared to those in their 20s, and it grew from stress to depression for those whose moms were 35 or older when they had them.
The study determined that the sons didn't seem to be impacted by their mother's age at their birth, and the age of the father didn't appear to have an effect either. Researchers thought that it might have to do with the relationship between the mother and daughter, but that is only theoretical at this point until more research is done.
Geriatric moms are more likely to have high blood pressure during pregnancy and an even more serious related condition. Preeclampsia, which is a type of hypertension, happens to nearly 10 percent of mothers over age 35. That is several percentage points higher than the risk for younger new moms, although higher risk factors include diabetes and smoking.
Preeclampsia is related to the pressure in your blood vessels, which can be especially high during pregnancy because of the increase blood flow . Some doctors say the increased risk could be because the vessels are older for geriatric moms, although the research is still out for the cause of preeclampsia. It could be related to the placenta, as well.
The condition can be deadly for the mom and the baby. Doctors of geriatric moms will keep an eye out for a rise in blood pressure, and they will test for proteins in the urine at each appointment. Other signs include shortness of breath, severe headache, blurred vision and nausea, and the situation can quickly get severe. The only cure for preeclampsia is delivery of the baby, so the worst cases could lead to a premature delivery or C-section or even worse.
4 Gestational Diabetes
Women who are older when they get pregnant are at greater risk of having diabetes; sometimes that is in the form of type 2 diabetes and sometimes it is through gestational diabetes, a condition where the body doesn't make enough insulin during pregnancy.
Gestational diabetes happens more often as you age and is more likely if you are overweight or gained a lot of weight during pregnancy, although it can also happen for women who are of average weight. Every woman is tested for the condition during her second trimester, and the diagnosis can mean that you have to regularly check your blood sugar and monitor your diet. You may also have to take medication or even insulin shots.
If a mom-to-be doesn't keep control of her blood sugar during pregnancy, it can lead to an overly large baby, which makes delivery difficult, and it can even lead to stillbirth or medical complications for the baby after he is born.
Gestational diabetes makes a pregnancy high risk, but a geriatric mom is already in that category and her doctor will already be keeping a close eye on her and the baby.
Many women over the age of 35 will be encouraged to induce their labor if it hasn't happened at 39 weeks because of the risk of stillbirth in the latest stage of pregnancy.
Unfortunately, women who are older are 1 to 2 times more likely to experience stillbirth than younger moms, although the research has varied widely on the topic.
Women who are of advanced maternal age are more likely to have gestational diabetes, preeclampsia, birth defects and more, which can contribute to the stillbirth rate. Women who are healthier have babies that do better, but doctors are still trying to figure out the reasons that the stillbirth rate goes up for geriatric moms.
For this reason among others, doctors consider moms-to-be of advanced maternal age to have a high risk pregnancy, and they will closely monitor the baby at the end of the pregnancy. The risk is real, so pay attention to the doctor's recommendations.
2 Delivery Complications
While plenty of older moms give birth to healthy babies with no complications, there is a much greater likelihood of a C-section if a mom is over 35. According to the National Center for Health Statistics, more than 43 percent of first-time moms over the age of 40 at one Boston hospital gave birth via cesarean, while the number was only 12 percent for those under 35. That was in 1998, and C-section rates have declined overall since then. But the research still shows that the higher the age the higher the likelihood of the procedure.
The increased likelihood for multiples, for birth defects and for conditions like diabetes and preeclampsia certainly account for the higher likelihood for a complicated delivery. On top of that, for some reason, geriatric moms are also more likely to have breech babies.
The higher likelihood of complications during delivery could make an older mom pretty anxious, and we don't blame them for that concern. However, a late-in-life pregnancy is a blessing, and we hope that all goes well so that mom and baby get through it healthy and happy.
Pregnancy is hard. It drains your energy when you are young, so for a woman in middle age, it can be even harder to get through the day. As women get older, their bones lose density, and they start to slow down — it's only natural.
With a baby on board, and even after the birth, a woman who is just past her prime could soon start to feel her age. Running after a toddler can be exhausting at 20 and twice as tough at 40, and dealing with a teenager in your 50s or 60s can seem impossible. While an older mother is more prepared for the emotional and physical toll that parenting takes, it can still be hard.
The harsh truth about being a geriatric mom means that you will be among the older moms in the carpool lane, and by the time you are an empty nester, you could also be a retiree. There are a lot of downsides, and your child could very well drive you to the nursing home early.
But the positives of having a child far outweigh the aches and pains that the body goes through and the brain suffers. Your little miracle will remind you every day how important your job is as a parent, and with age comes the wisdom that can help guide you along the way.
Sources: WebMD, Parents, Evidence Based Birth, Self, March of Dimes, Mayo Clinic, BabyMed, Today's Parent, American College of Obstetricians and Gynecologists, Autism Speaks, Centers for Disease Control, Pregnancy.org, Newser, CBS News