Getting pregnant over 35
Introduction
on older motherhood - why are more women choosing to have children later
in life?
The trend towards later maternity is strongest among women with better educational qualifications, as they increasingly postpone child rearing to pursue their careers. In addition, some women who have already reared a family wish to have another child with a new partner.
A century ago, when the average life expectancy for a woman was approximately 50, a woman would be considered elderly by 35. However, today's better living standards, healthier lifestyles and modern health care means that a woman of this age is in her prime. Since more and more women are choosing to start their families later in life and feel no desperate rush to do so until well into their thirties, one might say that the biological disadvantages of being an older parent are, to an extent, balanced out by the social advantages.Older mothers often feel more settled and more ready in themselves to have a baby, possibly due to already having had career and leisure opportunities and are more likely than their younger counterparts to want to make the necessary sacrifices that having a baby inevitably brings. Increasing maturity also means they are perhaps better able to cope with the emotional and financial aspects that having a baby inevitably means.
Where there are no tangible medical complications of pregnancy, the risks of childbirth in older women are no greater than in younger women.
John Grant, British Journal of Obstetrics and Gynaecology
Another positive aspect is that the offspring of older parents do better at school than those born to the very young and studies have shown that children of older mothers tend to do better in ability tests. Research shows that older mothers are more likely to breastfeed and that they may be less prone to postnatal depression than younger women.
Co-author of 'Older Mothers: Conception, Pregnancy and Birth After 35', Dr Julia Berryman, says, "On the whole, babies are more likely to be planned and wanted by women in their thirties. There is evidence that older women express greater satisfaction and feel they are ready to have a child because they have been fulfilled in their lives before that time. The notion of sacrifice is more often talked about in younger mothers. Older mothers may want to spend more time with their children."
What are the potential pregnancy / birth risks for an older mother?
Overall the age-related risks have been exaggerated, particularly in the popular press, although women over 35 are more likely than their younger counterparts to already suffer from common chronic diseases such as arthritis, hypertension, and diabetes prior to pregnancy. They are also at greater risk from developing high blood pressure and diabetes during pregnancy. However, modern techniques mean that these can be successfully detected, treated and monitored.
Chromosomal abnormalities, increases in birth intervention and more Caesareans
The older a woman gets - particularly past her early thirties - the less supple her body becomes and the more likely she is to experience complications. There is an increased rate of intervention during birth that rises with the age of the mother. Women of 35 and over are more likely to have induced labour, diagnosis of foetal distress, epidural anaesthesia, forceps or ventouse delivery, and virtually all studies conclude that the rate of Caesarean sections rise with increased maternal age.
One study showed that first-time mothers over the age of 40 were 14 times more likely to have an elective caesarian than those under 30. As a result, there have been calls for doctors to reassess their views of older mothers. John Grant, editor-in-chief of the British Journal of Obstetrics and Gynaecology, where the study was published, said it was time for doctors to re-think their opinions of the older mother:-
"How often have you seen 'Elderly primigravida' (first-time mother) written in the special features column of the maternity record? This will convey a subliminal message to the obstetrician and midwife caring for the woman in labour, which will colour their judgements, and lead inevitably to a Caesarean section. Where there are no tangible medical complications of pregnancy, the risks of childbirth in older women are no greater than in younger women."
Increases in birth intervention do not appear to be connected with any
specific problems, so exactly how much of this intervention is necessary
and how much is caused by a general perception that 'older' mothers are
'high risk' is not known. Indeed, studies indicate that there is no greater
risk to a woman giving birth for the first time at 40, than there is to
one at 35 years old.
In 2000, a large study into the effect of giving birth later in life was published using data collected in Denmark, from 1978-1992 . This also confirmed that older maternal age strongly increases a woman's chances of at least three undesirable outcomes - miscarriage, ectopic pregnancy and stillbirth. Older maternal age also increases the risk of having a handicapped baby. Whilst it is natural to be concerned about such age-related risks, it is important to realise that the vast majority of babies are, in fact, born perfectly healthy. According to the National Association for Down syndrome, "80% of babies born with Down syndrome are born to women younger than 35. The average maternal age is 28 years old." [Yes, this is the correct term - Down syndrome. "Down" without an "s" and the "s" in syndrome is not capitalised].
With increasing age other rare chromosomal abnormalities such as Patau's syndrome and Edwards' syndrome are also more likely. The offspring of older men have an increased risk of schizophrenia and genetic disorders [read more about later fatherhood].
More babies born to older mums die 'in utero' at the end of the pregnancy
A small, but nonetheless serious risk is that more babies born to older mothers inexplicably die 'in utero', right at the end of pregnancy. In women aged 35 or more, this is 1 in 440 pregnancies, as opposed to 1 in 1000 for younger women.
Diabetes in first babies of older mothers?
According to a British study carried out by Professor Edwin Gale and his team at Southmead Hospital in Bristol and reported in August 2000 by the BMJ [British Medical Journal], there is an increased risk of the first babies of older mothers developing diabetes. The mother's age at delivery seems to be strongly related to risk of type 1 (insulin-dependent) diabetes and a 45-year-old mother is more than three times more likely to have a child who develops diabetes than a 20 year old. However, even in 45 year old mothers the likelihood of their child having diabetes was only one in a hundred. Read more about this survey >>
Premature birth?
In August 2006 doctors warned that a world-wide boom in premature babies was creating a public health 'time-bomb'. The report by the US Institute of Medicine said that premature births - defined as less than 37 weeks gestation - have risen by 30 per cent in the past 25 years. In 2004 they accounted for 12.5 per cent of all births. The report's authors blamed the trend for older mothers and increasing obesity as factors. In Britain there are about 45,000 premature births a year. Andrew Shennan, head of obstetrics at St Thomas Hospital, London, said that postponing motherhood and increasing obesity were "good candidates" to explain the increases.
"Premature babies are at great risk of death and disability and the health burden to the population will not change unless the number can be reduced," he said.
Not just age-related...
The risks associated with pregnancy and giving birth over 35 are not just 'age-related', other factors also need to be taken into account such as lifestyle (healthy diet, exercise, avoidance of "bad habits" etc), family history, socioeconomics and demographics. All of these will have a large impact on the well-being of both mother and baby. Additionally, the number of previous pregnancies (the risks are less for women giving birth who already have children), when they occurred, the parents' genetics and mother's prenatal care are all considerations.
What about fertility in older women?
For a woman over 35, getting pregnant is probably one of the hardest things to overcome. Unfortunately, getting pregnant does become more difficult with age, since fertility gradually declines and drops dramatically after 35. Women release fewer eggs as they get older and those eggs may not be as easily fertilised; also the risk of genetic material within the egg being defective increases with age, although the reason for this is not yet fully understood.
During in vitro fertilisation procedures, it is not the implantation of embryos in older women that can fail, it is their inability to sustain the embryo, as an older woman has a less efficient uterus than a younger one. According to some sources, 40 per cent of all pregnancies for women aged 40 or over, whether achieved spontaneously or through IVF will, unfortunately, end in a miscarriage.
The Danish study published in 2000 (mentioned above) also confirmed that in addition to foetal loss, older prospective parents are more likely to be unable to conceive than younger ones. Despite the fact the menopause occurs around the age of 50, it is a fact that women in their late forties seldom conceive and complete pregnancy without the help of modern techniques.
Am I more likely to have twins or triplets when I am older?
The incidence of multiple births does increase with maternal age, but more so for dizygous twins (two separate eggs fertilised by two separate sperm, i.e. non-identical twins) rather than for monozygous twins (twins which are the result of a single fertilised egg splitting into two cell masses and becoming two genetically identical individuals, always of the same sex, i.e. identical twins). It increases more so again for triplets. In any case, developments in infertility treatments have also increased the incidence of multiple births in general.
As an older mum will I receive any special medical care if I become pregnant?
If you are healthy yourself and have no problems, your antenatal care will probably be much the same as a younger woman's. If it is your first baby, or there has been a long gap since your last pregnancy you may be offered extra antenatal checks. In addition, if you are over 40 then you may receive extra careful attention during your pregnancy (see Medical Tests), and especially as the birth draws nearer.
Statistically, older mothers are more likely to give birth to left-handed children and, in Britain, around 13% of men and 11% of women are now left-handed, compared to just 3% of those born before 1910.
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How can I lessen any potential risks?
Pregnancy and giving birth can be just as safe for a healthy older woman than a younger one and your experience of pregnancy and birth does depend, to some extent, on whether everything is straightforward. Whilst not able to predict this in advance, you can improve your chances by making sure that you are eating properly, keeping fit and not smoking.
Smoking during pregnancy, whatever the age of the mother, is associated with premature births, low-birthweight babies, more miscarriages and vaginal bleeding. Also, if you are over 35 there is a significant increase compared with a younger smoker in the risk of your baby having a minor malformation, and five times the risk of low-birthweight, which is a major cause of illness in babies. Additionally, recent research has found that if a mother of any age smokes during early pregnancy, it can significantly increase the chances of her baby having autism.
What is folic acid and why is it important in pregnancy?
Folic acid is a vitamin in the B group and has been found to be especially important in the prevention of neural-tube defects such as spina bifida and anencephaly. The Department of Health recommends that 0.4mg of folic acid supplement per day be taken both before pregnancy and for the first 12 weeks of pregnancy. Women who have already had a baby born with a neural tube defect are recommended to take 0.8mg per day (please note that there are exceptions to this for women who suffer from epilepsy, who are taking anti-convulsant drugs or who suffer from vitamin B12 deficiency, but you must take expert medical advice).
You can also make sure that you have a diet rich in folic acid by eating dark green, leafy vegetables such as broccoli and spinach, beans, asparagus, citrus fruits and juices which all contain this. Folic acid is quickly destroyed by cooking (particularly boiling), so it is wise to either eat vegetables raw, or very lightly cooked. It is, however, difficult to get enough folic acid through diet alone and that is why the supplement is recommended.
>> Read more about folic acid and a diet rich in iron
Outcomes of pregnancy and birth: older mothers -v- younger mothers
It is worth remembering that all studies agree that the actual outcome for the baby is every bit as good as that for younger mothers. This is supported by the 'Apgar scores' of babies born to older mothers. The Apgar score, which was first created in 1952, rates the newborn on five parameters: respiratory effort, heart rate, reflex irritability, muscle tone, and skin color with a value of 0 to 2 (worst to best) for each. Thus, a total score of 10 is optimal. The score is calculated at 1 and 5 minutes after birth. ). It is also backed up by results of routine childhood checks on children born to later life mothers.
Excepting chromosomal abnormalities, research supports the fact that the babies of older mothers are no more at risk of birth defects than the offspring of younger mothers.
Finally...
left-handed geniuses?
Statistically, older mothers are more likely to give birth to left-handed children and, in Britain, around 13% of men and 11% of women are now left-handed, compared to just 3% of those born before 1910.
Professor Chris McManus of University College, London, has carried out a study into left-handedness (March 2002) and reports that the number of left-handed people is rising. He says that historically, they achieve more than their right-handed counterparts and that their brains are structured differently in a way that widens their range of abilities. The genes that determine left-handedness also govern development of the language centres of the brain. Professor McManus says that the increase could produce a corresponding intellectual advance and a leap in the number of mathematical, sporting or artistic geniuses!
Source: Anything Left Handed
Well-known / celebrity older mums
Cherie Blair (baby at 45), Madonna (baby at 41), Sarah Brown (wife of Gordon Brown - baby at 40 and 42), Jane Seymour (twins at 45), J K Rowling (baby at 37 and 39), Patricia Hodge (twins in her 40s), Emma Thompson (baby at 40), Liz Hurley (baby at 36), Susan Sarandon (baby at 46), Mimi Rogers (baby at 45), Iman (baby at 44), Jerry Hall (baby at 41), Annette Bening (baby at 41), Brooke Shields (baby at 37 and 40), Caroline Quentin (baby at 39 and 42), Sarah Lancashire (baby at 38), Mariella Frostrup (baby at 41 and 43), Christie Brinkley (baby at 46), Geena Davis (baby at 46), Courtney Cox Arquette (baby at almost 40), Julianne Moore (baby at 37 and 41), Helen Hunt (baby at 40), Helen Fielding (baby at 46 and 48), Lowri Turner (baby at 42), Meera Syal (baby at 43), Holly Hunter (twins at 47), Sian Williams (baby at 41), Jennifer Beals (baby at 40), Sarah Edwards (baby at 46), Beverly D'Angelo (twins at 49), Fiona Fullerton (baby at 39), Sarah Jessica Parker (baby at 37), Elle Macpherson (baby at 39), Anna Nichol Smith (baby at 38), Marcia Cross (baby at 45), Kaye Adams (baby at 39 and 43), Salma Hayek (baby at 41), Jackie Brambles (baby at 39 & 40), Sharron Davies (baby at 44), Sophie, Countess of Wessex (baby at 42), Helena Bonham Carter (baby at 41), Jennifer Lopez, (twins at 38), Halle Berry (baby at 41), Ulrika Jonsson (baby at 40), Tamzin Outhwaite (baby at 37), Nicole Kidman (baby at 41), Gwen Stefani (baby at 38), Sarah Parish (baby at 40), Natasha Kaplinsky (baby at 36), Lisa Marie Presley (twins at 40), Gillian Anderson (baby at 40), Jo Whiley (baby at 43), Kate Garraway (baby at 42), Cerys Matthews (baby at 40), Sam Taylor-Wood (baby due at 43), Claudia Schiffer (baby at 39), Samantha Cameron (baby at 39), Monica Bellucci (baby at 45), Dannii Minogue (baby at 38), Celine Dion (twins at 42), Mariah Carey (baby at 41), Julia Bradbury (baby at 41), Helen Fielding (baby at 48), Arlene Phillips (baby at 47), Carla Bruni (baby at 43 .
The world's oldest mothers
In the past...
In 1939 a Mrs Steve Pace from the U.S. was reported have given birth to her 17th child, a boy, in 1939, at the extreme age of 73. It was apparently a natural conception. [Source: Wikipedia]
Present...
In November 2008, an Indian woman, Rajo Devi, officially became the 'world's oldest mum' after giving birth to a baby girl after fertility treatment, at the age of 70.
In June 2008, a 70-year-old Indian woman gave birth to twins. Omkari Panwar, the wife of a retired farmer, delivered a boy and girl by caesarean section. The one-month premature twins were born weighing only two pounds each.
The mother, Omkari Panwar, has no birth certificate and does not know the day she was born, so uses the date of India's independence in 1947 to guess her age. She said she was nine when the British Raj left India, meaning that she is now 70.
Omkari lives in Muzaffarnagar, seven hours drive north of the capital New Delhi.
On Saturday 30th December 2006, Maria del Carmen Bousada de Lara, a Spanish woman who became pregnant after fertility treatment in Latin America, gave birth by caesarian section to twin boys just before her 67th birthday. It was her first birth, and she is one year older than Adriana Iliescu (see below), who previously held the record as being the 'world's oldest mother.'
In December 2007 Maria was diagnosed with cancer, just three weeks short of the twins' birthday and died in July 2009.
In July 2006, 62-year-old child psychiatrist, Patricia Rashbrook, became the oldest woman in Britain to have a baby. Patricia, of Lewes, East Sussex, had a 6lb 10oz boy nicknamed JJ, by Caesarean section. Her husband John Farrant, was 60. JJ was conceived through IVF using a donor egg and was the result of the couple's fifth and final attempt at the process, which cost £10,000. The couple travelled to eastern Europe to get fertility treatment from Italian doctor Severino Antinori.
In January 2005, a 67-year-old Romanian woman, Adriana Iliescu, gave birth to a girl who weighed 1.4 kilograms. The baby, Eliza-Maria was delivered by caesarean section six weeks early, after a twin embryo died in the womb. Adriana, a university professor, began fertility treatment nine years previously at the age of 58.
In 2001, a 56-year-old woman, Lynn Bezant, from Croughton in Northamptonshire, became the oldest mother of twins in the UK, after receiving fertility treatment. She gave birth by Caesarean section at 36 weeks into the pregnancy.
In November 1997, Liz Buttle, from Wales, was 60 years old when she gave birth to a son, Joseph. It was revealed that she had lied about her age to receive fertility treatment at a London clinic.
On November 7 1996, Arceli Keh of Highland, California, made headlines by giving birth to a daughter, Cynthia, at age 63 years, 9 months, at Loma Linda University Medical Center.
In 1995 Rosanna della Corte gave birth aged 62 in Italy.
----------------------------------------------------------------------------------------------Statistics and information on older fathers >>
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