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Older Mothers: the good, the bad and the ugly!

Pregnancy and older motherhood

As an older mother myself, having just given birth to a baby girl eight weeks before I turned forty, I find myself sensitive to all the expert opinion on the subject. During my pregnancy some of the comments I received made me wonder if I should just book into a retirement home at the same time I booked in for my antenatal care. I even considered the ultimate defence, lying about my age but this was made difficult when my seven-year-old daughter kept telling everyone about my impending, rather significant birthday. Frankly, I would prefer to follow the mantra, ‘breed old, die late and leave a beautiful brain.’ As a midwife, however, I was mindful of some of my increased risks and was grateful to have the knowledge to make informed decisions that resulted in the birth of a healthy baby.

Women who give birth later in life do so for a variety of reasons. Some have chosen to establish their careers first or to ensure financial security before embarking on motherhood. Others may not have found a partner until later on in life while others may have had difficult childhoods that they need to resolve before they become parents themselves. There are also increasing numbers of women who have undergone years of fertility treatment in order to have a baby.

Older mothers are defined as women who become pregnant and give birth at 35 years and over. Far from being a minority any more we are fast becoming a majority. In Australia in 2004, women had on average 1.77 babies. This is the highest fertility rate since 1995. This rise was seen largely amongst women who were aged between 30-39 years of age and for the first time women aged between 35 and 39 years of age are having more babies than women aged between 20 and 24 years of age. The average age of all women giving birth in Australia is now 30.6 years of age and the average age of fathers is 32.8 years of age.

What problems can older mothers encounter?

Is age a problem when it comes to pregnancy and birth or is the problem people’s attitude to age? Being an older mother has pros and cons that are supported by good scientific evidence but there is no doubt that people’s attitude to older mothers can in fact generate problems. Research has shown that where there are no identified medical complications of pregnancy, the risks of childbirth in older women are no greater than in younger women. This is an important consideration because health professionals can create a self-fulfilling prophecy when they become anxious and intervene or perceive problems. Older mothers are more likely to be induced, have their labours sped up or have a caesarean section even when you exclude problems. The older body is less supple and flexible and this may partly account for the increased need to intervene in birth. It is interesting to note, however, that older women who give birth at home or in a birth centre are much more likely to have a normal birth than those that receive a more medicalised approach.

While research into pregnancy and birth for older mothers does tend to confirm the view that women aged 35 and over are more prone to complications it is important to take underlying health issues into consideration. For example, the older we get the more likely we are to be overweight and suffer from problems such as high blood pressure and diabetes. This adds risk to any pregnancy we then have. If a risk factor exists before we go into labour then this can impact on the labour and increase the need for medical intervention.

Unfortunately high-profile examples, such as Madonna, who had her last child at 42, and Cherie Blair, Prime Minister Tony Blair’s wife, who gave birth at the age of 45, make women think age is not an obstacle to their fertility. The reality is that for women over 35 getting pregnant is often the hardest part. Fertility declines as we get older but the drop is quite dramatic after 35. Women release fewer eggs as they get older and these eggs are less likely to be fertilised or to implant in the uterus and grow a health baby. As good as you may look on the outside, and even feel on the inside, your eggs are as old as you are. If IVF is attempted it is also less successful in women over 35- and if successful more likely to end in miscarriage. On the other hand twins are more common in older mothers (non-identical). While this is partly due to the increased use of fertility treatments by these women, the likelihood of naturally conceived twins peaks between ages 35 and 39.

The rate of miscarriage in older women is significantly greater than in younger women. Studies have found that about 9 percent of recognised pregnancies for women aged 20 to 24 ended in miscarriage. The risk rises to about 20 percent at age 35 to 39, and more than 50 percent by age 42. This is mainly due to the increased risk of chromosomal abnormalities that occur with age. Older mothers are also more likely to have ectopic pregnancies. Sadly the risk of stillbirth is also increased, though some studies provide evidence that disputes this.

Older mothers are more likely to have bleeding before pregnancy. This is mostly due to the way the placenta implants lower in the uterus. Older mothers are more likely to have babies that are born premature and that are in a breech position. They are also more likely to have children born with a chromosomal abnormality. Despite the increased risk of abnormality, it is important to remember that the vast majority of babies are normal. The incidence of Down syndrome is much higher in women over 35 years of age yet the majority of babies with Down syndrome are born to women younger than 35 years of age because they are less likely to have testing for it.

Stamina does decline as we grow older and a screaming newborn at 3am will not leave you as unaffected by minimal sleep the next day as it would have in your 20s. Older mothers tend to have developed comfortable routines and a level of independence in their lives, so the 24 hour-a-day responsibilities that come with caring for a child can be a shock. Women in this older age group also are used to a higher wage than their younger counterparts and can feel the effects of lost income or a break in career. Surveys have shown that women over the age of 35 suffer most when it comes to trying to juggle family life with a job. New mothers get less than an average of four hours of sleep in the first four months of their baby’s life and this effects relationships and work performance. The key is to take as much maternity and paternity leave as possible.

What are the advantages of having children later in life?

One could argue that the biological disadvantage of having babies later on in life is balanced by the social advantages. Older mothers are more likely to be educated and financially secure. Older mothers are often more settled in themselves and ready make the necessary sacrifices that having a baby brings. Children of older parents are more likely to do well at school than those born to very young parents. Both these factors can lead to positive effects in the child. Interestingly, older mothers are more likely to give birth to children who are left-handed. People who are left-handed tend to achieve more than right-handed people because their brain is structured in a way that widens their range of abilities. Lots of actors for example, are left-handed. Older women have more confidence in their bodies and in themselves and they are more likely to negotiate care they want for themselves and their baby. The added years and life experience can give us extra courage and resilience, which are vital for motherhood.

Women who are able to have children later in life may also live longer. Research indicates that women who have one or two children in their 30s and 40s have a greater chance of living into their 80s and 90s. One study found that women who lived until at least the age of 100 were four times more likely to have had children in their 40s than women who survived only to the age of 73. The researchers concluded that the genes that allowed a woman to give birth later in life might also slow the rate of aging and decrease their susceptibility to diseases in old age.

The other benefit of pregnancy and lactation at any age is they are supposed to make us smarter. Changes occur that appear to mark the brain for life, suggesting women’s brains are much more capable of change than men’s. As if any of us doubted that!

Can women over 35 years of age reduce their risk?

At any age, a woman should consult her health care provider before trying to conceive. A preconception visit helps ensure that she is in the best possible physical condition before conception. This is especially important with women who have chronic health problems such as diabetes or high blood pressure, which can be harmful to them and their baby. These conditions are much more common in women in their late 30s and 40s than in younger women. Careful medical monitoring and appropriate choice of medications, started before conception and continued throughout pregnancy, can reduce the risks associated with these conditions and, in most cases, result in a healthy pregnancy and birth.

Having a healthy diet, undertaking regular exercise and maintaining a healthy weight is important. Taking folic acid 400 micrograms daily before and during the first 12 weeks of pregnancy can help prevent serious birth defects. If women smoke then they should try to give up or dramatically cut down, as this will have an enormous impact on the health of the baby. Smoking is linked to premature births, unhealthily small babies and more miscarriages and bleeding in pregnancy. It is also linked to stillbirth and later on to sudden infant death syndrome. Likewise it is best to avoid alcohol during pregnancy and not to use any drugs unless recommended by a health professional.

What about older fathers?

There is so much focus on older mothers in the media and by the medical profession that older fathers are hardly ever mentioned except in the context of their amazing virility. There are some risks with fathering children later in life, with an increase in rare birth disorders and schizophrenia in offspring. Women with older partners are also likely to take longer to conceive.

Do older mothers need special medical care?

Having a child between 25 and 35 years of age is probably ideal but it is not always desirable or possible. Having a baby between 35 and 45 year of age is still reasonably safe in Australia. Pregnancy after 45 years of age becomes the domain of the very healthy and very wealthy. Women who are healthy with no medical problems will need the same care as any other pregnant woman. The only additional considerations will be genetic counselling and testing for abnormalities in early pregnancy. It is important therefore that women book in early for antenatal care. There is no reason why older mothers cannot have their baby in a birth centre or at home if this is their choice and everything is straightforward in the pregnancy.

As an older parent myself I have had the advantage of watching and learning from the mistakes friends made raising their children. As an older parent I can regale my children with stories of travel and adventure from my well-spent twenties. But as an older parent I also feel a tug at the heartstrings when I consider that I won’t be with my children as long nor perhaps see as many grandchildren as some of my friends will. But then I can honesty say, I wouldn’t change a thing.

Disadvantages

  • Less energy
  • More pregnancy and birth complications
  • Longer recovery after the birth
  • Being mistaken for the grandmother!
  • Overcoming a widening generation gap (especially when it comes to music)

Advantages

  • Children make you feel and appear younger
  • More experience in life
  • More patience
  • Less insecurity about image
  • Financially secure
  • Just being a mother at any age!

Good book

‘Older Mothers’ by Julia Berryman, Karen Thorpe and Kate Windbridge

Websites

Just type in ‘older mother ‘and you will be inundated with websites.

 Dr Hannah Dahlen is the Associate Professor of Midwifery at the University of Western Sydney. She has been a midwife for more than 20 years. Hannah is also an executive member of the Australian College of Midwives, NSW Branch. She has researched women's birth experiences at home and in hospital and published extensively in this area. Hannah's website is www.hannahdahlen.com.au

Comments

16 comment(s) on this page. Add your own comment below.

Shannon
Jun 16, 2012 4:17pm [ 1 ]

Thank you so much. I was feeling concerned tonight about being an older parent. My precious little boy was unplanned, but incredibly wanted. I just wish that he could have come 10-years sooner for his sake. Lately I have been reading about how "old People smell is a reality" and how children of older parents are often embarrassed and have other issues as well. Amazing since we have so many teenage moms who are undereducated and lack any true financial abilities, with the exception of the grandparents who often end up raising the children. Thank you so much again.

Megan
Sep 22, 2013 9:23pm [ 2 ]

Thanks - I'm 44 and 8 weeks - my boyfriend is 51 and this is our unexpected love child! I have a 13 yr old and his oldest is 21 - I will have to give up my career for a while but if this pregnancy turns out to be viable, your story has made me feel much more positive... New directions but we are both professionals with a big life ahead of us!

Simone
Nov 13, 2014 1:50pm [ 3 ]

Thank you for your story. I had my first child at the age of 38 and have just found out we are pregnant again I am now 45 and 9 weeks (due a day after my 46 bday) I am looking forward to staying young and giving my children all the l be in the world. I too believe that they keep you feeling and looking younger no-one ever guess my age !!!

Heather Hossack
Feb 2, 2015 3:40am [ 4 ]

Thanks so much for sharing. I have just found out I am pregnant with my 3rd child, at 44. We already have a 15 and 10 year old sons. IT was a bit of a shock, as we were not trying. I have been up all night worrying myself sick about so many of the issues you spoke about. I feel much better now, and not alone. I am just going to take each day as it comes and love this new little person.

Ingrid
Feb 11, 2015 4:12pm [ 5 ]

Thank you for that great information and support to older mums. I had my first baby at 44yo. Happy, healthy, and smart. I was lucky, no complications and quick recovery. Sleep deprivation was a shock to the system, though. Yes, it's tiring, but so is my teaching job! After 6 months I'm back at work 4 days (partner stays home and looks after bubs). Nothing beats coming home to my little one yo boy's big smile and cuddles and "mum, mum". Wouldn't have it any other way!

JO
Mar 4, 2015 4:50pm [ 6 ]

In February after years of horrible periods and not conceiving I decided to book in for a Mirena. Instead I am 7weeks pregnant and will be 41 when baby is born.Baby number four will be due in October. Our beautiful children are 10,9 and 6. This baby will be so loved and cared for, but there are nay sayers and tsk tsks, from my family that Im a little tentative, but in our extended family babies are born every year. This year with mine there will be three... Lokk out world..

Terri
Mar 5, 2015 8:38pm [ 7 ]

Hi Heather! My name is Terri, i have your same story! We should talk! I cant wait to share with you.. my email address is wealth01health@gmail.com

Kelley Amsler
Mar 12, 2015 4:17am [ 8 ]

Thank you for the positive words. I am 44 and am 5 weeks pregnant. I took 3 pregnancy tests all positive, then became glued to the internet, worried about if I was to old and the effects on the baby. I was so excited when I found out I was pregnant then after I read all the horrifying things that could happen I was crying. I have 3 other healthy children, i was 40 when I had my 3rd child, I appreciate your uplifting words and now I can be excited again.

Kate
Mar 20, 2015 8:02pm [ 9 ]

Thank you - at last something positive. I was 33 when I had my last child and was called an elderly parent then !! Having just discovered at 45 that I am pregnant again I dread to think how I will be classified now. I am well aware of the risks and just wish to be treated equally to other mums without the 'red flag' approach being so evident. Great to hear of others experience.

Roseanne
Apr 8, 2015 12:46am [ 10 ]

Thank you for the incredible read. I am 40 this month and pregnant for the 4th time and at 36 weeks today. I have had a few complications, which has put me on bed rest, but for the most part my pregnancy has been healthy and exciting. I have had those wonderful tests early into my pregnancy and my daughter is healthy (no birth defects) and active. I feel great for the most part and can attest that I am appreciating every moment of this pregnancy due to being older. My youngest is 15 and even though I was excited about pregnancy in my early 20s I find that I didn't have the same level of appreciation for my pregnancies then as I do now. I am loving pregnancy and will miss the experience of carrying a little one inside of me when she is finally here. Everyone around me has been very supportive of mine and my partners age (he's 53) and we are looking forward to staying and feeling younger. I feel that becoming pregnant at a later age isn't something to fear, but rather embraced. Congratulations to all mature parents out there and wishing you safe pregnancies and parenthood.

Ann
Apr 13, 2015 2:59am [ 11 ]

Thank you everyone for all the positive words, but I think I may be the oldest on here at 50! My very best friends are in menopause and here I am 6 weeks pregnant?! I did miscarry unexpectedly last year, but just assumed it was a fluke pregnancy. I have had two children the youngest is 18!! My ex-husband had a vasectomy and being with a new love, and statistically thought I would never get pregnant again. I am just taking it one day at a time and trying not to freak out. Risk of miscarriage is so high that I don't want to think too far ahead. I am wondering if someone can tell me about when you have the testing done to determine if pregnancy is healthy? Much Thanks!

Raquel
Apr 16, 2015 3:33am [ 12 ]

Thank you for sharing. I am 38 married, financially secure with a 21 yr old, 7 y/o, and 4 y/o. A 4th would be a blessing. I am active, lead a healthy life, and no health problems to date. I hope my 4th pg is healthy and kicking :) God willing, God bless. xoxo

Sandee Goulbourne
May 3, 2015 8:41am [ 13 ]

Reading all these wonderful stories has really lifted me. Im 44 and expecting my first child due a month after my 45th birthday. My pregnancy has been fine so far, and I'm just praying for a healthy baby. My family are amazed as I've never really talked about having kids before and now here I am. I'm so excited and nervous at the same time. Stumbling across this article today was exactly what I needed. Thank you all and best wishes.

jo
May 7, 2015 10:09pm [ 14 ]

Hi, I'm 37 and 6 weeks 5 days pregnant and could be expecting twins (find out for sure Saturday) i'm absolutely worried sick it'll be twins as the pregnancy was a total shock any way and unplanned being that i was on the pill at the time of conceiving. I really don't no what to do. I have a very loving and caring boyfriend who I've only been with for 8 months and will support me in what ever decision i make but either way im scared stiff, don't no if i can do this. Im so so tired and lacking energy, feeling so sick and already just cant be bothered. Please help me xx

lisa
May 8, 2015 9:28pm [ 15 ]

Thanks for all the supporting stories..im 44 n 7 weeks pregnant with my 4th child..its my partners first..not gonna lie im scared..my friends have all deserted me as i used to go out n now im at home all the time..im looking for new friends n a support network..

judy kibinge
May 11, 2015 7:42am [ 16 ]

Although many women in large cities around the world are having children later in life for various reasons, its still unusual to have a first child in ones 40's here in Kenya.

I had a happy but intense career, and when the dust settled, as I approached 40 it occurred to me - maybe for the first time in my life, that I maybe wouldnt meet anyone and maybe would never be a mother, something iId never thought much about, or actively coveted, but was surprised to discover I deeply desired. But not with anyone - it had to be with someone I loved, and what was the chance of meeting him, in a city where I had dated so many frogs? I honestly didnt quite think Id meet Mr Right but lo and beho;ld, I met the sweetest, kindest,most loving - and very handsome! - husband and got married at 42. Even though we hoped for a little one, I secretly didnt think it would be possible - and was relieved that my husband (my age and also childless) put no pressure on me about this, happy for us simply to have found each other so late in our lives. My gorgeous son, now almost 3 was born after a happy healthy pregnancy.
I thought that was a nice fairytale ending and expected no more, but this weekend, just a few months after my 48th birthday , I did a pregnancy test after wondering where my periods had suddenly vanished to. I assumed this must be the beginning of menopause, but googling, found I had none of the symptoms - hot flushes, erratic preceeding periods etc.
And so... my husband and I hovered over the stick I'd just peed on, and when the two lines showed, I burst into tears of joy. Even though Id spent alot of time worrying about my son in 20 plus years with two aging parents and no sibling to share any worries or simply share a background with, I thought the only possible solution was adoption, and was trying to wrap my head around that, wondering if we should, could..... And here I was, pregant again! And ecstatic to be - mostly because of my son, who I feel really needed a sibling with such older parents.
But this evening, as the surprise and euphoria dies down, the familiar fears come back - I'd had him at 44 and now, I will be having the second (hoping all goes well) at 49! Its mpossible not to think about Downs, about miscarraiges and so on. In addition, I never quite lost my pregnancy weight, so I am not in the great shapeI was when I had my first, and so up go the risks that accompany being overweight AND older. But... what a joy, and whatever is meant to be, will be. All I can do is prepare the best I can, by long walks, eating right, staying positive and not getting stressed out by work or life or all these fears and simply celebrating our good fortune with joy and grace and love for each other over the next months which hopefully will end up with a beautiful, bright new spark of life in our lives. Wishing all the rest of you older mothers joy and strength and love too!

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