The Later-In-Life Pregnancy

Older, wiser and, yes, of "advanced maternal age." But becoming a mom can still be cool when you're over 40.

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By the age of 43, Jamie Rhein of Columbus, Ohio, thought it was unlikely she'd have a baby. "I had never gotten pregnant," says Rhein, whose adopted daughter was then 9. "My husband and I had been going our merry way with unprotected sex for years." But when Rhein started craving Whopper Jrs., she knew something was up. At an age when many women were parenting teens, she was preparing for a newborn. "I went from shock to being pleased with the idea," says Rhein, now 49.

After her son was born, Rhein discovered that her age gave her an outlook on mothering that she probably wouldn't have had if she were younger. "I don't worry about being the best mother in the world," she says. "I'm able to just enjoy him for who he is. I'm just glad he's here and I'm having this experience."

Midlife Baby Boom

Record numbers of women over 40 are having babies. In 2005, their birth rate was 9.7 per 1,000, compared with just 3.8 per 1,000 in 1981. Another way of looking at the phenomenon: In 2005, 13 times as many women between the ages of 40 and 45 delivered their first child than had done so in 1975.

"We're seeing over-40 pregnancies more often, and more that are successful," says Barbara O'Brien, M.D., a maternal-fetal medicine specialist and director of perinatal genetics at Women and Infants' Hospital of Rhode Island. Better medical care, including increasingly successful infertility treatment, has improved older women's chances of conceiving and having a healthy baby. Knowing this, older women are more willing to take a chance on pregnancy. (Women over 40 also have an unintended-pregnancy rate that's second only to very young women.)

In some respects, age is an asset, not a liability. "You're so much more emotionally ready to be a parent," says Tracy Gaudet, M.D., executive director of Duke Integrative Medicine in Durham, N.C., and co-author of Body, Soul, and Baby (Bantam). "I see in my older patients that they have more life experience—they're more likely to honor pregnancy as the sacred experience it is."

Legitimate Concerns

A later-in-life pregnancy tends to entail more complications, however. "It does pose some substantial concern for women>> and their babies," says Alan Fleischman, M.D., medical director of the March of Dimes.

Over-40 mothers are between 2 percent and 5 percent more likely than younger women to experience gestational diabetes, placental abnormalities, high blood pressure, miscarriage and stillbirth. Their offspring are at higher risk for genetic disorders, premature birth and low birth weight.

Age can also complicate breastfeeding, says Kathy Leeper, M.D., I.B.C.L.C., medical director of Milkworks, a breastfeeding support center in Lincoln, Neb. In her experience, some older mothers have milk-supply issues, and this is particularly likely in women who needed medical assistance to become or stay pregnant.

Hurdling the Age Obstacle

Any pregnant woman over 35 is considered of "advanced maternal age," meaning the medical establishment considers her pregnancy at high risk for complications. But that doesn't mean an individual woman is destined to have a problem pregnancy.

"It's a label, not a diagnosis," Fleischman says, adding that older women may need a few extra prenatal exams.

If you're over 40, you can boost your odds of having a healthy pregnancy by making smart lifestyle choices:

• Be as healthy as you can before you conceive. See your doctor for apre-conception checkup; make sure all your existing health problems, such as diabetes or thyroid problems, are under control; and start taking prenatal vitamins with at least 400 micrograms of folic acid.

• Take extra-good care of yourself during pregnancy. "Eat well, exercise, gain a healthy amount of weight, see your doctor for prenatal visits, and keep your blood pressure and blood sugar under control," O'Brien recommends.

• Give yourself a break when you feel worn out. "Older women are more established in their routines, and they tend to want to continue doing everything they did prior to pregnancy," says Bonnie Berk, R.N., M.S., founder of Motherwell Maternity Fitness in Carlisle, Pa.

n Find a local lactation consultant before delivery so you'll be able to get breastfeeding help quickly.

• A Cesarean isn't your only option. Over-40 mothers are more likely to have a C-section because of their higher rates of multiple births and medical complications, but you shouldn't have one unless it's medically necessary.

•Build a support group of other new mothers, even if they're much younger. You may think you have nothing in common with women half your age, but once you start talking pregnancy, the age difference will matter less.

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