Trying to get pregnant? Make sure you know the bottom line on baby-making—what you don't understand can affect your bub-to-be's health.
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“As women grow older — a group I like to refer to as chronologically advantaged — there is a greater respect for the process of pregnancy and an awareness of the potential danger,” says Raul Artal, M.D., professor of obstetrics and gynecology at State University of New York at Syracuse. There also are great rewards.
While women in their 40s might be at a slight physical disadvantage when it comes to bearing children, they are at their prime psychologically. Women in their 40s often have well-established careers and have waited so long for motherhood that they feel time spent with their baby is their right. “These women were thrilled to be pregnant,” Gottesman says of the women in her study. “They spent a lot of time thinking about what the baby might look like and imagining themselves pushing the stroller.”
Women in their 40s also had a greater repertoire of soothing behaviors with their infants, had less financial and marital stress, and were more likely to breastfeed, according to Mercer’s research.
Perhaps the most interesting advantage to bearing children in the 40s is that doing so may prolong a woman’s life, granted that she conceives without medical intervention. Research conducted at Harvard Medical School found that the genes that allow a woman to bear children in her 40s also may be responsible for longevity. The study compared 132 women born in 1896, 78 of whom lived at least 100 years, and 54 of whom died at age 73. The researchers report that the centenarians were four times as likely to have had children in their 40s than those who survived only to 73.
Know the risks
Despite the good news, there are increased risks of bearing children in the 40s. For example, medical complications and chromosomal abnormalities go up dramatically with age. “At the age of 45, the risk of chromosomal abnormalities is one in 20,” Artal says.
Just as the rates of abnormalities increase with age, fertility rates plummet for women in their 40s. A couple in their 30s with no reproductive problems have an 18 percent chance of becoming pregnant per ovulatory cycle. But for every 1,000 women ages 40 to 45, only seven have babies, according to 1996 statistics from the National Health Center. The rate is .3 for every 1,000 women ages 45 to 49.
The drop is attributed to lower egg quality, which decreases the chance of normal embryo development and increases the risk of chromosomal abnormalities. “At age 43, a woman has a 5 percent chance of getting pregnant per cycle, but it goes up to 50 percent using a donor egg,” Ringler says. “The dramatic difference can be seen by [reducing] the age of the egg.”
Costume designer Shelley Promisel-Ryan, 43, is aware of the problems that can accompany pregnancy. After taking fertility drugs combined with in-vitro fertilization, Promisel-Ryan, who divides her time between New York and Los Angeles, is 32 weeks pregnant with her first child. The path to pregnancy has been arduous.
Two years ago, Promisel-Ryan became pregnant, but her fetus died in utero in the first trimester. She later learned that she suffered from ovarian failure, a condition in which the ovaries stop producing eggs. Infertility treatment enabled her to become pregnant again at 42, but Promisel-Ryan’s body began producing antibodies in response to the fetus, which increased her chances of miscarriage. Her obstetrician remedied the condition by having Promisel-Ryan give herself twice-daily injections of the anticoagulant heparin to help her body sustain the pregnancy. During the fourth month, she stopped taking the heparin and now is taking baby aspirin.
“I wanted two or three children,” says Promisel-Ryan, who didn’t marry until she was 40. “When the baby is born, I will be 43. ... I always say, ‘We charged our baby.’ After we pay the infertility expenses off, we’ll adopt.”
While each age group brings its own strengths to mothering, women in the different decades of life are equally competent in their roles as mother, Mercer says. And women of all ages describe the process of becoming responsible for another human being as one that weighs heavily on them but fills them with joy. But it is this rite of passage that they have felt driven to win for themselves.
“Somebody came to my baby shower with a stroller,” Promisel-Ryan says. “I wheeled it across the room and started crying. It was the moment of realizing ‘God, I’m going to be a mother.’ It’s really happening. And I can’t wait.”
Further reading: Mothers’ Nature