Older Parenthood

Genetic testing, sweatpants and choosing when to worry.


I walked my 5th grader to her classroom on the first day of school this week. As I looked around at the other parents, I recognized once again that I'm one of the older mothers in the hall. I was 39 when I had this daughter; what my obstetrician called: Advanced Maternal Age. It's not like I'm really old, but now, ten years later, as I stand outside the classroom, three things cross my mind:

1) Dang, these parents are young and

2) There's no way I could show up here wearing sweats and a dirty pony tail like they can and

3) I'm glad I'm not as stressed out about everything as they are.

I don't know if it's age or experience, but I was a lot more worried and stressed when I was one of the 20-30-something parents than I am now, parenting in my dotage.

Here's the thing about the sweats and ponytail. One day last year, I overslept, pulled on my workout gear, wiped off my day-old mascara and drove my daughter to school. One of her classmates asked if I was her grandmother. Thank God I had the grace and maturity not to backhand the little darling. Instead, I said, "Uh, no, uh, I'm just tired." I made more of an effort after that to look somewhat fresher than the crypt-keeper.

I get emails regularly from older moms worried about everything from genetic anomalies and pregnancy complications to how motherhood will affect their careers. Even though mothers today have excellent chances of having perfectly normal, healthy pregnancies and babies, we know more than ever before about the small risks for abnormalities. The more you know the more there is to worry about. That must be where the phrase "ignorance is bliss" came from.

Take, for example, the genetic screening and diagnostic tests mothers have access to now. All mothers have some risk for having a child with a birth defect, but sadly, the risks go up with age. ACOG used to advise genetic testing for women 35 and older but now they recommend it for all mothers.

Genetic testing is not mandatory, though many patients don't realize that. It's a choice – do you or don't you want to know if something's wrong with your baby? If you don't want to know because you aren't going to do anything about it, don't want the interventions, expense or worry; just opt out. If you do want to know however, genetic testing starts with screening exams.

Blood and ultrasound tests in the first trimester tell you if your baby is at increased risk for having a genetic deformity. That's sort of like finding out the odds on a bet without finding out exactly who's going to win or lose. Most of the time, the results are reassuring that everything's A-OK. Sometimes, however, results come back with increased odds, meaning your baby might be perfectly normal, but it might be at increased risk for a genetic problem. Next step? Choose whether or not to move on to diagnostic tests. That's how you know for sure.

Diagnostic tests include additional blood work, ultrasounds, chorionic villus sampling (which can be done as early as 10-12 weeks) and amniocentesis (done between 15 – 20 weeks). Chorionic villus sampling tests for many, but not all of the same chromosomal problems as amniocentesis. If there's anything questionable about that test, the next step is amniocentesis, which is more definitive. It takes up to four weeks to get results from an amniocentesis. That means you'll be around 20 - 24 weeks pregnant before you can stop worrying.

There are benefits to knowing your baby's genetic status, like the privilege to choose whether or not you'll continue the pregnancy or raise a child with a genetic anomaly. From a purely sociologic/psychological perspective however, you have to wonder, do we really have it better than our grandmothers did? They didn't have the choices we do, but they might not have had as much worry and stress about either. They just took their chances with whatever baby they got. They knew there were risks and hoped for the best.

I'm glad I'm an older mom this time around. Many of the younger parents at school are stressed about details like who their child's desk-mates are and whether they have the "right" after-school activities. There was much discussion about whether the books on the reading list were the "best" ones. I know that stuff isn't really such a big deal in the grand scheme of parenting. The really important stuff is much easier:

Be there for everything you can

Listen more than you talk

Help your child understand that not everything has to be "perfect" for them to be happy and successful.

Teach them they have choices and that being kind is more important than being right.

Then, just hope for the best, because no matter what, your child is guaranteed to be the best. Oh, but the sweats and dirty hair thing? That's totally worth worrying about.

  • Jeanne Faulkner, R.N., lives in Portland, Oregon with her husband and five children. Got a question for Jeanne? E-mail it to labornurse@fitpregnancy.com and it may be answered in a future blog post.

    This Fit Pregnancy blog is intended for educational purposes only. It is not intended to replace medical advice from your physician. Before initiating any exercise program, diet or treatment provided by Fit Pregnancy, you should seek medical advice from your primary caregiver.