More women are starting their families around age 40 or later

by Symptom Advice on December 29, 2010

“I was, I guess, shocked, seeing people posting pictures of their grandchildren who are about the same age as my kids,” said Horwitz of Tuscaloosa.

Horwitz, 43, has a 4-year-old daughter and 2-year-old son. Statistics call her a “midlife mother,” one of a growing number of women who are becoming first-time mothers later in life.

Between 1970 and 2006, the number of first births to women age 35 and older increased nearly eight times, according to the National Center for Health Statistics. in 1970, 1 out of 100 first births were to women age 35 and older; in 2006, it was 1 out of 12. The birth rate for women ages 40 to 44 has more than doubled since 1981.

Women are having babies later in life because they are pursuing careers, marrying later, dealing with fertility issues, divorcing before having kids, waiting for mr. right, restarting motherhood, and living with partners before marriage, experts say.

“I was one that used to say that I wanted kids, but I wasn’t going to have kids at 40 or anything like that,” said Joan King of Tuscaloosa with a laugh.

But she had no idea that her first marriage would end in divorce and she’d wait until her second marriage to start a family.

Today she is the 47-year-old mother of a 6 year old.

Janice Smith has a similar story.

She was married for 13 years and dedicated to her job in politics.

“Both of us were career-

oriented,” said Smith, who served almost 10 years on a town council in new Jersey. “we both loved children but put (having children) on the back burner because of our careers.”

And then came the divorce.

Smith was 40 years old and began to think she may have missed the boat on motherhood. That is, until she took a trip to Nashville. That’s where she met her current husband, 30-year-old Billy Smith of Romulus.

“Billy and I met in Nashville and fell in love and wanted to immediately start a family,” said Smith, 46.

She became pregnant at 43. she left her job in new Jersey and moved to her husband’s

native Alabama to become a stay-at-home mom.

Because of Smith’s age, she was monitored closely during her pregnancy.

According to the American Congress of Obstetricians and Gynecologists, women’s fertility starts decreasing in their early 30s. That’s because ovulation occurs less often, an older woman’s eggs are not as easily fertilized and there is an increased chance of blocked fallopian tubes and endometriosis.

Doreen Nagle, author of, “but I Don’t Feel Too Old to Be a Mommy!: The Complete Sourcebook for Starting (and Re-Starting) Motherhood beyond 35 and After 40,” said while researching her book she came to the realization that women are ignorant of their own fertility timeline.

“they think, ‘well, I’m only a certain age, so, well, I can get pregnant next year or I can get pregnant four years from now,’ ”

Nagle said.

But experts and mothers agree that older women often have a harder time getting pregnant. All the mothers in this story had fertility treatments.

“I had difficulty getting pregnant,” Horwitz said. “it is harder. there is no guarantee in terms of being able to get pregnant.”

There are more risks for women who delay childbirth, risks such as high blood pressure and diabetes, premature births and birth defects.

Both of Horwitz’s children were premature, and she says her age may have contributed to that.

According to ACOG, at age 30, the risk of having a baby with a chromosomal abnormality is 2.6 births per 1,000; at age 35, it is 5.2 births; at age 40 it is 15.2 births; and at age 45 it is 47.6 births out of 1,000. this is why women older than 35 should have genetic counseling, said Dr. Gary Helmbrecht, a maternal fetal medicine specialist and member of ACOG. He sees about 500 women a month at the Prenatal Diagnosis Center in Virginia.

But with proper care, older women are having healthy babies every day, said Helmbrecht, who sees many pregnant women older than 40 and even some older than 50 at his practice. however, he said having a child with special needs “is a real consideration.”

“It’s something that’s very important for a couple to talk about, particularly if they have a child later in life,” Helmbrecht said. “I think everybody has to search their own souls in that regard. you have to decide for yourself, do I have the fabric in me to take care of a child with special needs?”

Helmbrecht, 53, speaks from experience. His 9-year-old child Wesley has the rare Rubinstein-Taybi syndrome.

“planning, planning, planning,” he said. “go into it with your eyes wide open.”

“(Older women) need to understand they may have to invest more time and effort in the pregnancy than their 22-year-old next-door neighbor,” Helmbrecht said.

That means more doctor visits, more ultrasounds, more tests and a closer evaluation of the fetus, he said. Women older than 35 are encouraged to get an amniocentesis at 15 to 20 weeks or chorionic villus sampling at 10 to 12 weeks to check for

abnormalities. The procedures involve extracting fluid from the mother’s abdomen or uterus

using a fine needle. there is a 1 percent chance of miscarriage with both, according to the Fetal Medicine Foundation in London.

In the past 15 years, some women in the U.S. have been able to get a nuchal translucency screening test in the first trimester. this is a non-invasive ultrasound done with high-

resolution equipment by specially trained doctors who are certified by the Fetal Medicine Foundation in London. Helmbrecht’s center performs the test, and he calls it “a major breakthrough in screening women over 35.”

There are no needles and no chance of causing a miscarriage, and it has a higher success rate because it is more sensitive and specific than the other procedures, he said. Yet there are “very few” places in the U.S. that offer the NT, Helmbrecht said, because the quality assurance is so rigorous and a certification process was devised only four years ago.

Smith, after genetic counseling, had CVS done.

“if there were any major issues, I wanted to be prepared for it,” Smith said.

But there were none. Her pregnancy was healthy and so was her son Brent, born at 7 pounds, 7 ounces, three years ago.

Horwitz has done the math. if her son waits until he’s 41 — like his mother — to have children, she will be 82 when his child is born.

King thinks about it, but doesn’t dwell on it. she has only to think of her 92-year-old grandmother, who lives independently, for inspiration.

“Young people also die,” said Nagle, who adopted a baby in her 40s. “so we can’t jump ahead and assume we won’t see our grandchildren. you can’t let that stop you, because if you did there would be little we could accomplish.”

In Nagle’s book, she writes, “Anyone in our age group considering motherhood knows we are anything but old. With our looks, intelligence, creativity, spirit and wisdom, we certainly don’t see ourselves that way and neither does anyone we know.”

“I’m comfortable with my age,” said Smith, who said she works out, eats healthy and feels great. “Age is a number. It’s just your mindset.”

But being an older mom does come with guilt.

“The guilt is going to be there partly because you are wanting to do the best job in the world so you’re holding yourself up to very high standards,” said Linda Lisi Juergens, executive director of the National Association of Mothers’ Centers, whose programs offer support for mothers nationwide.

According to experts and moms who are living it, midlife mom guilt looks like this: worrying about having the energy to keep up with your kids, juggling menopause symptoms (hot flashes, sleepless nights and hormonal changes) with parenting demands, wanting to remain emotionally, physically and financially available for your children, hoping to know your grandchildren and praying no one mistakes you for your child’s grandmother.

“if you are 50 years old and you are running around after a 2-year-old, that is really physically hard to do,” Juergens said. “That’s when mothers need to realize their limits and you kind of have to roll with that.”

For example, enlist a younger relative or friend to play ball with your child, she said.

“I had a friend whose feelings were hurt,” King said. “She’s 44 or 45 with dark hair that’s graying. Her children were 2, and a young mother in her 20s asked if they were her grandchildren.”

King said, though she recognizes signs of perimenopause, she absolutely does not feel her age.

“I do think, yeah, I would have had a whole lot more energy 10 years earlier than I do now,” Horwitz said. “but I don’t regret that. I like my life. I like the way it turned out.”

Secure, sandwiched in

Many moms say having kids in your 40s is sometimes an advantage because it means you are financially secure.

With a long career behind her, Smith is retired, receives a pension and is able to stay at home and raise her son.

“I couldn’t be writing my own ticket in my career right now if I didn’t have something to build on,” Horwitz said.

She also serves as a member of the Tuscaloosa City Board of Education.

Older moms report feeling wiser about being parents. Smith said she doesn’t get caught up in “the mom race,” competing with other moms, although two decades ago, she may have. she said she also feels more confident talking with doctors than she did in her youth and thus feels she is a better advocate for her child.

King, who works part time as an adjunct professor at the University of Alabama, found herself in an unexpected situation when, six years ago, she became the primary caregiver for her sick mother.

Older mothers are part of what is being called the “Sandwich Generation” because they find themselves caring for aging parents as well as their children. King’s mother was diagnosed with a brain tumor at the same time her son was born. as her mother’s health declined, she found she was driving both her child and mother to doctor’s appointments, feeding and bathing them, and waking up in the middle of the night to meet both of their needs.

“it was physically and emotionally exhausting,” said King, whose mother passed away three years ago.

The bottom line, Nagle said, is that deciding what age to have children is a very personal decision.

“For some people, 35 may be too old. For some people, 65 may not be,” she said.

“Motherhood is rewarding at any age,” Horwitz said. “there are pros and cons. The debate will go on as long as there are parents.”

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