I met my new neighbor this week, a young-looking and very pregnant woman. During our getting-to-know you conversation, she described herself as an “older mom” having her first baby and said she’s getting a lot of intense scrutiny from her doctor and midwives because of her age. I couldn’t believe it when she said she was 44. She’s fit, fashionable and looks all of 30. She could be the poster model for “mothers of a certain age.”
I didn’t ask my new neighbor if she’d become pregnant through infertility treatments, but it’s a safe bet she did. At 44, the chances of getting pregnant through plain-old-fashioned unprotected sex (without the benefit of drugs to boost ovulation) are very, very slim. Sure, it happens, but not that often. That said my sister knows a woman who got pregnant by surprise at age 50. Swear to God, she thought she was menopausal.
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I interviewed an infertility specialist recently who said his business was booming, because so many young-on-the-outside couples who figured they had plenty of time are facing the truth: Despite being healthy and looking years younger than parents did in previous generations, they’re having trouble getting pregnant. That’s because it’s the age of the egg, not the age of the uterus that’s getting in their way. Eggs age at a reasonably predictable rate, which means most women enter their 30s fertile but enter their 40s, “not fertile.”
A recent study released by the Centers for Disease Control National Vital Statistics System shows women over 40 are getting pregnant at rates 65% higher than they were in 1990. In contrast, 20-something women are getting pregnant 18% less often. What’s going on here? Obviously, reproductive technologies (infertility treatments) have a lot to do with it, but there are also several sociological factors that are making women put off having kids until later in life.
What used to be considered prime childbearing years, a woman’s 20s are now her prime career-building years. If she spends that decade having babies, she might miss out on important opportunities that will advance her career and increase her income. That increased income means she and her children will live at a higher standard of living than if she’d had her babies when she was younger. And considering the success of infertility treatments, waiting until later isn’t as big a risk as it was for women even 10 years ago.
The first successful infertility treatment happened in 1978. It was incredible, in a sci-fi/Futurama kind of way. People speculated this child would be inherently different than “normal” children. They talked about whether her conception was ethical and what the societal repercussions would be from messing with Mother Nature. “Test tube” conception was a little weird and somewhat frightening, and as people do when they don’t understand something new, many initially judged the concept of conception by unnatural means harshly. Many others, however, saw it as a key to advanced opportunities for women and families.
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That first “test tube” baby was born to Lesley Brown, who died recently at age 64. She was a pioneer who permanently changed the course of women’s history. She must have shared at least some of the general population’s fears that her baby might be different. How could she not? No one had ever done this before. But we can thank Lesley, her husband John and their perfectly normal daughter, Louise, for their bravery, which paved the way for more than 4 million other babies (and counting) to be born through infertility treatments.
The ability to wait to have children has created a lot of questions about how to organize and plan a life. Anne-Marie Slaughter’s cover article in a recent issue of The Atlantic magazine ponders, Why Women Still Can’t Have It All. Slaughter explores the common issues women face while trying to be everything they dreamed they’d be when they grew up, including when or if to have children, how to mingle motherhood and career, when and if to marry, travel, engage in leisure, volunteer and civic opportunities; in short—how to have a full life.
Back to my new neighbor and that extra medial scrutiny she’s getting. She’s aiming for a low-intervention labor and birth, but balancing that with her healthcare providers’ concerns about her “advanced maternal age.” Older moms have increased risks for high blood pressure, premature labor, and other complications related to her general health. The older any person is, the greater chance she’ll have something going on health-wise. Generally speaking, though, as long as Mom is healthy, those risks are fairly low.
I can only guess my new neighbor is feeling a little concern herself about this pregnancy, considering she’s 44. If anything goes wrong, the chances of carrying another pregnancy to term drop dramatically the older she gets. My neighbor is balancing her increased risk factors with her desire to have as natural a birth as possible by choosing a hospital that supports water birth, uses midwives as primary care providers and hospitalists (obstetricians who only work in the labor and delivery unit) to cover any complications that might pop up. Add in a good prenatal education, a few well-practiced techniques to manage labor pain (like HypnoBirthing or Lamaze) and I’d say she has a great chance of having the birth she wants.
Can women have it all? I think that depends on the cards you’ve been dealt, what resources you have and what your definition of “all” includes. But Lesley Brown made it possible for women like my new neighbor to include having children later in life as part of her “all.”
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Jeanne Faulkner, R.N., lives in Portland, Ore., with her husband and five children. Got a question for Jeanne? Email 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.
