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Health Information Five Things You Should Know About ... Midlife Motherhood

Experiencing pregnancy in your late 30s or early 40s isn't just a Hollywood thing, it’s a national trend. According to census data and statistics compiled by the Pew Research Center, the number of births to women ages 35 and older grew 64 percent between 1990 and 2008, with dramatic increases noted in women 35 to 39 (up 47 percent) and 40 to 44 (up 80 percent). While many women praise the benefits of midlife parenthood — which often include greater financial stability and flexibility with work schedules due to having established careers — conception and pregnancy can prove challenging for older women. Amy Rouse-Ho, MD, a high-risk obstetrician/gynecologist at Rush, offers the following insights about having children later in life.

At age 40, your chances of having a healthy pregnancy are still good
Despite some definite downsides to pregnancy in your late 30s and early 40s (including increased risks of having a miscarriage, a child with a chromosomal disorder, gestational diabetes, preeclampsia and c-sections), the odds of having a healthy pregnancy at age 40 are still in your favor. Just make sure to get standard screening tests (e.g., pap smears, mammograms) and prenatal care. 

Thinking of getting pregnant in your 40s? Expect some challenges
While it's possible to get pregnant in your 40s, it is significantly more difficult. A woman's fertility dips sharply after 40 due to a depleted egg supply, less frequent ovulation and fewer healthy eggs. A woman in her mid 30s, for example, has a 75 percent chance of conceiving within a year, while a 40-year-old has a 40 to 50 percent chance and a 43-year-old woman has only a 1 to 2 percent chance of conceiving. Also realize that your partner, regardless of age, might be the one with fertility issues, health experts attribute one-third of fertility problems to men.

When it comes to getting pregnant, older women have options
Older women wanting to have children have more options today than ever before. If conceiving naturally isn't possible, women can pursue assistive reproductive technologies, such as in vitro fertilization, or IVF, and the use of donor eggs. Donor eggs have a live birth rate of 50 percent. As for risks of miscarriage and chromosomal problems with donor eggs, those risks relate to the age of the donor, not the recipient. So if your donor is in her 20s or early 30s, the risks are relatively low. 

Plan ahead: See a doctor before you try to conceive
Women in their late 30s and early 40s should see their doctors regularly before they even start trying to get pregnant. A primary care doctor can help address any undiagnosed or untreated health conditions that could prove problematic during pregnancy, such as high blood pressure and diabetes. They can also advise you on how to prepare your body for a pregnancy, such as taking daily doses of folic acid, and discuss any issues related to medication use and pregnancy. Primary care doctors may also test your hormone levels, which can provide insights regarding fertility. 

There is a bright side

While the statistics can be disheartening for older women considering pregnancy, research related to older moms and their "mom skills" is quite positive. For example, older moms make healthier nutritional choices for their babies, according to a study published by the Journal of the American Dietetic Association. This includes breastfeeding their children, which provides babies powerful antibodies that help prevent illnesses.

In addition to addressing the physical challenges of conceiving and giving birth later in life, Rouse-Ho and her colleagues help their patients cope with the emotional aspects. "We explain how important it is to set realistic expectations," says Rouse-Ho. "Many of these women have delayed pregnancy for a career or until they were in a relationship. They have often been successful in their previous endeavors, and they have worked hard or made financial sacrifices to become pregnant. They may compare their emotions and experiences to a romanticized ideal of pregnancy and motherhood, and end up feeling bad when things are different than they expected. In our practice, we encourage our patients to express their emotions but not to focus on what other women’s experiences may have been."


More Information at Your Fingertips … 
Please note: All physicians featured in Discover Rush Online are on the medical faculty of Rush University Medical Center. Some of the physicians featured are in private practice and, as independent practitioners, are not agents or employees of Rush University Medical Center.  

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