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The uncomfortable truth about older mums

iVillage editor Holly thought she was an old mum, until she heard about a 49-year-old Hollywood star giving birth this week. Here, a personal tale about  a ‘geriatric’ pregnancy, and some wise words from an obsty who knows…

When it comes to telling young women to hurry up and have a baby, I always feel like directing them to the wise words of Tina Fey.

“Yes, I definitely should have had a baby when I was 27, living in Chicago over a biker bar, pulling down a cool $12,000 a year. That would have worked out great.” Yes, Tina, it would.

Or Tina’s colleague, Maya Rudolph, who was responding to an expert’s book urging women to get on with it: “Yeah, Sylvia, maybe your next book should tell men our age to stop playing Grand Theft Auto III and holding out for the chick from Alias.” Perfecto, Maya, even if those pop-culture references are now more dated than the Spice Girls.

These days, I think most women have pretty well swallowed the message that fertility drops drastically when you’re older. The Laura Linneys (first child at 49) and Halle Berrys (second child at 47) of the world are diluting that message, but the attention given to their stories illustrates they are the exception, and not the norm. And, as ivillage’s publisher Mia Freedman very well argues, those women have likely had some scientific assistance.

But also, you don’t always get to choose when you become a mother.

I had my first baby at 38. My second (and last, I am pretty certain) at 40. Before that, I was not ready. I spent my 20s travelling and thoroughly enjoying dating inappropriate men. I spent most of my 30s working, working, working, having found my feet in a career that I love.

Crucially, I didn’t meet the man I wanted to have children with until I was 33. And then we had to, you know, get to know each other. And the path to successful pregnancy was not entirely smooth (possibly it might have been if I was younger, but I’ll never know). So now I’ll spend my 40s being a working mum to small children. Which sometimes feels like an exhausting prospect, but also feels right, because I am where I want to be.

My numbers are not unusual any more. It’s not Laura Linney territory. But is 40 too old? It depends who you ask.

It’s certainly old enough to ring alarm bells in prenatal care.

“Um, Holly,” my midwife was on the phone. It was a Saturday morning, so I knew something was up. “I just realised, you’re 40”

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Under any other circumstances I’d be flattered being mistaken for a 30-something. It’s my youthful good looks. But since my lovely midwife had been seeing me regularly for months, with a big file of my personal information in front of her,  I’d assumed that she knew some basic facts about me, like my age.

“Thing is,” she said. “We’re not meant to let women over 40 go overdue.” I was a week overdue. Let’s say I was tired and emotional at this news.

So I was ushered in for a Sunday morning induction, with the obstetrician on duty assuring me that in fact, the ‘too old’ tag was somewhat arbitrary. Apparently, in New South Wales you’re considered of ‘advanced maternal age’ at 37, and offered an induction on your due date. An induction is recommended (but not compulsory) because of fears that past that due date, older mother’s placentas may begin to deteriorate at a faster rate than their younger counterparts.

But in the area where I live, there are lots of older mums, so the goalposts have been shifted. Hospital policy has pushed the age limit  for advanced maternal age to 40. “Otherwise,” my doc told me helpfully, “We’d be inducing every day.”

I was lucky. My 40+ pregnancy was straightforward. I was alarmed by the number at my nuchal translucency test, because it gave me drastically shorter odds of my baby being Downs than the one just two years before based almost entirely on my age. But further tests showed no signs of abnormalities, and until the final days of my pregnancy, everything went swimmingly.

So I get a little uncomfortable about 30-something women, especially single ones, being made to feel they need to hurry, hurry, hurry, find that man, lock him down, get up the duff, stop messing around. If you leave it too long, it will be a disaster. Perhaps. But rushing into motherhood when you are not ready, or with the right person, can be a disaster too. Tina Fey says so.

Of course. Pregnancy is different for everyone and while many post-35 pregnancies do go smoothly, we need to be realistic about health concerns. 

We asked Brisbane obstetrician/gynaecologist Dr Brad Robinson about the risks of pregnancy after 40. And here’s what he said:

The risk of miscarriage is greater:  A woman less than 30 has a miscarriage risk of 12 percent, while a woman aged 40-44 has a risk of 51 percent.

The risk of chromosomal defects is greater: An example is Downs syndrome.  A woman aged 20 years has a risk of this of 1 in 1,500.  A woman aged 43 has a risk of 1 in 45.

An early delivery is preferred:  First and foremost is the need to effect delivery prior to 40 weeks so as to reduce the elevated risk of stillbirth and deteriorating medical problems or concerns about fetal growth and placental wellbeing.

But it’s not all bad news! One significant study found that increasing maternal age was associated with improved health and development outcomes for children up to five years of age.  Improvements were noted in the rates of unintentional injuries, immunization rates, and language and social development in such children.  Similarly it found that children of older parents believed they benefited from ‘the devotion, patience, and attention of their parents’, as well as from greater financial and emotional stability.

Do you feel you had a choice about when to become a mother?