The benefits of pregnancy after 40
For women planning to become pregnant, 35 looms as a big number. It is the age at which fertility rates markedly decrease while the risk of birth abnormalities will increase.
The medical profession would prefer us all to give birth before we hit this magical age. Yet worldwide figures show that one in every five women is delaying having her first baby until 35. What is more, many of these women are over 40 when they become pregnant. While medical statistics may strike fear into the heart of many a 40-year-old woman contemplating childbirth, the anxiety may not be totally necessary.
In the last decade or so it has become far more common for ‘older’ women to become pregnant. (Before I continue I will have to apologise for having to keep using the word older to denote the age group of women I am referring to. I tried other words like mature and middle-aged but everything comes off sounding rather matronly! It just points to one of the great difficulties for women choosing to become pregnant later in life, and that is the stereotypes that surround women once they hit 40. While 50 might be the new 40 there are still plenty of negative attitudes women have to contend with after 40. It’s just a bit too old! So when it comes to having babies at this age some people can be rather down on the whole idea.)
There may be little support for later pregnancies from the medical profession, from the media or even from your peers. The medical profession is full of disaster scenarios and warns women of complications. The media portrays these women as freaks or desperados in a last ditch attempt to procreate. And common knowledge has it that you will have no energy left for the vigorous role of parenting and even worse you will be on your deathbed when the child is still young! It can be hard not to be swamped by all this pessimism.
Finding a partner
Older women worried about the statistics may find some people less than sympathetic. There can be an attitude that goes something like, “Well, everyone knows the risks go up at age 35, so if you’re silly enough to wait until then, then you’ve only got yourself to blame.” It is a judgemental, opinionated and smug attitude that assumes everyone gets to choose when they can start a family. There may be no consideration given to the fact that it might take until 40 to meet the right partner.
Many women believe it’s better to be older and in a secure and loving relationship than young but possibly in an unstable relationship. If you have been with a partner a long time before having children, you may have resolved many differences compared to younger relationships where things are still being sorted out. You may then be able to give your children a more stable view of love and relationship than a young couple in the early tumultuous time of relationship establishment.
Amy*, a 40-year-old lawyer, believed it was important to wait until she met the right man: “There is no point settling for second best. This man will be the father of my child. I have to have his love and respect because this will get passed on to the child.”
Given that for many women it is essential to be in a stable relationship before they start a family, the difficulty comes when it takes decades to find the right partner. It’s not something you can create to order. If you are over 40 when it happens then there’s no reason this should have to prevent you from sharing in the joy of creating a family. No one bats an eyelid at a 40-year-old father, so why should a woman be treated any other way? And if it takes modern technology via in vitro to make this possible, why not put the technology to good use?
A conscious choice
There is something to be said for parenting at a more mature age. Older people usually don’t enter into the role lightly and may be more thoughtful about how they go about it. I have spoken to many people who own up to the fact that they had children while young simply because that was “just what you do”. It was the next thing in the progression towards maturity: you get into the workforce, you get married and then you have kids. Many do not take the time to dwell on their readiness, fitness or keenness to take on this new role.
If there was a choice, think about what sort of parents you would prefer as a child: a young couple who just had you because all their friends were having children or an older couple who were well prepared for the role. As one woman put it, “It is a loving, conscious creation, not something you take for granted.”
Attitude not age
Some people assume you slow down as you hit 40 but this assumption is based on an outdated sense of age. Many older women report they still have plenty of energy. Being older does not have to equal ill health and slowing down. We live longer now and the life stages have been pushed back a decade. People in the 50-to-70 age group are now far more vital and active than was the case a generation ago.
Medicos assume pregnancy is riskier for an older woman, but it’s not just a person’s age that affects the risk factors — it’s the woman’s health and fitness levels. If you are older but healthy, then despite the negative attitudes there is very little extra level of risk.
Older mothers do get more medical intervention such as inductions and caesarean sections but this is possibly due to the doctors’ perception of older mothers rather than any actual risk for the older woman. Some women describe doctors trying to “bully” them into safe methods such as caesarean section. This adds to the statistics of interventions for late-in-life pregnancies, thus creating a self-fulfilling prophecy.
I remember a client, Sophie, who was in her mid-40s and pregnant for the first time. She had done all the research on late-life pregnancy and knew the way she wanted to approach the pregnancy and birth. Sophie believed that one of the benefits of being older was she knew her own body and had trust and confidence in it now. She was motivated and determined not to have the process run by a conservative medical practitioner. She found a midwife and co-operative obstetrician and was supported in her desire to have a natural birth. After Sophie gave birth to a healthy baby boy the obstetrician told her she’d managed the process as well or better than any 20-year-old.
As Karen, a colleague of mine, put it, “Women want encouragement, not just grim warnings. We don’t want to be lectured at and alerted to the risks. We want to be spoken to from an awareness that as older women we do have resources that younger women may not have. We do not want to be seen from a position of deficiency.”
Readiness
Many women delay pregnancy until they have created the right life circumstances. This might include the right partner, financial stability or a work and living situation that allows for starting a family. It may also include psychological readiness. Each of these things can take years to create, so that beginning a family has to start later in life.
“I have done a lot of work to create a lifestyle that works for becoming a mother. And I am happy to have a baby now. It isn’t a compromise and I am not giving anything up. I have made space for a child; I have consciously crafted the space.” This was how Karen described the process of preparing to have a child later in life. She felt she had “given work a good burst” so that she had already achieved career satisfaction compared to younger mothers for whom it can still be an unmet need. Karen had a solid work history and so was able to set up work conditions that would be flexible enough to combine with parenting. A younger woman starting out in her career might not have such luxury.
Karen also believed that psychologically it was the perfect time to begin a family. She felt she was far more mature than in her younger days and this was important in taking up the role of mothering. When you are young you are understandably more self-obsessed or unsure of yourself. The confidence and wisdom that come with age are an asset.
Karen was also clear that she really wanted to be a mother whereas, like many women, she would have been more ambivalent about the choice when she was younger. Younger women may still be longing for more travel, more freedom for adventure or more career advancement and the birth of a child can inhibit all these things. For Karen, there were no competing issues to affect her decision now: “I am not rushing so I am ready at the starting line.”
Clare, a new mother aged 41, also spoke strongly about emotional readiness. She felt she was more patient and flexible than in earlier days and that these qualities would be important as a mother. Clare had worked at clearing unresolved personal issues and believed that now there would be less “baggage” passed on to her child. Indeed, Clare was the most relaxed and peaceful pregnant woman I have met. Despite physical complications that were unrelated to her age, she remained calm. This state would not have been possible when she was younger. It made for a relaxed pregnancy and would stand her in good stead as a mother.
Concerns
While older women speak about the wisdom that comes from maturity they are not naïve about the problems that may come with parenting later in life. Sophie, whom I mentioned earlier, was concerned that having been independent for so long she would be more set in her ways than someone younger. She was worried it would be a culture shock when the baby arrived. I did remind her, though, that it was actually a culture shock for every new mother; that there was no real way to prepare for the true nature of the role.
I remember Marie, a young teacher in her mid-20s, who became pregnant while she was in therapy with me. I warned her of the change in her life that would come from becoming a mother. A couple of months after giving birth she came back and said, “You were so right. I just had no idea. I could never imagine the changes that would happen.” Whether you are 20, 30 or 40, stepping into motherhood will always be a revelation.
Sophie was also concerned that while age gave you wisdom it paradoxically might mean you knew too much. What she meant was that she knew how much impact a parent had on a child’s life. She had worked through the effects her own parents had had on her life and knew all too well the harm that can be done by unaware parents.
Sophie imagined she would have thoughts like, “Did I just damage my child by losing my temper? Will that be years of therapy for the child now?” In this regard, ignorance is bliss. A younger person may just jump into the role without having to second-guess every parenting move they make.
Karen, my colleague, said she found it a challenge dealing with all the fears that accompanied being pregnant in your 40s. She felt there was a barrage of negative information that took a lot of effort to counter and found it useful to actually write down all the positives about being an older mother. She said that as she did this she came to realise just how much benefit her age gave her. She was then better able to hold on to this perspective in the face of negative attitudes she encountered.
It’s worth noting that it isn’t usually other women who give older mothers a hard time. Women are often pretty understanding of one another’s circumstances. It’s more often health professionals who, while meaning well, may not offer helpful support to pregnant women over 40.
Another concern for older women may be the fact that they meet their partner later in life and then have to begin a family quickly since their body clock is running out. There may be concerns about whether they have known their partner long enough and whether the desire to start a family is the woman’s agenda while the man is just going along with it. I recently saw a woman who did indeed report that her husband seemed resentful of the burden of becoming a parent (it was his second time around) and didn’t help with parenting duties. It might take him a while to “fall in love” with his new family and begin contributing more fully.
Another concern is that it can be hard to find similar-age mums, to find a group where you fit in. You are a very different person in your late 20s from who you are in your 40s. It could therefore be a little lonelier for an older mother if there are no women of a similar age in the local mother’s groups and school committees.
But then, I have heard young mothers say similar things. They join a local mother’s group only to find that they have nothing in common with the other women there. The shared role of becoming a mother in no way guarantees that there will be any other commonality. Better to stick with the friends you have even if they have already been through that stage long ago. You would have seen them through their parenting days, so now it’s their turn to reciprocate!
Choice
When it comes to giving birth it is like there is a mismatch in terms of the physical optimum of a younger woman and the emotional readiness of an older woman. So while there are higher risks of foetal abnormality for older women, there can be very good reasons for delaying parenting.
Given that there are positive aspects to both the younger- and older-aged mother, in the end it probably all balances out. And the bottom line is that everyone’s individual circumstances are unique, so it’s important that the decision matches a woman’s particular life and not some media generalisation nor outdated fears and stereotypes.
It’s all about choice: the freedom to choose to become a mother when it’s right for your life and to have that be culturally accepted and supported. Every mother, whether young or older, needs all the help she can get.
*Names have been changed to protect confidentiality
Cynthia is a psychologist working in Melbourne, Australia. T: 0417 103 018 www.cynthiahickman.net
