When Lilly Chase’s daughter Patrice Panza announced she was pregnant, Chase was elated. “I knew she wanted children so badly. It was very special,” says Chase, 69, of Little Neck, NY.That her daughter was 37 years old was of no concern.
“In my day we had the expression ‘change-of-life’ baby, and it happened a lot,” says Chase. “Patrice was healthy, and having children is a natural thing, so I wasn’t worried about her!”
But with all the ink devoted to older mothers, and everything that can go wrong with their pregnancies, you might not know what to believe –– whether it's best to be thrilled or concerned if your expectant daughter is past the average age of first-time motherhood (which, according to the Centers for Disease Control and Prevention, is 25). Here’s the scoop.
Most everything that can go wrong in pregnancy –– diabetes, high blood pressure, low-birth-weight babies –– goes wrong at a higher rate in women older than 40. But don't let this scare you! “The increase in risks is not that big,” says Kari Sproul, M.D., a reproductive endocrinology and infertility fellow at UCLA's Cedars-Sinai Medical Center. “So we don’t at all think it’s unsafe for an older woman to conceive. That is, if she is in good health.”
The Real Challenge: Fertility
In fact, if your daughter has conceived, consider her lucky! “The biggest risk age raises is infertility,” says Sam Thatcher, M.D., Ph.D., founder of the Center for Applied Reproductive Science in Johnson City, Tenn.
Fertility significantly declines at age 37, says Dr. Thatcher, and many women lose their fertility entirely in their early 40s. The good news is that assisted reproduction techniques, including in vitro fertilization (when doctors combine a woman’s egg and a man’s sperm in a laboratory and transfer the resulting embryo into a woman’s uterus), can help many women become pregnant.
“The quality of the egg is the most significant factor,” says Dr. Thatcher. A woman is born with all the eggs she’ll ever have. By the time she's 40, the eggs have aged as she has. Some women 42 and older can get pregnant with IVF using their own eggs, says Dr. Thatcher, but donor eggs from younger women are a much better bet because they are less likely to have chromosomal abnormalities.
Plus, older eggs are more likely to become fetuses with chromosomal trisomies (meaning there are three chromosomes instead of the usual two). The most well-known trisomy results in Down syndrome, which is found in about 1 in 250 35-year-old women during their midtrimester (months four through six of pregnancy). Other trisomies may cause miscarriages, because, explains Dr. Sproul, the resulting abnormalities would be incompatible with life.
Hold That Announcement
Older expectant mothers are more likely to suffer a miscarriage. The 2004 Assisted Reproductive Technology report (prepared by the Centers for Disease Control and Prevention) found, when it compiled research from 411 fertility clinics nationwide, miscarriage rates for women 34 and younger to be 12 percent; at age 40, they found the rate to be 28 percent. For women older than 43, they saw the rate jump to 59 percent. So when your daughter breaks her good news to you, don’t run out and share it with the rest of the family and all your friends just yet.
“Wait until she’s out of the first trimester,” says Dr. Sproul. Once she reaches her second trimester, her risk of miscarriage drops dramatically, and you can let everyone know you have a grandchild on the way.
Give Every Ounce of Support
Support your daughter as you would any pregnant woman. Tell her she looks beautiful, help her pick out a crib, sympathize with her discomforts, and make a toast to her at the baby shower. Don’t waste time worrying about the what-ifs.
While older women are at higher risk for pregnancy complications like gestational diabetes and pregnancy-induced hypertension, she can avert the former by maintaining a healthy body weight. Even if she is diagnosed with a problem, “they’re mainly medically manageable,” says David Keefe, M.D., the James M. Ingram Professor and Ob/Gyn Chair at the University of South Florida. “We tell women over 40 to expect to be a high-risk pregnancy. But that if something does go wrong, we’re really good at taking care of them.”
The final risks of older motherhood are pre-term labor and a higher likelihood of C-section. This just means, though, that if your grandchild arrives early, or surgically, your daughter will need a little more help with her newborn.
Keep A Healthy Outlook
In spite of all these possibilities, remember that they are just that: possibilities. Chances are, the worst your daughter will have to deal with during her pregnancy will be an endless parade of tests and doctors’ visits.
“I got pregnant again at 44 and was watched much more closely and constantly poked and prodded,” says Chase’s daughter Panza, now 45, of Huntington, NY. “For a few weeks, I had to go to the doctor every three days for an internal sonogram. But once they heard the baby’s heartbeat, I got on a normal schedule for doctors' visits.”
Panza admits to being a little worried at first about her advanced age. "I did the math. When my youngest daughter will be 16, I'll be 60. I just pray that I'll be in good health." Her fears were quelled by the constant support of her doctor –– and mother –– who reassured her. Panza went on to deliver a healthy baby girl.
“Giving birth in your 40s, you know who you are as a person. I have so much more to give to my children in terms of wisdom,” she says. And in terms of love: “If you yearn for something for so long, when you actually get it you really cherish it.” That goes for grandbabies, too!
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