Birth Beyond Forty

Announcing your thoughts of having a baby after age forty results in a variety of less-than-positive responses. Usually, eyebrows rise. Then, depending on the intimacy of your relationship, responses range from, "How old are you anyway?" to "Why don't you adopt?" to a more diplomatic version of "You can't be serious!" I've been on the fence about making this decision since I turned forty almost a year ago.

Until I began work on this story and interviewed three moms who delivered after age forty, not one woman with whom I discussed my tentative plans told me without hesitation to "go for it." The warnings have become predictable: "You're just getting some freedom now that your son is almost ten. Birth defects are much higher among babies born to older moms. You'll be almost sixty when your child graduates from high school."

Yet, despite all these discouragements, no one mentioned the additional health risks to older moms--or, on the other hand, the benefits of raising a child when you've achieved the wisdom required to survive the tempestuous twenties and the ambitious thirties. No one, that is, except the mothers with firsthand experience.

Maternal risks associated with mature births

Maternal risks to mature moms are real and well documented, according to Dr. Steve Calvin, who specializes in "high risk" pregnancy care at the University of Minnesota, Abbott Northwestern Hospital in Minneapolis, and United Hospital in St. Paul. He explained that the risk of having an "operative delivery" doubles in older moms. (Operative, he says, encompasses all medical procedures employed in nonspontaneous deliveries, from being induced to having a Ceasarean section.) He also confirmed that the risk of chromosomal damage increases dramatically--to almost one in 200 births to moms over age thirty-five. In addition, older moms suffer more frequently from gestational diabetes (occurrence is three times more likely). Older moms are also at risk for having larger babies, and premature deliveries occur almost twice as frequently. There are greater incidences of placenta previa (a situation in which the placenta grows over the cervix) and uterine bleeding.

The only good news from Dr. Calvin is that babies delivered to older moms tend to fare as well as babies delivered to younger moms. And it's no longer such a rare occurrence to be a new mom over age thirty-five. In a study done in Hawaii from 1975-1994, the number of women falling into this category increased by 129 percent.

But prospective over-forty moms have yet another issue to consider: older moms often have a harder time getting pregnant in the first place. Invitro fertilization works well for women up to age forty, according to Dr. Hugh Hensleigh, an embryologist at the University of Minnesota. But by age forty-one or forty-two, he says, the success rate declines to almost nothing. However, using a donor's ovum works really well for women in their forties and beyond, according to Dr. Hensleigh.

When I began looking for older moms to interview, I was surprised by three things: how easy they were to find, how eager they were to talk, and how, in spite of the story painted by medical statistics negative enough to warrant significant attention, the experiences of the moms interviewed and others I met while doing research for this article were overwhelmingly positive.

Cordelia delivers Sadie, the girl of her dreams

Cordelia Anderson, of South Minneapolis, had already given all her baby things away and announced to her six-year-old son, Sam, that he wouldn't be having a sibling. Then, in the spring of 1997, she began having dreams about babies, and there was a girl in the dreams. These dreams were similar to ones she'd had when she conceived Sam. When Cordelia went in for a medical checkup, her suspicions were confirmed by a positive pregnancy test.

Planning for a new family member was an "exciting adjustment" for Cordelia, Sam, and husband/father John Humleker. Cordelia runs a training and consulting business called Sensibilities and is well known for co-developing "Good Touch, Bad Touch," a curriculum on sexual health and violence prevention used by many schools. Pregnancy did slow her down a bit; she gained forty-four pounds "straight out" as she did with her first baby, which contributed to her tiredness. But she got good medical care and ran several miles every day until the day her daughter arrived.

Cordelia has some worries about being an older parent. "We have a responsibility to do everything we can to be healthy; I'd like to be around when [my children] go to college," she says. And she's had some anxiety about the new baby's affect on her work schedule--especially since infant care is very difficult to find. "We lost our original slot because our provider decided to get a job with benefits," Cordelia says wryly. "And I'm [extra] picky because of my abuse work." But her husband does more than half of the family chores, which makes a huge difference in her ability to get professional tasks done. "He does everything he can, but, of course, he can't nurse," which cuts into Cordelia's daily schedule considerably.  

Still, she's clear that the rewards of raising her unexpected daughter's arrival outweigh the challenges, and she's not about to bow to the negativism women experience as they age. "You have to be confident about what it really means to be in your forties now," she says. "Dear Abby had a column on the topic of older parents recently, and several readers pointed out that older parents could be dead or too tired to keep up with young children." Cordelia admits she can't do backflips anymore, but points out that children of older parents who responded to the Dear Abby column said parenting has nothing to do with age. It has to do with attitude and love. "Some people are in a better position to give that in their twenties, thirties, or forties," says Cordelia. Now, she says, she has something she didn't have when she was younger--sage wisdom to offer her children.

Cordelia's devotion to her career at the Illusion Theatre caused her to delay childbearing until after age thirty-five. Before that, she says, she was preoccupied with career development and financial well-being. Now, she puts these things into better perspective and has confidence in her prioritizing abilities. "I know what I know," she says.

Connie and Sachi survive the travails of premature labor

After years of saying she wasn't interested in having children, Connie Fukuda, of Minneapolis, changed her mind. She was married for the first time when she was thirty-seven. As she approached age forty, she realized she was reaching her last chance to have a child. Her husband, Ron Williamson, had two almost-grown children from a previous marriage. He was less than enthusiastic about giving up their carefree lifestyle. With the support of a marriage counselor, they decided to try to have a child.

Connie did her homework. She read some books, consulted with doctors, and reviewed her and her husband's family medical histories. She also took advantage of the testing options offered to older moms, including amniocentesis; she didn't think she'd have the patience to raise a severely handicapped child. Although Connie had fears about whether or not she could get pregnant, she didn't have any trouble, and her pregnancy proceeded with no difficulties, except a little morning sickness.

Then, Connie's water broke while she was at work as a communications specialist for what is now American Express Financial Advisors in the IDS Tower . . . a month before her baby was due. Suddenly, she was propelled into a situation none of her childbirth classes had prepared her for.

The baby was in a breech position and a C-section was called for. After her doctor was located, a seemingly healthy baby girl was delivered. Two days later, while Connie was still recovering from her own surgery, she was awakened at three a.m. by a nurse who informed her that her daughter, Sachi, was being taken to Abbott Northwestern Hospital for surgery.

Connie had to be taken by wheelchair to her new daughter's operating room. She was amazed by the crew assembled during the middle of the night to do an emergency operation on her newborn. Sachi was suffering from necrotizing, a kind of colitis common in premature babies, which is fatal in twenty percent of all cases.

During the operation, they removed a third of Sachi's large intestine and provided her with a colostomy. The newborn spent the first month of her life at Minneapolis Children's Hospital. Connie spent most of that month running back and forth from home to the hospital.

As a result of her early illness and surgery, Sachi crawled and walked a little later than is typical for infants. At the age of six months, they reattached her intestine to her colon, and she no longer had to use a colostomy. Today, she's a happy, healthy seven-year-old with an adoring family, including the two siblings in their mid-twenties from her father's previous marriage.

Although the family wasn't crazy about Connie's decision to add another member, they're very protective of Sachi now. And Ron and Sachi have an especially close father-daughter relationship, enjoying things he was never able to do with his older children, since he was at the height of his corporate career while they were growing up. "It may have taken a crisis for all of us to realize how precious she is," says Connie.

Maggie and Andrew: Doing things mom's way pays off  

Maggie Dooley Haldeman, of St. Paul, didn't decide to have her second son after age forty--although she'd always wanted another baby. "I decided that if I wasn't pregnant by May 1998, I was going to close the factory gates," she says.

It took five years to become pregnant with her first son, John, so she wasn't surprised that it took another eight to conceive Andrew. When it happened, she was thrilled. Since Maggie had been hoping to become pregnant, she was in top physical condition ("better than when I had the first one," she says). She decided against doing an amniocentesis test because she was told that there's a one-in-200 chance of terminating the pregnancy by doing the test, and she wouldn't have terminated the pregnancy if the test had been positive. She did, however, have two ultrasounds to determine whether she was experiencing the placenta problems she encountered in her first delivery.

The biggest difference between her first pregnancy and her second was "having the smarts to do what I was supposed to do." Maggie took care of her body by practicing aerobics and lifting weights, gradually easing up and replacing land aerobics with water aerobics at the three-month mark due to a "funny feeling" in her joints when she jumped around. Her physician gave her the book, What to Expect When You're Expecting, which she read from cover to cover. As a social worker for Ramsey County, Maggie's seen her share of young, unprepared moms. "We as a society have to do more about pregnancy prevention," she said. "They [teen moms] think they're having a baby doll they can dress up. When you're forty you realize how little you really know."

Maggie relied not only on what she's learned as a mature mom, but on her ability to ask for what she wanted to make the delivery as safe, comfortable, and predictable as possible. She chose a family clinic in Stillwater to provide her medical care, even though she lives and works in St. Paul, because she liked the Stillwater practice's friendliness and quality of care. She asked her best friend to help coach her through the delivery. Her husband was also on hand, but Maggie wanted the kind of nurturing only a best female friend could provide. Family members and friends were requested to wait a week before dropping by to visit Maggie and the baby so she could focus on nesting with her new family. In addition, she wanted to ride out the hormonal upheaval of the postpartum period without the complications of company.

Her older son is adjusting well to his new sibling--although he misses "alone time" with his mother and the freedom they once had to go on spontaneous trips to the zoo and other family spots. His mom has assured him that it's okay not to like these changes and that "Andrew will be portable really soon," so they can do some fun activities this spring and summer while mom's on maternity leave.

Maggie's only concern about being an older parent is that she'll be approaching sixty when Andrew graduates from high school. On the whole, however, she thinks there are a lot of benefits to being an older mom. Her family is more financially secure; they have access to good health care; and they understand the benefits of staying informed about current information on maternity and childrearing. "I feel so much more prepared and ready," said Maggie. "I could direct my own [maternity] care. Part of this comes from being more mature, and part of it is the attitude of my caregiver. You have to have the ability to ask for what you need. What I wanted drove the choices for this birth."

Autumn childbirth redeemed

While the medical statistics are sobering, having babies in the autumn of one's child-bearing years is undeniably becoming a more frequent choice and unplanned circumstance. With proper medical care and healthy lifestyle choices, over-forty moms are proving that age need not be a barrier to delivering healthy babies. From where I sit, the risks seem reasonable. Perhaps next year, I'll be writing about infants and their mature moms.

Lynn Ingrid Nelson is an over-forty freelance editor and mom, who lives in South Minneapolis and always writes before she leaps. She is a true Minnesota Parent old-timer.

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