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Despite physical toll, more over-40 women having babies

Catherine McDiarmid-Watt | Wednesday, April 02, 2008 | 0 comments

Kim Cabral of Brewster thought she was in early menopause. Instead, she found out she was pregnant.

In April 2006, Cabral gave birth to her third child, William, at age 45. During the pregnancy, she was "shocked and scared," so convinced was she that at her age the baby would be born with birth defects. She also discovered that childbearing is a different story after 40.

"I was preparing myself for (birth defects) by talking to friends and doing research," says Cabral. "I can tell you that having a child in my 20s, 30s and 40s had extreme differences each time."
Cabral is hardly alone in learning that lesson. On March 16, Oscar-winning actress Halle Berry, 41, gave birth to her first child, a girl. The number of U.S.-born women ages 40 to 44 giving birth has tripled since 1982, according to a recently published report from the Public Policy Institute of California. The numbers rose during that period from 3.5 to 10.5 births per 1,000 women.

Sally Goldberg, a parenting specialist and author of "Constructive Parenting" (Allyn & Bacon, 2001), points to an "increasingly complex society" for those escalating figures, with women getting married later and waiting longer to have children.

"A major reason for waiting longer is getting their careers under way. Another is the rise in infertility," she says. "It takes a while to determine that infertility is a factor and then even more time to treat it. A third reason is finances. It costs a lot to raise a child, and many couples need the time to save up for the responsibility."
But women have so many responsibilities these days that having young children can be especially stressful for women in their 40s.

Besides full-time jobs outside the home, Goldberg says, "Moms also have the mom-full-time job — basically 40 hours of work plus the additional 24/7 responsibility." Many moms are also students, full time or part time, plus "we all know it takes hours of work to take care of a home, and hours of work to love, honor and cherish a mate." Mom care — the hairdresser, clothes shopping, doctor visits, etc. — "all take time, so the list goes on."

Different decades
In her 20s, Cabral had had tons of energy, bodysurfing waves off Wellfleet the day her water broke with the first baby. And it was a good thing she had that energy.

"My son Rob was and still is my most active child. He could do a running flip from the ground at 3," she says. "I was also very socially active and took Rob to a lot of (political) demonstrations."

While carrying her second child at age 33, Cabral was "thrilled." As director of Kit Anderson House shelter in Hyannis, she worked until three days before her due date.

"I gave Rob a birthday party at an arcade — and that night, delivered Autumn. She was born in less than three hours, and Rob and Autumn have the same birth date! But I was so exhausted being a working mom, I didn't get to enjoy her babyhood like I wanted."
Time went on, and Cabral became a preschool teacher. Life changed when she started feeling strange.

"I figured out I was pregnant with William by the second month because my period hadn't come and I was tired and dizzy all the time," she says. "With William, it was entirely different from the beginning, mostly from the fatigue factor and I had morning sickness from the second month throughout the rest of the pregnancy. ... Then I had an ultrasound — and there he was — it looked like his hand was waving."
Cabral's doctors immediately let her know she had beaten the odds: There is only a 7 percent chance that a woman in her 40's can conceive naturally. Most women that age conceive through artificial insemination or donor eggs. There were also warnings.

"The OB-GYN laid it down for me," she explains. "At this age there was a huge risk factor. Down syndrome is the biggest risk for women in their 40s." In addition, the risk of miscarriage increases with age.

So it should come as no shock that this most recent pregnancy was hard for Cabral.

"I left my job two months early. I was so exhausted I just knew I couldn't do both."

Benefits, too
Being an at-home mom has been a different experience. Cabral acknowledges, "I felt isolated at first, but as William grew, we joined baby yoga and play groups. It's true I don't meet many women my age that are mothers, but that's OK. I have to also say this time around is very tiring, but I love every minute."

Stacey Horton, 43, of South Yarmouth is the mom of Will, 6, and Olivia, 3. She agrees with Cabral.

"Universally, our children are a gift," she says. "They bring us joy and teach us our most valuable lessons. They allow us to stay youthful and express our heart's desires."
There are definite benefits to having a baby later in life. The chief one that Cindy Horgan, family support coordinator at Cape Cod Children's Place in Eastham and co-creator of its parenting station, sees is that women over 40 "have a good sense of who they are and tend to be focused on guiding a young child because they aren't focusing on their own identities."

But, like Cabral, Horton feels having young children later in life can be challenging:

"My energy level is not what it used to be, and my stress level has begun to soar. Although our children get along very well, there are typical sibling rivalry issues. These can be extremely challenging, especially being someone who doesn't handle conflict very well. Again, a lesson for me."

Since Will had been born three months prematurely, her second birth was meticulously monitored.

Fortunately, Horton says, "Other than the typical three months of nausea, my pregnancy was fairly easy. Our daughter was born three weeks early, which was perfect for me."
Advances in medicine that allow that monitoring have helped more women conceive after age 40 and stay healthy during those later-in-life pregnancies. While there are more risks for that age group now, the risks were even greater a generation or two ago.

Taking a chance
One mother of six — who did not want her name used, but is affectionately called "Mama Jean" by friends and family — had her sixth child at age 41, in 1964.

"I was lucky to have six kids without any problems back then, especially since my blood was RH negative, which could cause health problems to the baby," she says. "I only stopped having children at 41 because the doctor told me I'd be taking a chance at my age to have more."

Back then, Mama Jean shares, "I would have kept having children if I'd been younger."
But nowadays, with priority on education and career before kids, women are willing to wait to give birth. And Cabral offers encouraging words:

"Doctors use new ultrasounds now that trace every physical aspect of the baby to determine the baby's health. So they know early on of any serious developmental and/or physical delays."
Using these new techniques, Cabral was given an ultrasound when she was less than four months pregnant, and then another when she was seven months along. She went through a variety of other medical monitoring, including a stress test, and doctors finally decided to induce labor to encourage the birth. William was a healthy, 9.4-pound baby.

More risks, more stress, more physical challenges — yet over-40 moms say the prize of the tiny life is worth it.

"My daughter has brought me such joy from the moment she was born," Horton says. "Although having one child would have been more manageable, I can't imagine our lives without my daughter. She is a beacon of light and a great sibling."
Cabral agrees. She marvels: "Each child is special, but when you're older, you cherish each little thing. My husband and I were at the playground the other day and he said, 'What would we be doing now without William?' I answered, 'We'd be home watching TV.'"

Image: What I Thought I Knew: A Memoir, by Alice Eve Cohen. Publisher: Viking Adult (July 9, 2009)What I Thought I Knew: A Memoir
by Alice Eve Cohen
--A personal and medical odyssey beyond anything most women would believe possible

At age forty-four, Alice Eve Cohen was happy for the first time in years.

After a difficult divorce, she was engaged to an inspiring man, joyfully raising her adopted daughter, and her career was blossoming. Alice tells her fiancé that she's never been happier. And then the stomach pains begin.

In her unflinchingly honest and ruefully witty voice, Alice nimbly carries us through her metamorphosis from a woman who has come to terms with infertility to one who struggles to love a heartbeat found in her womb - six months into a high-risk pregnancy.

What I Thought I Knew is a page-turner filled with vivid characters, humor, and many surprises and twists of fate.

With the suspense of a thriller and the intimacy of a diary, Cohen describes her unexpected journey through doubt, a broken medical system, and the hotly contested terrain of motherhood and family in today's society.

Timely and compelling, What I Thought I Knew will capture readers of memoirs such as Eat, Pray, Love; The Glass Castle; and A Three Dog Life.

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About Catherine: I am mom to three grown sons, two grandchildren and two rescue dogs. After years of raising my boys as a single mom, I remarried a wonderful man who had never had a child of his own. Unexpectedly, I found myself pregnant at 49!
Sadly we lost that precious baby at 8 weeks, and decided to try again. Five more losses, turned down for donor egg, foster care and adoption due to my age and losses - we have accepted that there will be no more babies in our house.

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