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Chance of Pregnancy Is Often Overlooked by Older Women

Catherine McDiarmid-Watt | Sunday, May 04, 2008 | 1 comments

Teresa Watts, 45 years old, expecting her second child

Teresa Watts expects to have her second child on May 28. The baby's room has been painted. The crib her older daughter once slept in has been pulled out of storage. In March, Ms. Watts's sister threw her a baby shower.

Sounds like any other mother-to-be -- except for the fact that Ms. Watts turns 45 in June, an age when many women are planning a life beyond babies.

Ms. Watts, who has a 16-year-old daughter due to graduate from high school next year, thought her days of diaper changes and 2 a.m. feedings were done. "I was shocked," the former waitress from Clarksville, Tenn., says of the home pregnancy test that came out positive. "Women my age just don't get pregnant."

Change in Plans

Well, they do. Doctors say women can get pregnant until they have completed menopause -- an event that happens sometime between the ages of 41 and 61. In the U.S., the average age of menopause is 51.

"It's very common that women don't realize they still need to worry about birth control even after they hit their 40's and move into their 50's," says Vanessa Cullins, vice president of medical affairs for the Planned Parenthood Federation of America. "Until they complete menopause, which means going 12 months without menstruating, women should consider themselves to still be fertile."

Sometimes called a "change-of-life baby," an unplanned pregnancy later in life can do just that. Couples who were looking forward to retirement, travel or an empty house can, instead, end up fixing up the nursery, buying a slew of baby gear and starting a college fund.

Having a baby later in life also comes with some increased health risks -- for both the mother and child. Older women can have healthy pregnancies and healthy babies. But compared with younger women, they are more likely to suffer miscarriages, develop gestational diabetes and experience problems during delivery. And the odds of giving birth to children with genetic birth defects are much greater in older women.

Almost 40% of pregnancies among women over 40 are unplanned, according to a 2001 survey by the National Center for Health Statistics in Atlanta, the most recent data available. And according to the survey, of 7,643 women and 4,928 men between ages 15 and 44, about 56% of all unplanned pregnancies among women over 40 are terminated.

Little Data

It's not clear just how many women over the age of 44 actually get pregnant. Doctors, government agencies and medical organizations all define the reproductive age for women in the U.S. as 15 to 44. So, there's little data collected on a national level regarding pregnancy, abortion, miscarriages or birth-control use among older women.

The Centers for Disease Control and Prevention does say that from 2000 to 2005, live births among women between the ages of 45 and 54 jumped 45% to 6,536. That number was less than 1% of all live births in the U.S. in 2005, the latest data available.

A woman's fertility starts declining in her 20's. It drops rapidly after 35, and at 45, she has a 1% chance of conceiving using her own eggs, according to Johns Hopkins Medicine, which includes the Johns Hopkins School of Medicine and the Johns Hopkins Health Systems. Many women who do choose to have children in their 40s and beyond use artificial reproductive technology, including eggs provided by a donor.

Given such odds, it's no wonder many sexually active women over age 40 don't practice birth control. The survey by National Center for Health Statistics found that 7% of women between the ages of 40 and 44 had recently had sex, weren't looking to get pregnant, but didn't use any form of birth control.

The news of Ms. Watts's pregnancy came after her 49-year-old husband decided to retire this spring as a supervisor at a truck-parts manufacturer. The couple had planned to cash in an individual retirement account, move to Florida and buy a boat. He still left the job, but is currently looking for a new one.

"This baby really is a blessing, and we've had time to adjust," Ms. Watts says. "But we're sending our oldest daughter to college next year, and now we have to start all over again."

Increased Risk

When it comes to preventing a pregnancy later in life, women with health problems may have fewer choices.

For instance, women over 35 who smoke heavily -- more than 15 cigarettes a day -- or have a history of uncontrolled high blood pressure shouldn't use birth-control pills or contraceptive devices that release estrogen. An already-elevated risk of blood clots and stroke gets pushed even higher by the estrogen.

A woman's risk of getting certain cancers also increases as she gets older, and some hormones can exacerbate that risk. One form of breast cancer, for instance, feeds off estrogen, so some birth-control pills, vaginal rings and patches should be avoided.

Women with liver disease and liver cancer should avoid contraceptives that release either estrogen or progestin, a synthetic form of the hormone progesterone. That includes pills, implants, vaginal rings, patches and some types of intrauterine devices, or IUDs, that release progestin. Sick livers can't break down the hormones, so women get exposed to higher doses than necessary.

And in some cases, women with cervical cancer and ovarian cancers shouldn't use IUDs.

To avoid these issues, some women opt for sterilization -- for their husbands. According to the National Center for Health Statistics survey, 13% of women between the ages of 40 and 44 have husbands who have had vasectomies.


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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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  1. Anonymous says:

    "A woman's fertility starts declining in her 20's. It drops rapidly after 35, and at 45, she has a 1% chance of conceiving using her own eggs, according to Johns Hopkins Medicine"

    This fact has long been accepted by the majority.
    I do however wonder when the age will start to climb, my reason to believe so is because man/woman is fairly adaptable to their environment in order to survive,(survival of the fittest)and particularity women living in modern and postmodern societies nowadays wait with their pregnancy of several reasons, career, studies, traveling etc.

Don't just sit there, reading this story or article - say something! Do you believe it? Do you think it is impossible? Do you wish it was you? Do you have a story to share (it might get published!)

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