Having children at 40 has pros and cons

In her early 40's, Deborah Walker still had hopes of becoming a mom.

Like many of her peers, she'd chosen to first focus on her career and then on children. The Hermitage, Tenn., woman had already suffered a pregnancy loss. But four days before moving from New York to Nashville to join her husband, she found herself pregnant.

At the age of 42, she gave birth to little Madeline.

"You have a rich life tapestry to wrap around your child," says Walker, now 45. "I love that I'm an older mom. I wasn't ready before; I wasn't the person I wanted to be to be a mother. I am now."

This is the age of the older mom. But fertility favors the young, raising the question of, biologically, how old is too old to have a baby. When a woman reaches her late 30's and her 40's, the possibility of conceiving naturally -- or conceiving at all -- is a door slowly swinging shut. Plus, there are higher risks of pregnancy loss and genetic issues that accompany pregnancy at an older age.

Beyond that, there are ramifications to consider, such as simultaneously funding college tuition and retirement. But many women feel there are inherent rewards in waiting those extra years.

"Many women in their 40's have had a chance to figure out who they are," says Dr. Cornelia Graves, medical director of Baptist Hospital's perinatal and obstetrics program in Nashville. "That's really important because when you're in your 20s, sometimes you have children because it's the expected thing to do. Whereas women in their 40s, this is what they've elected to do."
The risks of conceiving

Fertility drops off sharply in a woman's late 30's. But women can still conceive naturally up until around age 50, Graves says.

But biologically, the best time for having a baby is between the ages of 22 and 32, she says.

"If you're trying to get pregnant in your late 30s or early 40s, the literature says you should try for a year" before seeking help, Graves says. "I say three to six months, because your time is much more limited."

A woman's fertility is highest and the possibility of complications lower, earlier on. Women are born with a finite number of eggs. Not only do those eggs wane in number as a woman ages, but they've weathered more. When you're 40, your eggs are 40. That's why the possibility of genetic irregularities such as Down syndrome, a chromosomal disorder, grows as a woman gets older.

Fertility starts to slide in a woman's 30's, says Dr. Gloria Richard-Davis, chairwoman of obstetrics and gynecology at Meharry Medical College in Nashville. By age 40, the decline becomes even more drastic.

For all those reasons, the American Society for Reproductive Medicine encourages women to have all their kids by age 37, she says.

"Obviously, that's not realistic for many women and the type of lifestyle we have now," Richard-Davis adds. "Women are getting married later and having children later. It doesn't mean if you're over 40, you can't get pregnant, but the probability dramatically declines."

However, Hollywood has provided some recent examples of older moms. Oscar-winning actress Halle Berry had her daughter in March at age 41. Nicole Kidman, who's 40 and married to country music singer Keith Urban, is expecting her first biological child in July. (Kidman has two adopted children with former husband Tom Cruise.)

Why women wait

Age-related in-fertility is increasingly more common. One in five women wait until they're older than 35 to start their families, reports the American Society for Reproductive Medicine.

ASRM attributes the trend to several factors: the availability of contraception and the high divorce rate, coupled with more women in the workforce, women marrying at an older age and married couples waiting to be financially secure before starting their families. Add to this mix that many women simply just don't realize fertility begins to wane in their late 20's.

Then there are the added complications of raising a child at a later age.

Vikki Adkins of Mt. Juliet, Tenn., got married at age 33. She had her first child when she was 39 and her second at 41. Adkins considers herself a high-energy person, but keeping up with a 6-year-old girl and 8-year-old boy can still be tough.

She worries about the future, funding her children's college educations and her own retirement. Not to mention adolescence and menopause will probably make concurrent appearances.

"I am 48 now and lucky I have my children," Adkins says, "but I think it is harder than when you are in your 20's and early 30's."

Not that there aren't advantages, too, to have children later in life. Many moms feel their age is an asset, giving them patience they lacked before. Medical professionals also notice the difference.

"I think you've kind of learned to roll with the punches of life, so you don't fixate on every little thing," says Baptist's Graves.

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Category: Fertility, Old Eggs, Too Old