The Mature Mom: Your 40s
The experts won't lie: Having a baby now can be exhausting. "I make the analogy to my patients that there's a reason why football players don't compete after age 40 -- you don't have a physical advantage and energy reserve anymore!" jokes Dr. Niebyl. Jessica Kasten, who had her first child at 41, can relate: "I was so tired that I regretted choosing an ob-gyn who was 25 minutes away from me."
Chris Roll, who had twin girls when she was in her late 40s, recalls wanting to shut her eyes at precisely 3:00 every afternoon at work when she was pregnant. "I needed three extra hours of sleep at night, and if I could have taken that nap, I would have!" she admits. Still, Roll was so happy that she didn't care very much -- she had been trying to get pregnant for several years, a fairly common occurrence for a woman in her 40s, when conception is most difficult.
But even if being pregnant feels more taxing as we age, "we're a lot healthier at 40 than we were even a generation ago, so it may not be as difficult as you expect," notes Dr. Goldstein. On the plus side, you're less likely to experience morning sickness when you're older. "The placenta is smaller and producing fewer hormones, including HCG (human chorionic gonadotropin), the one that causes nausea," explains Dr. Niebyl.
What does become a bigger concern, however, is the risk of birth defects. "The older your eggs are, the more likely it is that an embryo's chromosomes will be improperly sorted," explains Dr. Schwarz. For example, individuals with Down syndrome generally have an extra chromosome, 47 instead of the normal 46. At 40, the chances a fetus will have Down syndrome is 1 in 100. This risk of chromosomal imbalance also partly explains why the risk of miscarriage stands at more than 50 percent by age 42. Due to these higher risks, you may be urged to get extra testing at this stage.
You can also expect your doctor to be highly vigilant about checking for chronic health problems. First-time moms over 40 are 60 percent more likely to develop high blood pressure and four times more likely to develop diabetes during pregnancy than mothers in their 20s, according to a study from the University of California at Davis.
The same study also revealed that fortysomething first-time moms are up to eight times as likely as women in their 20s to suffer placenta previa, a condition in which the placenta is implanted low in the uterus -- sometimes over the cervix -- impeding delivery.
"This condition can cause complications but can often be prevented with a cesarean," says Dr. Schwarz. C-sections are also more common in older moms, since they may suffer from other health problems such as fibroids, which can complicate delivery, adds Dr. Goldstein.
Kasten knew about all these concerns and though she worried, she also appreciates the advantages of raising daughter Lianna now. "I have more financial resources, so I can take a six-month maternity leave," she says. "And because many of my friends also waited to have kids, I have a better support network now than I would've had in my 20s!"
Jessica Brown is a writer who lives in Brooklyn, New York.
Originally published in American Baby magazine, January 2005.