Recently, Janet Jackson shocked the world with the news that she would be postponing her tour in an effort to start a family.  While many were in disbelief because they thought they wouldn’t be getting a refund on their concert tickets, most were shocked because they thought at 50 years old, she must be too old. Jackson hasn't detailed how she and her husband will expand their family unit, but if she did decide to carry a child, it wouldn't be the first time we’ve heard of successful pregnancies after the age of 40. After all, Mariah Carey did it. Halle Berry has done it…twice!

The fact of the matter is that pregnancy after the age of 40 is a growing trend in this country and in our community at large—but is it safe? The statistics say yes



Women over 40, or even over 50 years of age when they conceive generally have good outcomes with their pregnancy.  With the advances of medical technology, those who once felt it was impossible to experience motherhood at an advanced age are now being given that opportunity.  Reproductive assistance techniques such as in vitro fertilization and donor eggs now have women well into their 60s giving birth.

In the 1970s, the average age of women giving birth to their first child in this country was just over 21. Today it is almost 27 years of age. In fact, close to 10% of moms giving birth for the first time are now women over the age of 35.  Many women are now making the decision to start their family later in life—and the reasons are varied.  For some, the widespread availability of greater birth control options that didn’t exist decades ago are a factor.  For others it seems that personal goals such as career, financial gain, education, and stability are also driving the trend towards waiting to enter motherhood.

But let’s be clear. There are certain risks with attempting pregnancy as you age.  Fertility, or the ability to become pregnant begins to decline drastically in the mid 30s.  This is due to many factors including hormonal changes and the decreasing number of healthy eggs just to name a few.  Interestingly enough, while fertility itself seems to be impaired, the likelihood of conceiving twins is much higher as you age.  Research indicates this is true for those naturally conceiving, as well as those who may receive reproductive assistance to conceive.

Once over the initial hurdle of conceiving, those with advanced age are then at a much greater risk of not being able to successfully carry a pregnancy to term.  Not only are miscarriages significantly increased in older women, there is an estimated four to eight-fold increase in ectopic pregnancies (pregnancy outside of the womb) in women over the age of 35. 

While there are risks with attempting pregnancy at any age, there is also evidence that genetic complications, birth defects, and stillbirth are seen at a higher rate over the age of 40.  Research is ongoing as to the exact cause, but aging eggs appear to be at the root of many chromosomal errors.

Another common issue complicating pregnancy in older women is the health of the mother.  It is no secret that rates of obesity, high blood pressure, diabetes, fibroids, and other medical issues are much higher in older women and these chronic medical conditions can lead to many complications including low or excessive birth weight, birth defects, preterm delivery, and stillbirth.

Despite the fact that the ability to conceive is altered, and there are much higher risks of complications in the pregnancy, mom and/or baby when pregnant at an advanced age, many women are successfully giving birth to healthy children.  Additionally, research suggests that children of older parents just may have a slight advantage.  There are some studies that suggest a health benefit including improved language and social development and decreased injuries in children under 5 years of age.

So the question still remains…how old is too old to give birth? 

This is a personal decision that you must make along with the medical advice of your physician.  As Janet Jackson first schooled us way back in 1986, you have to be in "Control."  Take control of this decision by arming yourself with all of the necessary information to make an educated choice.  It is important to gain a thorough understanding of all of the potential risks and complications of an advanced age pregnancy, along with some of the benefits and availability of reproductive technology that can assist a woman in giving birth that desires to do so.

Dr. Karla and Dr. Rob are the founders of Urban Housecall, a multimedia health and wellness resource, and also hosts of the Urban Housecall Radio Show. For more from the doctors, visit their website at www.urbanhousecall.com, like them on Facebook, and follow them on Twitter @urbanhousecall.  



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