Feature Archive

Mother, May I? Late Motherhood Emerges

No. 10 of the Top 10 Stories of 2004: The number of women getting pregnant in their middle years is rising. But is later really better than never?

By Colette Bouchez
WebMD Feature

Reviewed By Brunilda Nazario

When actress Geena Davis gave birth to twins earlier this year, her age -- nearly 48 at the time -- became the bigger story. Likewise, a swell of publicity surrounded Elizabeth Edwards, wife of recent vice presidential candidate John Edwards, when it was learned that she too got pregnant at age 48, and again when she was nearly 50.

Soon after, however, both women began to seem like "younger moms" when in November of this year headlines touted the birth of twins to a 57-year-old, single, first-time mom, Aleta St. James from New York City.

Indeed, while the term "older mother" once referred to women who conceived around age 30, today our birthing timeline has moved significantly, with the number of much-older women becoming first-time mothers on the rise.

"There is no question that the age where getting pregnant is considered a possibility is definitely expanding -- we are continuing to push the time line up and up and have been doing so since the 1980s," says Frederick Licciardi, MD, associate director of the NYU Program for IVF, Reproductive Surgery, and Fertility in New York City.

A new report issued this month by the CDC control verifies that a greater number of older women are getting pregnant. The birth rate for women aged 30 to 34 increased by just 4% in 2003, while those giving birth between 40 and 44 rose 5%.

And while births to women aged 45 to 49 held steady (at 0.5 births per 1,000), the rates for women in their early 20s -- once considered the prime age for motherhood -- decreased by 1%.

But just because we can push the birthing envelope, should we? And are we tinkering with Mother Nature in a way that may come back to haunt us -- if not as a society, then on an individual case-by-case, mother-by-mother basis?

Doctors say it's a hard game to call.

"It's not an issue that is going unnoticed, that's for sure -- but right now we don't have enough medical data to tell us one way or the other if older motherhood is a good thing; there just aren't enough women over 50 who have pushed the envelope to give us a clear picture of what happens when you do," says Michael Brodman, MD, chairman of obstetrics, gynecology and reproductive science at the Mount Sinai School of Medicine in New York City.

Health, Age, and Pregnancy: What We Do Know Now

Among the major arguments in favor of advanced-age motherhood is that women are living longer and are essentially healthier than ever before. Brodman tells WebMD that better nutrition, better health care, more information about disease prevention, and better living conditions have all worked to increase a woman's life expectancy significantly.

At the same time, however, rarely do these benefits extend to the heart and soul of a woman's fertility -- her ovaries and her eggs.

"Despite the fact that we have advanced our longevity, menopause still remains pretty constant -- as does the fact that, as a woman ages, she produces fewer eggs, and fewer healthy eggs, " says Margareta D. Pisarska, MD, co-director of the Center for Reproductive Medicine at Cedars Sinai Medical Center in Los Angeles, and editor-in-chief of the American Society for Reproductive Medicine News.

And that, say experts, not only means that getting pregnant grows more difficult with each birthday, if you do manage to conceive, the risk of potential problems can be significant.

"The primary cause of some of the most serious birth defects, as well as miscarriages occurring after age 40, are related to egg quality," says Licciardi. By some estimates, miscarriage rates can soar as high as 90% in women over 40.

For many, however, the best solution to becoming pregnant later often lies in the technology known as "donor eggs."

"It's the great secret that no one talks about -- in all these late-life pregnancy headlines the vast majority of the women getting pregnant are using donor eggs," says Charles J. Lockwood, MD, chair of the department of obstetrics and gynecology at the Yale School of Medicine.

With widespread availability since the early 1990s, egg donation first stimulates egg development from the donor and harvests "ripe" eggs, which it later combines with sperm in a lab. The woman donating the egg is a younger female who is given medications, which stimulate egg development.