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During the past week, I met a woman at the clinic who is 52 years old and expecting her first child. She is pregnant through egg donation performed abroad. In this case, it involves another woman's eggs (a young woman in her 30s) and another man's sperm.
The pregnancy has been very complicated so far (she's in week 32). The umbilical cord is attached incorrectly, and the placenta is located very close to the cervix.
The woman has experienced bleeding throughout her pregnancy and has had numerous visits and ultrasounds with us. I've met this woman several times recently. These types of complications can occur, but they are more common when the woman is older.
The week before, I met another woman. She, too, had received an egg donation, was 51 years old, and was a first-time mother. She gave birth very prematurely (at 29+ days) due to severe preeclampsia with high blood pressure and organ involvement.
To save the mother, we had to deliver the baby much earlier than expected. As you may recall, the woman always comes first. This woman was also a single parent. The newborn is still in the neonatal unit and will be there for a while.
So, is it a good idea to have a baby after 45?
Over 50 and pregnant
I can't help but wonder when I meet these women. How is it to become pregnant when you are 50 or older? Is it okay to have a child so late in life?
They undoubtedly make extensive use of healthcare resources. At the same time, perhaps it fulfills their lifelong dream of becoming a mother.
But what is it like to be a child of older parents?
It's worth noting that I am a 'latecomer' myself. My oldest sister is 15 years older than I am, so I've experienced growing up with 'old' parents.
My mother told me that when she went for her first prenatal visit when she was pregnant with me, they questioned whether she should have an abortion because she was 'so old' (she was about to turn 41).
At that time, Sweden did not have free abortion (it was introduced in 1975). Despite that, they questioned her choice. She was 'too old.' This could never go well...
My mom got angry and said, 'This is the only one of my children that was actually planned!'
To have a baby after 45 - to grow up with "old" parents
What was it like growing up with 'old' parents? Overall, I can say it was good!
It's important to note that my mother wasn't a first-time mother. I was the third child, so I just went along with it somehow. That probably made it easier. It might have been different if I were the first and only child.
I do remember feeling embarrassed at parent-teacher meetings and similar events when my parents were at least 10 years older than everyone else's parents.
But perhaps that has changed today when it's more common to have children later in life.
Dad at 50
I usually read mostly medical articles, but last night, I stumbled upon a tabloid. I think it was 'Se & Hör' or something similar.
I came across an article that caught my interest given my thoughts. It was titled 'We Who Became Dads After 50...'.
It featured celebrities like Richard Gere, who became a father at 70, Al Pacino at 83, Bruce Willis at 59, Robert De Niro at 79, Mick Jagger at 73, and Rod Stewart at 66.
'Dad or granddad? In some cases, it's hard to tell... But true dad joy knows no age, right?'
the magazine introduced the article.
How is it really? How common is it? What do we think? Do we accept it more when the man is older and the woman is younger?
It's a fact that these 'dads of joy,' as the magazine describes them, will hardly see their children grow up. For instance, it's well-known that Bruce Willis has early-onset dementia. The article mentions that the family is a great support for him...
The World's Oldest Mother
The world's oldest mother, as far as we know, is a 73-year-old Indian woman who had twins through IVF and egg donation.
Her husband was 84 at the time and passed away shortly after due to a heart attack. "He did get to experience the joy of being a father," the woman said.
She described how her biggest wish came true when she became a mother. She also has identified a close relative who will take care of her girls the day when she gets too old. Is this okay?
To have babies when you pass 45
To begin with, I must admit that when I meet an older (often first-time) mother who became pregnant through egg donation, often in another country, alarm bells start ringing! Warning! Warning!
You might think I'm prejudiced, but it almost always leads to problems. These women often develop high blood pressure or other complications that make the pregnancy complex and risky.
Almost always.
I usually think that nature is wise, and there's a reason women typically go through menopause around 50 and don't get pregnant.
Simply put, women should not give birth when they're older. However, we try to challenge 'the natural' with today's trends, definitely.
My family on my mother's side comes from Slite on Gotland. My grandmother, Anna Maria, had many children, precisely seven. Her last child was born when she was approaching 50 years old.
Back then, women gave birth until menopause, and in my family, we have a late onset of menopause. Was that more right than today's efforts to have children when you're over 50 because the possibility exists?
My grandmother was probably very happy with all her children and loved them equally. Then she died relatively early from a stroke with extremely high blood pressure. That's a different story.
How do we handle these women when they come to us in healthcare?
Because they do come. Since 1970, the number of births to women aged 15-19 has decreased significantly from over 7,000 to about 500 births per year, while the number of births to women aged 45-49 has increased from about 120 to 500 births per year.
In 2022, 410 children were born to mothers aged 19 or younger. At the same time, 537 children were born to mothers aged 45 or older, according to the latest figures from Statistics Sweden (SCB).
In other words, more newborns now have mothers in the older age group than teenage mothers.
A woman's egg reserve is located in her ovaries, and the first egg matures when a girl enters puberty.
A woman's fertile age usually lasts for most until they are 45-50 years old, and she can become pregnant until ovulation and menstruation cease.
Regarding older fathers, it refers to men around the age of 50. According to an article published in the journal Nature, children of older fathers have a greater risk of developing schizophrenia, autism, and other genetic disorders.
This is because more genetic mutations occur during sperm production in men as they age.
Risks for older first-time mothers
Definition: An older first-time mother is defined as a woman who is ≥ 40 years old at the birth of her first child.
The risk of perinatal mortality, stillbirth, preterm birth, growth restriction, gestational diabetes, thrombotic disorders, and preeclampsia is increased in pregnant women over ≥40 years.
Pregnant women over 40 more often have cesarean sections than younger women, and in vaginal delivery, the frequency of severe birth injuries is increased in 'older' women.
First-time mothers, in general, have an increased risk of preeclampsia, stillbirth, cesarean sections, and sphincter injuries.
Older first-time mothers have the added factor of age as a risk, so they require extra attention during pregnancy and childbirth.
How do we handle older pregnant women?
Midwife visits follow the basic program but with more frequent visits as needed, especially toward the end of the pregnancy.
We try to plan the pregnancy with checks, ultrasounds, and more.
Growth ultrasounds in pregnancy week 32 and at the end of pregnancy in week 36.
Induction by pregnancy week 41 at the latest.
However, older mothers are a somewhat new-old trend. In the late 1800s, 12% of all women who gave birth were over 40 years old.
That was before contraceptives, abortion rights - in a rural society where having many children was often an asset on the farm. Having children later in life can involve some health risks, but from a socio-economic perspective, primarily positive effects have been observed.
Children born to slightly older mothers often have a better start in life than those born to very young mothers. The mothers have better incomes, social resources with a larger network, and greater personal maturity.
An anecdote
You know I love them after all my years as an obstetrician!
I met a woman at my clinic. She came in because she thought she had reached menopause. She was 55 years old, and her husband was just over 60, actively planning for retirement.
She came in because she hadn't had her period for a while and was feeling unwell. She felt nauseous in the mornings and generally quite off.
She was convinced she was going through menopause and wondered if she needed estrogen. During these checks, we always do a pregnancy test, just in case...
The woman was pregnant! And she was around week 25!
We have free abortion in our country, but only up to week 22.
This caused complete chaos! The couple was just in the midst of planning for a retirement life. They were going to buy an apartment in Spain and move to the sunny coast. They didn't intend to become parents again.
I can tell you that I met them later in a different context. It went well for them. They had an incredibly cute little girl. However, it felt a bit strange for her siblings (2 of them), who were both around 25-30 years old and on the verge of starting their own families. Life sometimes brings surprises.
So, what do I think about this issue, really?
As usual, there are two sides to the coin.
I understand women who are happy to fulfill their lifelong dream of becoming a mother. At the same time, most of these pregnancies are risky and require significant resources from healthcare. Is it right or wrong?
I think I'll refrain from answering.
/Doctor Eva
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