The Cost of Delaying Childbirth

The Cost of Delaying Childbirth

Celebs can afford to do it, can you?

So many stories abound about celebrities in their late 30s or 40s giving birth to healthy babies, that delaying childbirth seems like a normal, natural experience. Yet women who wait until their mid-30s or later to have a baby face certain risks.

“The first important hurdle they have to overcome is the ability to become pregnant because of issues of infertility [common] in women in their late 30s and 40s,” says Dr. Susan Gerber, assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, who specializes in fetal maternal medicine. “As women get older, the risk of conceiving a fetus with multiple types of chromosomal abnormalities, such as Down syndrome, is also considerably increased. The increase of chromosomal abnormalities also leads to an increased risk in the miscarriage rate in the first trimester because [many] miscarriages are due to chromosomal abnormalities.”

Statistics from the March of Dimes underscore that reality. At age 25, a woman’s risk of having a baby with Down syndrome is 1 in 1,250; at age 35 it is 1 in 400; at age 45, 1 in 30. The risk of miscarriage in the first trimester is about 20 percent for women between 35 and 39 and more than 50 percent by age 45.

Women over 35 are also more likely to have problems with gestational diabetes and high blood pressure, called preeclampsia when it is more serious, which develops during pregnancy. These women also have an increased risk of stillbirth. “Those risks are not overwhelmingly high, and, generally, women can do quite well,” says Gerber. “If a woman is 40 with no underlying conditions and conceives a chromosomally normal child, there is a very high likelihood that she will do fine. I practice high-risk obstetrics, and there are days in my practice when I don’t see anyone under the age of 40. In my experience, when women have delayed pregnancy to that age, they often come expecting outcomes that are far worse than the ones they are at risk for.”

As for the celebrities who give birth at a later age, Gerber says, “They may have gone through fertility treatments that the public doesn’t know about, and, in general, they tend to be healthy, without the chronic medical conditions that may affect other people.”

Gerber recommends that women have a preconception medical checkup. “If a woman is thinking about getting pregnant, she should absolutely [get checked by] her OB/GYN to see if there is anything that needs to be pursued [diagnostically] before she gets pregnant [and certainly] optimize her healthcare such as losing 20 pounds,” says Gerber “It allows women the ideal opportunity to plan a pregnancy at a time when they are healthy to give them the best prognosis for a pregnancy that will go well.”

Published in Chicago Health Winter/Spring 2013