Babies-After-40 Phenomenon Is Picking Up Momentum : Lifestyles: More and more, women are having their first child after their 40th birthday, and new studies indicate that it’s not as risky as once thought.
Pat Packer met Ross Williams when she was 38 and married him three years later. Even as they said their vows, the bride could hear her biological clock ticking.
“As soon as I left the altar,” she said, “I knew it was time to start making a kid.”
Now 47, Packer-Williams, a graphic designer in Winchester, Mass., is the mother of 4-year-old Gavin and 17-month-old Colin, a situation that confounds financial planners.
“They’re used to helping people plan for either retirement or college tuition. You never hear about plans for people with both.”
Financial planners take note: Packer-Williams represents a small but growing group of women who are pushing nature’s envelope, delaying motherhood until after their 40th birthdays.
These women aren’t pioneers, though the over-40 phenomenon is undergoing a revival. What’s new is a more optimistic outlook for late-in-life pregnancies, the result of encouraging research.
A study in the New England Journal of Medicine in March showed no evidence that advanced age reduces a healthy woman’s chances of delivering a healthy baby. The Mount Sinai School of Medicine researchers cautioned that their findings may not apply to women over 40, too small a group to yield reliable data. But an accompanying editorial called the message “clear and optimistic.”
“The bottom line of the papers is that people today are in much better shape, and that changes the whole concept of being pregnant,” said Dr. Manuel Alvarez, assistant professor of obstetrics and gynecology at Mount Sinai.
Role models abound. Actresses Bette Midler, Glenn Close, Ursula Andress, Vanessa Redgrave and Jane Seymour all gave birth to healthy first babies after 40. Patti LuPone, 41-year-old star of the ABC series “Life Goes On,” is expecting her first child in November. And CBS recently announced it would scale back “Face to Face With Connie Chung” this fall to accommodate the 44-year-old newswoman’s efforts to have a baby.
“After consulting with my doctors, I became convinced that to make this effort, I now need to take a very aggressive approach to having a baby,” Chung said in a statement.
Should she succeed, Chung will join a tiny sorority. First births to women over 40 accounted for just 6,909 of the 3.9 million babies born in America during 1988.
They have much in common, these predominantly white, middle-class, college-educated urban professionals. They often marry later if at all, putting off family for career, and as a result sandwich themselves between aging parents and young children.
Years of dieting and aerobics have paid off. “I think of myself as indomitable,” said Tina Walton-Virta, 43, mother of 15-month-old Olivia. But like most older mothers, she is ever mindful of the realities. “It’s very sad when I think about not being able to participate in her life for as long as I’d like.”
For now, the biggest problem is postpartum exhaustion. “It’s not having a baby at 45, it’s having a 2-year-old at 47,” says Polly Ham, a teacher and potter on Lopez Island, Wash.
Women over 40 have been having first babies for years. In each of the years from 1950 to 1955, more women over 40 gave birth for the first time than did so during 1987, the Census Bureau reports.
Between 1970 and 1986, the rate of first births increased by 50% for women 40 to 44, a natural progression of the growing numbers of career women over 35 who began having babies more than a decade ago.
“At 30, my cutoff was 35. At 35, my cutoff was 40. When you really want to have a child, you just keep moving the cutoff point later,” Ham said.
At 45, she gave birth to Laurel. Like Walton-Virta and Packer-Williams, Ham is married to a man nine years her junior.
“It’s almost like watching evolution in progress, the way nature accommodates these lifestyle changes,” said New York obstetrician Jonathan Scher. First-time mothers over 40 constitute 20% of his practice, a fivefold increase from a decade ago.
That isn’t to say the next trend will be motherhood after 50. “We will reach a biological limit, and we are getting close to it,” said Dr. Siegfried Rotmensch, a high-risk specialist at Yale-New Haven Hospital in Connecticut.
For the time being, the pattern is apt to continue. In a 1989 Census Bureau survey, more than half of childless married women 30 to 34 said they still planned to have babies.
Not all will get their wish. One in six of all couples is infertile, and fertility decreases with age, Rotmensch said. About 90% of 25-year-old women not using birth control will become pregnant within a year. At 40, that figure drops to 30%.
Today’s infertility specialists have more to offer women unable to conceive on their own, but the conception rate among artificially inseminated women also declines with age. In vitro fertilization has proved less successful in older women as well.
Mary Ellen Conway, an art therapist in a Boston suburb, spent two years undergoing infertility treatment before giving up. “I had completely resigned myself to not having a child and, under the circumstances, was adjusting very well.”
Now she’s adjusting to 4-month-old Jacob, the baby she inexplicably conceived at 43. After so many years without children, parenthood takes considerable getting used to, said Steven Shade, the 37-year-old artist Conway married nine years ago.
“The downside is that we had really developed a certain lifestyle for ourselves--that and the fact I don’t have as much patience as I’d like.” Fortunately, there’s also an upside: “My son is a genius,” he said.
Infertility isn’t the only reason doctors advise older women not to wait too long.
The incidence of Down’s syndrome, 1.5 per thousand among women of 31, jumps to 1 in 350 at age 35, 1 in 100 at age 40 and 1 in 30 at age 45.
Prenatal testing, recommended for all women over 35, can now be done earlier and with less risk to the fetus. The most common procedure is amniocentesis, in which amniotic fluid is withdrawn by syringe from the uterus. Cells are isolated, grown in a laboratory and analyzed to determine the number of chromosomes in the fetus. An extra chromosome 21 indicates Down’s syndrome.
Once performed 18 weeks into pregnancy, amniocentesis can now be done at 13 or 14 weeks. “A pregnancy won’t show before 20 weeks, and the woman won’t feel it before 18 to 20 weeks, so early amnio helps avoid a lot of issues,” said Dr. Steven Swersky, a high-risk obstetrician in New York.
The New England Journal of Medicine editorial stressed that the few pregnancy-related problems more common among older women, such as high blood pressure or diabetes, “are readily manageable in 1990.”
In the past, such problems may have been overstated, Swersky said. “Risks do go up, but in some cases, they go from 3 to 3.1. A lot depends on how it’s reported.”
A lot also depends on who’s being studied. The Mount Sinai findings were based on private patients who were predominantly white, married, college-educated non-smokers--precisely the group most apt to delay childbearing.
The good news has yet to find its way into some doctors’ offices. “In today’s medical-legal climate, a woman of 39 can go in with a dream and come out feeling like a time bomb that’s waiting to go off,” Swersky said.
“Senior people in the field still have certain attitudes. Doctors have been bombarded with such negativism for so long.”
Attitudes are changing--but slowly.
Kate, a 50-year-old New York writer who asks that her last name not be used, wanted natural delivery in a birthing room. Instead, like more than 50% of pregnant women over 40, she wound up with a Cesarean section.
Such surgery is not always warranted, doctors say.
“You’re taught that these are ‘premium’ pregnancies, so doctors tend to bail out and do C-sections sooner in these patients,” said Dr. John Elliott of Phoenix Perinatal Associates, the nation’s largest private practice of high-risk obstetrics.
“Some physicians tell women just because they’re older that they’re fragile and need special handling. That attitude really bothers me. All of a sudden, this woman who thought this was the neatest thing in the world has had all the fun taken out of it.”
For some older women, the fun is already diluted by anxiety. “Particularly if she’s had problems with infertility or previous miscarriages, a woman may have tremendous fear of losing her baby,” said Patricia Schreiner-Engel, associate professor of ob-gyn and reproductive science and psychiatry at Mount Sinai.
While many pregnant women worry about losing their babies, older women’s fears often are heightened by the likelihood that they won’t get another chance--a situation that also can create anxious, overprotective parents, she says.
On a brighter note, “many older people see themselves as better parents, and I think it’s true. Most of us would make better parents when we’re older and have less pressure in our lives.”
Women who come late to the baby business often find motherhood a great leveler. “My grooming is slipping--there just isn’t time,” Packer-Williams said. “I used to look at mothers and say, ‘Look at her. Why can’t she get herself together?’ Now I know.”
Walton-Virta, who lives in Brooklyn, N.Y., spent her 20s and 30s living abroad and indulging her love of adventures. So far, raising Olivia is on a par with the best of them, she said.
“All the normal things I associated with being a mother, like Little League, pediatricians and station wagons, I thought would disgust me. I thought, what a boring way to live. I was wrong about what happens when you fall in love with a baby.”
Of course, motherhood after 40 is not without trade-offs.
An only child, Packer-Williams finds herself too busy to pay much attention to her own elderly mother and father. “I’m really caught in the aging parent-baby sandwich,” she said. “Not to mention, I’d like younger grandparents.”
There’s also one’s own mortality to consider.
“You do worry. It’s a reality, and you don’t ignore it,” says Neen Hunt, 49, head of the Calhoun School in New York. Hunt, the mother of Evan, 10, and Richard, 6, lost her own mother at 50. “We’ve talked about new moms and dads. My kids are more attuned to that possibility.”
Polly Ham’s brother and sister both died young. Her husband lost his mother when he was 14. “There are moments when he has concerns about my being older,” she said, “but I have to trust the wisdom of the universe that somehow Laurel came into my life at the right time.” She says her daughter is a great incentive to stay healthy.
Classic comedy routines can take on new twists when hard-bitten professionals meet Dr. Spock.
Unexpectedly pregnant at 42, Sally Anderson, a college science textbook editor in New York, didn’t worry about telling her parents or husband, children’s book illustrator Fred Winkowski.
She worried about telling her boss.
“I had been so devoted to my job. When I finally broke the news, I had tears in my eyes and my upper lip was shaking. Would I be demoted? Would I lose my window office?
“My boss said, ‘How did this happen?’ I said, ‘I don’t know.’ And he said, ‘You’re a biologist, Sally. Of course you know.’ ”
Erik Winkowski, who has his mother’s Scandinavian cheekbones and straight, silky hair, turned 7 in June. At an age when most women are spoiling their children’s children, Sally remains on the front lines of motherhood, a 50-year-old Teenage Mutant Ninja Turtle expert who speaks fluent Nintendo.
“He’s such a treasure. I think I look at him differently than I would have at 28, but it’s so arrogant to say so,” she said. “Who am I to say that a 28-year-old wouldn’t love her child as much?”
Occasionally, she caught herself doing mental arithmetic. “I told a friend just after Erik was born that when Erik is my age, I’ll be almost 90. There was a brief pause, then we both started laughing.”
Anderson has no regrets. Younger friends who left lower-level jobs to have babies found their careers derailed, she said. “Being where I wanted to be in terms of my career has made a big difference.”
By contrast, Kate has neither a stable career nor a husband to help support and rear 2-year-old James, the son she delivered at age 47. Her partner, a man in his 50s with grown children, walked out when she refused to terminate the pregnancy she had thought they both wanted.
As a single parent, Kate finds it doubly hard being so out of sync with her peers. A friend’s child is about to get married; hers is learning to speak in complete sentences.
“I read the books written for older mothers, the ones that assume you have your life all pulled together, and I just laugh. I am so up against it financially, I’m living from week to week.”
Last winter, unable to afford child care, she left her baby with her 82-year-old parents in Florida while she continued to work in New York. “At one point, I was away from him 2 1/2 weeks. It was hell.”
Given the hardships, is she sorry?
“I thank the Lord, the stars, the universe and all of the angels. It is a miracle,” she says, “and I’m grateful.”
