The risks of trying to conceive a baby later in life, amid statistics about
fertility plummeting with age and the relentless tick of the biological
clock often hit the headlines.
Last week Maja Butscher made medical history when she was born after the
world's first successful ovary transplant. Her mother, 39-year-old Susanne,
who had suffered early menopause, became pregnant a year after being given
an ovary from her twin sister in a pioneering new procedure.
But while the number of women giving birth in their late thirties and forties
has doubled in the past decade, there is little focus on the psychological
and physical challenges of late motherhood. No matter how much they want it,
pregnancy and the turmoil of bringing up a baby can still come as a huge
shock.
Two years ago, 40,659 mothers in England and Wales aged 35 and over gave
birth, compared with 19,468 in 1996. Of the 669,601 babies born in 2006,
22,512 were born to mothers aged 40 and over, according to the Office for
National Statistics. A further 1,064 mothers aged 45 to 49 gave birth to
1,123 children, and 55 women aged 50 and over had 71 children.
Juliet Cadzow, an actress, married David McLennan, a theatre director, when
both were aged 40 and they assumed a family would follow. “The first
miscarriage was traumatic as it was at the three-month stage. The second was
much earlier, and when the third pregnancy happened we were very careful,
but again I miscarried,” Cadzow says. “We thought it wasn't meant to be and
with interesting careers we could compensate for not having children.”
When Cadzow became pregnant a fourth time, the couple's previous anticipation
and excitement turned to apprehension. As the pregnancy progressed they
began to feel more hopeful, only for Cadzow to suffer from postnatal
depression after their son Shane was born.
“I got depressed probably about a month after the birth with the realisation
of the turmoil that a child brings to your life. With a baby you can't just
walk out to do the shopping; you have to make elaborate arrangements to go
out at night. A child consumes your entire day and night.”
To her surprise, she found a baby son who could not verbalise his needs much
more awkward than she expected. “That sounds awful, but I was slightly at
sea with this little thing, much as I loved him. He'd start waking up and
I'd see these bright eyes looking and me and I'd panic - what on earth am I
doing with him now? What if he cries? David was fantastic and my mother was
marvellous, but she was older and not able to help a great deal.”
According to Belinda Phipps, chief executive of the National Childbirth Trust
(NCT), Cadzow's reaction is fairly common among older mothers who have
enjoyed successful careers before giving birth. “They've spent a large part
of their lives in a world of logic, deadlines and where people do what they
are asked. When they have a baby, none of these applies,” she says. “It's
also physically very wearing and isolating. They're missing their job and
colleagues and their partner will probably also be at work. And what they're
doing now is essentially extremely menial. So it comes as an enormous,
exhausting shock.”
For many older women, births can also be more physically demanding, as
complications that come with age may result in emergency Caesarean sections
or other interventions that take longer to recover from. In addition, they
may not have the energy they had a decade earlier to cope with the broken
nights of a newborn.
Dr Anna McGee, senior lecturer in developmental psychology at Caledonian
University, Glasgow, says that motherhood can take a bigger psychological
and physical toll on older mothers than on younger ones.
“There doesn't appear to be an increase in postnatal depression as it is
hormonally driven, but tiredness is a key difficulty, as is reduced
flexibility in adjusting to someone else's needs,” she says. “An older
childless couple will be accustomed to making last-minute decisions or being
free to schedule what they want to do when they want to do it. This goes out
of the window with children - from the early days of the four-hourly feeds
right through school age.”
These problems may be exacerbated, says McGee, if the pregnancy is unexpected,
because the older mother's idea of her “ideal self” will no longer chime
with her new life. “Some women will have realised there was little
likelihood that they would become mothers and altered the ‘ideal self' to
make it a closer fit with what seemed possible within their lives - by
reducing the perceived value of what they could not have - to protect
themselves from disappointment,” she says.
“This may include emphasising the downside of having children and exaggerating
the benefits of being child-free. If they have managed that task
successfully, they will then feel ambivalent if they find themselves
pregnant because the situation requires them to ‘backtrack' on a sense of
self.”
This was the case for Diana Greenham, who discovered she was pregnant on the
eve of her wedding at 44. “I wasn't particularly maternal and when I met
Laurence I was 40-odd and it never crossed my mind, even though he had a
four-year-old son,” she says. “When I showed him the positive pregnancy test
we just looked at each other in shock. It was a bombshell, to be honest.
Having a child is such a huge responsibility and a complete change of life.
We were going round in circles talking about ‘Can we do this? How do we make
it work'.”
She miscarried shortly afterwards, but having weighed up the consequences of
children, soon got pregnant again with Zach. “We were both very worried
throughout and although our son Zach added to the drama by arriving early
and being desperately ill, at 20 months now he's best described as Zach the
Destroyer - a hurricane of a child, who leaves a path of destruction in his
wake!”
Sarah Courcha, from West Sussex, had a similar experience, though at an
earlier age. “I didn't meet my partner Jason James until we were both 35 and
neither of us were interested in children. I had a career and he played in a
rock band so was out most evenings,” she says. “Children didn't come into
the equation, but when I was 37 I discovered I was pregnant and it was a
total shock. If you haven't planned something like this you don‘t know what
to do, especially when you hear so much about women being desperate for a
family. We talked seriously about our options and then we got used to the
idea. At 21 weeks I went into labour and our daughter was born but didn't
survive. We were heartbroken as it had taken us that long to get used to the
idea that we were going to have a baby. We tried again and had Morgan, who
is now 8 months, when I was 39. He has taken over our lives, but we wouldn't
have it any other way.”
Coming to terms with pregnancy later in life may often be complicated by the
knowledge that mother and baby are more susceptible to Down's syndrome and
conditions such as pre-eclampsia, a complication in pregnancy that can
result in premature births, or even death.
However, experts insist that if women are not obese, if they do not smoke, nor
suffer from long-term health problems, they have little real cause to worry.
Peter Bowen-Simpkins, medical director of the London Women's Clinic, says that
while the risk of having a baby with Down's syndrome increases once a mother
reaches 40, the chances of having a healthy baby at an older age are still
high.
“It certainly adds to the strain of the pregnancy, because most chromosomal
abnormalities occur in women over 35 and as they get older they are more
common,” he says. “Overall, the chance of having a Down's syndrome baby is 1
in 650 before you reach 40 and then it's 1 in 100. But that still means that
99 women out of 100 give birth to a healthy baby.”
So should more advice be given to women about parenting before they launch
into expensive rounds of IVF treatment and fight to conceive?
No, don't waste your breath, says Belinda Phipps, of the National Childbirth
Trust, which sees 300,000 parents every year. The parenting charity runs
helplines for new mothers and classes to get people to understand what they
are in for after a child is born, as well as how to make a network of
friends among other mothers in their area.
“Antenatal classes cover what it's like to be a parent. But people don't take
it in. They see women in the floaty nighties and think it will be fine,
until a few weeks later when they say, ‘Why didn't someone tell me it was
going to be like this?' When we ask women if it was easier in their twenties
or forties, they say that in the former they had more energy and less
patience, but in the latter it's the other way round.
“However, these women have had children before, so will be more relaxed with
their last child. It's not the same as having your first at 40,” she says.
“I would advise someone who is thinking of having a baby later to visit
friends who have a newborn and spend time with them.”
And however bad the broken nights and disruption to their lives, she insists
that for most women, a child still brings great happiness, however old they
are.
Juliet Cadzow, 20 years after her marriage, confirms that: “I wouldn't change
anything, but it's hard work and I don't think anyone can pretend otherwise.
David and I were both 60 this year and Shane was 16 in July so I qualify for
the pension and child benefit. Luckily, we don't have to worry about the age
difference because he still thinks we're pretty cool!”
Tips for mother
Before giving birth, I signed up for a National Childbirth course with a group
of young mothers. The NCT tried hard to link me to a group closer to my age
of 38, but the bond was already forged with the original set and the eight
of us were loath to give each other up.
There is little information out there specifically for older mothers. Bump to
Baby, run by the NCT, links new mothers with mothers-to-be so that they hear
first-hand about how to cope with two-hour stretches of sleep a night for
the first six weeks (coffee and banana cake for me) and when to let your
baby cry for ten minutes to snatch some food. Mothers35plus.co.uk also links
older mothers around the country.
While friends may have had their babies years ago, your mother will also not
be as physically capable of helping to look after a newborn as she was a
decade ago. In my case, with my husband away, my mother generously paid for
a maternity nurse to help me for a fortnight. Agencies such as Tinies or
Eden Nannies can help. If that is too expensive, Night Nannies can help
during the night shift, but also ask a friend or sibling if they could move
in briefly.
At times all mothers feel shattered and wretched. Talk to other mums: it
always helps to hear other's trials. And take exercise - Buggyfit is a great
way to get in shape with other mums and is run nationwide. Parentlineplus
has a helpline and internet advice, as does NCT.
If you are hating motherhood, talk to your doctor: you may have postnatal
depression, which is common among mothers in the first year of their child's
life. Ten to 15 per cent of new mothers are depressed after a birth, with
more experiencing weeks or months of such feelings.
Alexandra Blair
