The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

Spring
2016

Monday, January 9, 2017 (Volume 5: Issue: 2)

The Topic: The Downside of Delayed Motherhood

The News Story: Five Things For Parents To Know About Having A Baby In Your 40s Or 50s

The New Research: Delaying Parenthood—Formula for Problems

 

The News Story: Five Things For Parents To Know About Having A Baby In Your 40s Or 50s 

Janet Jackson made headlines last week when she became a first-time mother at 50 years old. In a litany of such stories, the UK branch of the Huffington Post published an op-ed highlighting the things that later-in-life new parents should know.

Sure, “you may have trouble conceiving,” admits the story, but every woman will be approached on “an individual basis” throughout pregnancy, age aside. Age does not determine health. “In general, women are much more healthier [sic] in late age than they used to be,” Mervi Jokinen of the Royal College of Midwives told The Huffington Post UK. “Whereas before having a baby at this age would be seen as later on in life, now women plan their life very differently.” And although there may be a few bumps—such as more difficulty adjusting set schedules and routines to a newborn—women giving birth for the first time in their 40s and 50s “will probably have more confidence.”

But research indicates that such calm reassurances may underemphasize the difficulty and even danger of delayed first-time motherhood. And “delayed” for researchers is quite a bit younger than 40.

(Sources: Amy Packham, “Five Things For Parents To Know About Having A Baby In Your 40s Or 50s,” Huffington Post UK, January 4, 2017.)

 

The New Research: Delaying Parenthood—Formula for Problems

As Western nations have turned away from family commitments in recent decades, those men and women who have still included parenthood in their life script have typically done so later in life. But some researchers have demurred. For their inquiries are exposing serious medical and psychological problems inherent in delayed parenthood. These problems receive sobering attention in a study recently published by medical researcher Ulla Waldenström of Sweden’s Karolinska Institutet.

Building on an earlier medically focused study of delayed parenthood, Waldenström’s new study probes the medical, social, and psychological aspects of this phenomenon. And it is a phenomenon: Waldenström remarks that “parental age when having a first child in Sweden and Norway has increased by five years” in a single generation, adding that “a similar development has taken place in many other high-income countries.” This development has typically been viewed as “a rational adaptation to changes in society” in an era characterized by “women’s increased participation in the labour market, including longer education and career engagement, and couples’ inclination to schedule the first child to a point in time when family income is high.”

But Waldenström asserts that delayed parenthood proves “problematic for several reasons.” It can “partly explain [a] declining birth-rate” that is “associated with economic cost for society.” National birth rates can certainly be expected to decline when many couples who have postponed parenthood unhappily learn that their bodies have lost some of their earlier fertility and that “treatment for involuntary childlessness can be . . . expensive, time-consuming, and draining.” Furthermore, “childbirth at advanced maternal age is associated with medical interventions and adverse pregnancy outcomes.”

To limn the medical and psychological profile of delayed parenthood, Waldenström correlates data from the Swedish and Norwegian Medical Birth Registers with data from a Norwegian survey of mothers and children, a Swedish survey of young adults, and a Swedish survey of mothers. These data were supplemented with data from a controlled trial of prenatal education, and were interpreted in the light of Waldenström’s earlier study of the medical sequelae of delayed parenthood. Analysis in a statistical model that accounted for factors such as smoking and obesity reveals that in having a first child at ages 30 to 34, women were notably more likely than mothers ages 25 to 29 to give birth to a very preterm baby (adjusted Odds Ratios of approximately 1.25 in both Sweden and Norway) and that women ages 30 to 34 were more than half again as likely as the younger reference group to have this unfavorable birth outcome (adjusted Odds Ratio of 1.64 in Sweden and of 1.76 in Norway). Waldenström discerns a comparable linkage between maternal age and stillbirths. She stresses that the “absolute risk” for an older individual woman having a very preterm baby or a stillbirth was “small . . . but may be significant for society as a result of the large number of women who give birth after the age of 30 years.”

Society as a whole may also bear part of the expense of the more costly medical procedures commonly required when older women bear a first child after age 30. Among the Swedish women for whom she has data, Waldenström finds that “the rates of elective and emergency caesarean section increased continuously by maternal age. Only 57% of the oldest women had a normal vaginal delivery compared with 77% in the youngest group.” What is more, Waldenström finds that 7% of the infants born to the mothers over age 34 required transfer to the neonatal clinic after birth, compared with 1.6% of the infants born to mothers under the age of 29. Remarkably, she adduces evidence that older women do not face the same higher risks of medical complications when giving birth to a second child, perhaps because “structural changes during the first pregnancy [can] have a positive effect of placental perfusion during the second pregnancy . . . [and so] could reduce the negative effects [that are] . . . age-related.”  

But more than medical complications may account for older women’s negative experience in first childbirth: Waldenström reasons that “older first-time mothers may also be less prepared [than younger counterparts] for the unpredictable life of parenthood after having been used to a higher degree of control during many years.” And though it is mothers who experience the medical consequences of delayed parenthood, fathers share some of the psychological consequences. In this realm, Waldenström reports that “analyses of data on first-time fathers suggest that advanced paternal age has similar effects.” More specifically, the data indicate that while the mother of their child was going through her first pregnancy, “mixed or negative feelings about the upcoming birth were more prevalent in the oldest [fathers ages 34 and older] (29%).” Compared to younger fathers, the oldest fathers also experienced significantly more “childbirth fear” (p < 0.01).  In sum, Waldenström characterizes older fathers’ “overall experience of childbirth [as] less than positive.”

In reflecting on her findings, Waldenström acknowledges that many Swedes and Norwegians hold the “common view . . . that postponing parenthood to advanced age may be beneficial because of a higher degree of socioeconomic stability and parental maturity.” This view, she asserts, “is challenged by our finding that first-time mothers’ satisfaction with life decreased by age, suggesting that becoming a parent later in life may be more difficult than expected.”

Waldenström piquantly contrasts “public awareness in Sweden . . . in relation to negative effects of smoking during pregnancy,” with public ignorance of “the negative effects . . . of advanced maternal age,” which have “still not gained the same public attention.” It is time, she argues, for her colleagues and for the public in general to recognize “advanced maternal age should be regarded as a modifiable lifestyle factor that could affect pregnancy outcomes”—just like maternal smoking, which obstetricians universally and vigorously combat.

(Source: Bryce Christensen and Nicole King, forthcoming in The Natural Family. Study: Ulla Waldenström, “Postponing Parenthood to Advanced Age,” Upsala Journal of Medical Sciences 121.4 [2016]: 235-243.)