Our society is changing and so are fertility rates. Recent news reported by the BBC a few months ago sent alarm bells ringing that for the first time ever, our population rates are in decline. Not only are people chosing to have fewer children, but they are also leaving it until later in life to do so, with pregnancy over 40 becoming increasingly common.
There is no doubt that over the last couple of decades, socially everything has changed for women. Finally, we are beginning to gain an equal footing to men in terms of career opportunities and, understandably, the majority of women are making the most of these new opportunities, by creating an identity outside of their traditional role in the household.
The challenge of getting pregnant
Whilst this has brought personal satisfaction and financial freedom, it has also left many dealing with the problem of subfertility, or difficulty getting pregnant. We now hear that 1 in 6 couples, and up to 20% of individuals face trouble conceiving. This figure is only set to get higher as biologically, we struggle to keep up with the tremendous societal change that has occurred.
In fact, the only age group where fertility rates are on the increase is in the over 40s. Which is a bit of an ironic paradox, in that this is also the age group where many will face tremendous struggles to conceive. In 2017, just over 16 births per 1000 was to women aged 40 or over, according to the Office of National Statistics. Fertility rates decreased in 2017 overall and for every age group, except for women aged 40 years and over. This trend is not going to reverse as women seek to create a stable set of circumstances for themselves before having children, that includes financial independence as well as a life partner.
As many are now recognizing that they may be affected by subfertility at this stage of life, they are taking active measures such as egg freezing earlier in life, in order to allow themselves a better chance at conceiving, should they need it later in life.
The most important determinant of a woman’s fertility is her age, and as a woman becomes older, the likelier it is that she may require assistance to become pregnant. Over the age of 40, this assistance is likeliest to be IVF, but the success of this remains low if a woman uses her own eggs, due to the fact that they have declined in both number and quality. Conception with donor eggs then becomes the most successful route to motherhood.
Our modern times
Traditionally speaking, all women are generally told to get on with having children before the age of 35. But in reality, how many women in our modern era have the financial means, career freedom and a suitable partner to be able to do that with?
The short answer is not many and as a result of the growing demands being placed on women in our modern societies, we have to be able to provide better solutions and not discouragement for a trend that we cannot reverse and that is a direct consequence of our democratic and progressive society.
All too often women are unfairly criticized and judged when through no fault of their own they have to postpone childbearing. Many decide to find the correct partner for life, rather than trying to beat their biological clock. Or invest into their careers to be able to offer them the financial freedom they need to have the same opportunities as men, only to find that whilst they’re feeding into our nation’s economic prosperity, they are ultimately being denied the chance to have their own prosperity in terms of a family.
Whilst there is nothing that medicine has yet offered us to reverse the effect of age on human eggs, there is plenty that can be done to help optimise their condition and to also help optimise a woman’s health before and during pregnancy, thereby reducing the risk of any obstetric complications.
And just as importantly, a new area of epigenetics is emerging which is showing us lifestyle measures, such as diet, can create lasting changes to the genetic blueprint of any offspring, meaning that a woman is able to have a certain degree of control on the health of her baby, by virtue of what she choses to eat, how she exercises, manages stress and what she exposes herself to in her immediate environment. I discuss this in The Conception Plan, which is just as applicable to women over 40 as it is to younger women.
The reality of becoming a mother in your 40s
Being an older age mother can bring its own challenges. First of all there are the obstetric risks that become more common with age. This includes things such as high blood pressure, diabetes, thyroid disorders, fibroids and also pre-eclampsia, all of which can complicate older pregnancies and lead to poorer outcomes for mother and child. In addition, the risk of twin pregnancies becomes higher the older a woman is, both naturally and also via IVF, which can also make a pregnancy over 40 more complicated.
There are also the issues around child rearing, such as possibly diminished stamina and judgement from the outside world, it has a whole range of benefits too, such as better financial security and provision for the child, maturity of mind and approach to childcarea.
And as the latest research is suggesting, there may also be a health benefit to children in that studies have shown that those born to older mothers did better in cognitive ability tests than those born to younger mothers. These tests are thought to be predictors for educational achievements and health in later life.
Pregnancy over 40 is becoming relatively common. Instead of labeling women as geriatric or judging their decision to have children at this age, we need to be finding ways to support them and enable them to become mothers in the healthiest and safest way possible.
Pregnancy over 40 and empowering women
If we’re to help empower women, we need to be able to have open and honest conversations regarding the difficulties they may face around fertility, remove the stigma and offer better support and guidance. Improving access and affordability of fertility treatment is the number one priority here that recognises the growing trend towards older age motherhood.
All women over 40 will have spent their entire lives investing into the health service only to then be told that the service they invested is not willing to offer them treatment for a condition that was imposed on them as a result of our modern means of living. It’s time we stopped discriminating against older women and started helping them achieve their dreams that as human beings, we are all entitled to have.
Investing in women and children is an investment in our future generations and the stability of our economy avoiding the socioeconomic consequences that have been predicted if we do not offer opportunities for fertility rates to increase. Not to mention the personal sorrow of not being allowed to have a family of your own.
It’s no longer OK to just keep telling women to get on with having a family when they are younger. As a society, we have progressed too far and life has become too complicated to be able to accept this as a realistic option. But it is time to embrace pregnancy over 40, show compassion and help women fulfil the most basic and inherent of human needs. Our societies depend on it.
What are your thoughts on pregnancy over 40? Do leave a comment and share.
ABOUT DR LARISA CORDA
Dr Larisa Corda is a Consultant in Reproductive Medicine. Her training to date has seen her gain an understanding and appreciation of womens’ health concerns, that range from medical to surgical. She has been involved in caring for women from pre-conception through to pregnancy and thereafter. She believes in a holistic approach to treating a patient, that addresses a combination of physical, psychological, and lifestyle factors, that include nutrition, exercise and spiritual wellbeing.
With a focus on fertility specifically, her interests include investigating the inequity of access to reproductive healthcare, as well as the impact of emotional wellbeing on IVF. She has presented at major international meetings and won awards for the research she helped to conduct, and has published on older age motherhood. S
She is a passionate believer that every woman deserves to be empowered with the necessary tools and information to be able to make her own decisions and judgements, that will allow her to influence the course of her own life. She continues to promote this message in the care she offers her patients, as well as her media work, such as This Morning’s Fertility Expert and also the Channel Mums Fertility and Pregnancy Expert, with appearances on Lorraine and Loose Women. Larisa is also a Foundation Board Director for Sexplained, which is an international organisation that educates teenagers about reproduction, as well as an ambassador for the international humanitarian organisation, The Circle, and in her various roles, has worked with women of all ages and from all backgrounds, helping them to achieve their goals.S