Panelists explore trend toward later parenthood

May 23, 2014 by Alvin Powell
Experts I. Glenn Cohen (from left), Marie McCormick, Jeffrey Ecker, and Alison Earle discussed the risks and rewards of delaying parenthood during a panel at the Harvard School of Public Health.

If there's one thing couples contemplating starting families later in life should keep in mind, it's that despite advances in fertility technology in recent decades, there are still no guarantees.

Experts on a panel Wednesday at the Harvard School of Public Health said media reports of women giving birth at age 45 or 50 might perpetuate a misperception that getting pregnant when you're older is easy and that there are no consequences to delaying the start of a family.

The reality is a rapid decline in fertility from a woman's early 30s, when the chances of conceiving during a single menstrual cycle are 15 to 25 percent, to her mid-40s, when the chances are just 1 or 2 percent, said Jeffrey Ecker, a professor of obstetrics, gynecology, and reproductive biology at Harvard Medical School.

"People plan pregnancy for this time in life," Ecker said. "[Getting pregnant] doesn't always happen this way, and becomes less likely as you get older."

Older women are more likely to require fertility technology, including using donor eggs. Older mothers have higher rates of gestational diabetes and , which can cause premature births. Infants born prematurely have a higher risk of several complications, including attention-deficit/hyperactivity disorder, asthma, and genetic issues such as the chromosomal abnormalities that lead to Down syndrome. Rates of miscarriage and cesarean deliveries are also higher among older pregnant women.

Despite the complications, many more women are delaying having children than did several decades ago. A recent government report found a ninefold increase in first births among women age 35 and older since the early 1970s.

That increase has changed the face of the older mother, according to Marie McCormick, a professor of maternal and child health at HSPH. Decades ago, later-in-life mothers tended to be lower-income women who had already had several children. Today, they are increasingly middle-class professionals who have delayed starting a family to devote time to their careers.

Panelists spoke during a webcast of The Forum at Harvard School of Public Health, "Delaying Pregnancy and Parenthood: The Risks and Rewards." The event, sponsored by the Harvard School of Public Health, WGBH, and Public Radio International's "The World," explored the ramifications of the trends identified by the report, released this month by the National Center for Health Statistics.

Ecker and McCormick were joined by Alison Earle, a visiting scholar at Brandeis University, and I. Glenn Cohen, co-director of Harvard Law School's Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics. The discussion was moderated by Carol Hills, a senior producer and reporter for "The World."

While highlighting the heightened risks of parenting late in life, panelists stressed that risks are far from certainties, and that many babies born to are healthy and develop normally.

The panel explored the use of various fertility technologies, including in-vitro fertilization, in which eggs are fertilized in the lab and then implanted in the womb. They also looked at the newer technology of freezing eggs for use later in life, a strategy recently approved for women undergoing cancer treatment.

The trend toward having children later in life is not just a medical matter but a social one as well, Earle pointed out. First, parents starting families older tend to have fewer children. That means there are fewer caregivers in the family to care for aging parents. On a society-wide basis, it means fewer working young supporting more elderly.

"Implications from the trends are potentially significant," Earle said.

Cohen raised the possibility of dramatic changes to families in the middle class, where the trend is most pronounced. Parents having children at older ages will be grandparents for fewer years, if at all, he pointed out.

"You're talking about a world without grandparents. That's a profoundly different world than we've been in."

Explore further: More women delaying first pregnancy, CDC reports

Related Stories

More women delaying first pregnancy, CDC reports

May 9, 2014
(HealthDay)—New U.S. government data confirms the trend: the average age when women have their first babies continues to increase.

Older infertile couples should try in vitro fertilization first, study says

May 6, 2014
(HealthDay)—Middle-aged couples who want to have a baby but are having trouble conceiving should go straight to in vitro fertilization (IVF), skipping other types of fertility treatment, a new clinical trial recommends.

More US women having twins; rate at 1 in 30 babies

January 4, 2012
More U.S. women are having twins these days. The reason? Older moms and fertility treatments.

Smoking during pregnancy may raise risk for heart defects in babies

May 3, 2014
Women who smoke during pregnancy may be putting their newborns at risk for congenital heart defects, and the more they smoke, the higher the risk, according to a study to be presented Saturday, May 3, at the Pediatric Academic ...

Midwifery students learn about women over 40 having a baby

January 10, 2014
The Royal College of Midwives State of Maternity Services Report 2013, out this week, shows an increase in the number of older and obese mothers and a baby boom in 2012. Dr Tracey Mills, from The University of Manchester's ...

Child's autism risk accelerates with mother's age over 30

April 22, 2014
Older parents are more likely to have a child who develops an autism spectrum disorder (ASD) than are younger parents. A recent study from researchers from the Drexel University School of Public Health in Philadelphia and ...

Recommended for you

To reduce postoperative pain, consider sleep—and caffeine

August 18, 2017
Sleep is essential for good mental and physical health, and chronic insufficient sleep increases the risk for several chronic health problems.

Despite benefits, half of parents against later school start times

August 18, 2017
Leading pediatrics and sleep associations agree: Teens shouldn't start school so early.

Doctors exploring how to prescribe income security

August 18, 2017
Physicians at St. Michael's Hospital are studying how full-time income support workers hired by health-care clinics can help vulnerable patients or those living in poverty improve their finances and their health.

Schoolchildren who use e-cigarettes are more likely to try tobacco

August 17, 2017
Vaping - or the use of e-cigarettes - is widely accepted as a safer option for people who are already smoking.

Federal snack program does not yield expected impacts, researchers find

August 17, 2017
A well-intentioned government regulation designed to offer healthier options in school vending machines has failed to instill better snacking habits in a sample of schools in Appalachian Virginia, according to a study by ...

In a nutshell: Walnuts activate brain region involved in appetite control

August 17, 2017
Packed with nutrients linked to better health, walnuts are also thought to discourage overeating by promoting feelings of fullness. Now, in a new brain imaging study, researchers at Beth Israel Deaconess Medical Center (BIDMC) ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.