Advanced Parenthood: Physical, Mental, and Social Factors

Most women learn about the notion of a “biological clock” from an early age (whether or not they express interest in raising children!). Social pressures and stigma around the “ticking” clock aside, it’s important to recognize the term has a concrete basis in biology:

• The older a woman is, the fewer eggs she has – Women are born with a cache of eggs (between 1 and 2 million) in their ovaries known as their ovarian reserve. By puberty, that reserve declines to 400,000 (at most). As women age, this quantity diminishes significantly—by 40 years old, most women have around 25,000 eggs.
• The older a woman is, the lower quality her eggs are – Lower egg quality results from normal hormonal shifts that occur in women of advanced age. Two compounds in particular—antimüllerian hormone and inhibin B—are disbursed in lower quantities, which is suspected to impair the chromosomal and genetic makeup of eggs. Fortunately, there are several ways to improve egg quality.

The clinical consensus is that women over the age of 32 experience a sharp decline in fertility, and the term advanced maternal age is used for expecting mothers over the age of 35.

So, if you’re considering joining the 20% of American women choosing to start families after they’ve turned 35, it’s important to develop a grasp of the physical, psychological, and social influences that make this parenthood journey unique.

The Physical Piece

Because women in their 30s and 40s undergo significant biological changes in these years, their bodies can experience more stress during pregnancy than in their earlier reproductive years. These stressors are associated with heightened risks, including:

• Higher risk of pregnancy loss, miscarriage, or stillbirth due to lower egg quality
• Higher risk of having multiples, particularly if pregnancy is sought through IVF therapy
• Higher risk of birth defects, including genetic or chromosomal abnormality like Down syndrome

Older women are also more likely to struggle with maternal health issues like gestational diabetes or hypertension during pregnancy. They may also face more difficulty adjusting to postpartum life, whether because of age-related health concerns or social stigmas surrounding older parenthood.

Due to these heightened hazards—and the growing population of mothers who are older than previous generations—fetal and maternal health are monitored closely by clinicians during advanced-age pregnancies. In fact, the American College of Gynecologists and Obstetricians recommends routine check-ups, ultrasonograms, and genetic testing to ensure maternal and fetal health remains sound during a rigorous care regimen.

The Mental Piece

Pregnancy on the whole can be a period of significant emotional ups and downs, but some older expecting moms find more distance between these two stretches.

One of the most pressing mental health concerns for advanced-age mothers is postpartum depression, which national surveys report affects as many as 1 in 8 of all new mothers. In the weeks and months following delivery, this could look like:

• Extreme mood swings
• Fatigue
• Anxiety or panic attacks
• Sleep disturbances or pregnancy insomnia
• Loss of pleasure derived from former interests and hobbies
• Fears surrounding your fitness as a parent
• Feelings of hopelessness
• Struggling with shame or feelings of self-worth
• Impaired concentration or decision-making
• Social withdrawal or isolation
• Having trouble bonding with your baby

A Canadian study suggested women of advanced maternal age are more likely to develop postpartum depression than their younger counterparts. While more research is required to understand why, the researchers suspect stigmas surrounding later motherhood and a lack of community support can make this period especially challenging.

Postpartum depression is a serious matter that can affect both maternal health and infant development. But often, building community and conversation—whether through support group networks or individual therapy—are an effective antidote to the mental health struggles older mothers uniquely face.

The Social Piece

Despite tremendous advances in assisted reproductive and other medical technologies, few would argue against the persistent stigmas attached to older motherhood. Whether it’s fending off questions about how you conceived to neutralizing speculation on what life will be like parenting a teenager in your 50s, society is a long way from normalizing middle- and advanced-age motherhood.

But accounts from older parents aren’t so uniform. Many older mothers report they feel glad and even privileged to have postponed child-rearing. As research unfolds, several advantages—for both parents and children—have come to be associated with this lifestyle choice:

• One study from Sweden showed being a new mom up to 40 years of age is linked to better long-term childhood outcomes
• Having more life experience by dint of more years lived may be associated with improved cognitive abilities and higher academic achievement
• Children born to older parents are more likely to enjoy quality time at home, improving their sense of safety, stability, and emotional welfare
• Having a child later in life may encourage refined cognition in parents for longer, allowing you to have a closer connection to and more vivid memories of their childhood

Remember, it’s more than possible to be a caring figure in a child’s life at any age. Regardless of when you decide to pursue parenthood, the end goal is simple and universal: to foster a nurturing, supportive, and loving home.

A Brief Introduction to Assisted Reproductive Technologies

Assisted reproductive technologies include several procedures designed to treat or extend both female and male fertility. ART has helped combat infertility in some 13% of reproductive-aged women, and while it’s difficult to quantify the success rates of these procedures, about 2% of children born annually in the US are thought to be conceived artificially.

Whether you’re in your early 20s and looking toward the future or you’re in your 30s or 40s and planning to grow your family, familiarizing yourself with ART options and outcomes can be an important first step in meeting your family planning goals.

Let’s take a look at two of the most popular current technologies: egg freezing and in-vitro fertilization.

Oocyte Cryopreservation (Egg Freezing)

Egg freezing is an increasingly popular method of fertility extension, enabling women to make more deliberate decisions about how they choose to build a family. The procedure involves several steps:

• Evaluation – Fertility specialists will administer tests to check your ovarian reserve and screen you for any health condition that could potentially affect a future baby.
• Hormonal therapy – You’ll take several hormone injections to spur egg maturation. You’ll also be given some ultrasounds to ensure your eggs are developing normally.
• Retrieval – A healthcare provider will retrieve your eggs from the ovary in a low-impact procedure. This usually does not require an overnight stay.
• Vitrification – Following retrieval, your eggs will be vitrified. This means they’ll be frozen at a temperature that will preserve your eggs but won’t form ice crystals (which could compromise their genetic composition).

Barring health complications, oocyte cryopreservation can often be completed within a matter of weeks. Your eggs will be viable indefinitely, enabling you to make decisions regarding your family long into the future.

In-vitro Fertilization (IVF)

IVF is a versatile technology that can be performed for couples, non-traditional families, and prospective single parents alike. It involves retrieving mature eggs from the ovaries and fertilizing them with sperm (a partner’s or a sperm donor’s) in a laboratory setting.

IVF can transform reproductive outcomes, particularly for individuals living with conditions like:

• Anatomical damage, such as blockages in the fallopian tubes
• Anovulation
• Endometriosis
• Uterine fibroids
• Genetic disorders

Depending on your (and, if applicable, a partner’s) health status, the process of IVF may take a short or long amount of time. It’s also important to be aware of several complications the procedure can present, including:

• Giving birth to multiples (this is more likely in IVF therapy)
• Low birth weight or early delivery
• Ectopic pregnancy
• Miscarriage
• Excessive stress

Between the years 1987 and 2015, an estimated 1 million children were born using IVF. For this reason, it’s considered the single most effective form of ART.

SneakPeek’s Final Note on Motherhood at an Advanced Age

If it’s your dream to have children later in life, advancements in medicine have made it possible to do so with remarkably improved health outcomes for both parents and children. From egg freezing to genetic screening that assesses the health of your future, starting or growing your family may look different—but the potential for finding fulfillment through care is no less possible.

Once you’ve embarked on your path to parenthood, check out SneakPeek’s Early Gender Blood Test. With this DNA-based at-home test, you’ll learn your baby’s gender as early as 6 weeks into your pregnancy and with over 99% clinically proven accuracy¹.

The process is simple: you’ll take your sample from home, send it to SneakPeek labs, and we’ll triple-review your results before sending them to you the same day.

Learn why SneakPeek remains OBGYN’s #1 recommended at-home early gender test with the trust of over 1 million new moms behind it by visiting SneakPeek today.