Choosing pregnancy over 40. And not apologizing.

In the 1970’s, the decade of my own birth, pregnancy at 40 was rare, and hardly ever a conscious choice.

Fast forward to now, the futuristic year of 2020. Pregnancy, and the creation of ‘family’, is a completely different game. With the science of fertility clinics worldwide, those who would have never been able to mother or father children outside of adoption, have available a host of opportunities.

Many women of my generation have chosen to pursue careers, second marriages, or even honored sexual orientation attractions they would have never ventured for. All with the knowledge of the many fertility options when the time came to start their own family, however that may look.

The wonders of Intrauterine Insemination (IUI), In-Vitro-Fertilization (IVF), surrogacy, and fertility drugs such as chlomid, are just a few examples of how the miracle of pregnancy has reached new heights of possibility. Many who venture on these alternative measures for pregnancy have tried the “natural way” and failed. These are the women who have weighed their options, know the risks, and forge ahead.

Photo by Carlo Navarro on Unsplash

But what if you are 40 (or more), and you just want to have more children? What if you were the one who pursued that amazing career, or traveled the world instead of conforming to a family of 2.5 children? You explored, grew up, invested and indulged. There was no one depending on you to be at their preschool concert or 5th grade graduation.

What if it was your choice to not have children, or wait to have children, and now you are ready???

There is an underline stigma surrounding women over 40 who do choose pregnancy. As a labor and delivery nurse, I feel it in the words of the twenty-something colleague who reports the woman’s history and labor progression. I know the insinuation coming from the forty something OBGYN, calling me to request their labor induction appointment.

It many be unintentional, but the judgment remains.

There are good reasons to avoid pregnancy at Advanced Maternal Age (AMA), which is determined to be at 35 years. In fact, the term AMA is sometimes referred to as a “geriatric pregnancy”, which intones a whole new level of stigma and discomfort. (Who would ever consider themselves to be geriatric at age 35????).

With it comes the realities of increased risk of miscarriage, chromosomal abnormalities, low birth-weight or premature delivery, or conceiving more than one baby (twins). It can also effect how efficient the placenta is and how quickly it breaks down. Any labor nurse will tell you an “old placenta” is not a desirable placenta, when the mother enters labor and the stress begins to affect the baby. There is also an increased chance of c-section delivery for some of these very reasons (The Mayo Clinic, 01/20/20.

The effects are also not exclusive to the baby. Women are at a higher risk for gestational diabetes and high blood pressure over the age of 35 (The Mayo Clinic, 01/20/20). These health considerations can lead to hospitalizations, a need for medications such as insulin and antihypertensives, and more frequent evaluations for the woman as well as baby’s health. Add to the list any preexisting health conditions such as obesity or asthma, and the stakes only get higher.

Many questions surround a woman’s decision to intentionally get pregnant after age 40, especially if they have already started their family. It’s impossible to escape the scrutiny and judgment of society, and that of the healthcare providers who know the risks involved.

Photo by Camylla Battani on Unsplash

So to answer the question of IF, you must first answer the question of WHY. Humbly, this is so personal a decision it is not for myself, or any of us really, to pass judgement on.

Nearly forty when my third son was born, it was almost expected I would not press on. How fortunate indeed I was to carry three beautiful, healthy, term children. Even more so, I did it without any sign of complication so often associated with pregnancy of any aged mother.

In fact, how dare I even consider pressing my luck?

Still, I had to consider it. I still wanted a daughter for one thing (see Letting Go of My Girl to Fully Embrace Boy Motherhood). But aside from that, I LOVE being a mom. At any stage. Sure, sleepless nights and dirty diapers can strain any desire to re-procreate. But in my mind, the pros definitely outweighed the cons. Even IF it was another little boy.

But age does factor in, and in the end I decided it was unfair to bring another child into this world intentionally, when its parents would be pushing 70 at their high school graduation. Nature decidedly had a point; I was accepting my body may not be up to the challenge again. I was ready to embrace where life had led me, at the stage that it had, without complaint or regret.

I decided to just be grateful and accept this next stage of my life, letting go of my youthful child bearing years. I was embracing my new body and my new life ahead with all the challenges and rewards it may bring.

I did not come to this decision easily. I did not come to this decision without some sense of loss. But I DID come to this decision on my own, without listening to the judgement others feel so freely to pass.

Photo by Kalea Jerielle on Unsplash

It’s your body, your life, your happiness. If it feels right to you, move forward with your eyes wide open, while taking the rest of it in stride.

You’re over 40 and want to get pregnant? Think through your options, risks and desires. If you decide to go for it, NEVER apologize for wanting to embark on this beautiful, life fulfilling journey no matter what circumstances led you here.

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