Fear of being an old mother

By Lee Hye-jun

Emily is a 36-year-old fashion designer. She has been married for four years, but postponed pregnancy because she knew being a designer and a mother would not go easily together. However, she recently learned that because of her ovaries and her age, she may not be fertile when she feels ready.

Women are born with a certain number of eggs and this number diminishes with age. Female fertility peaks in the early 20s, gradually decreases and drops sharply when women are in their 30s. This is because of the lowered quality of the remaining eggs, skipped ovulation and infrequent sexual relations. Therefore, women older than age of 35 are recommended to visit a fertility doctor for check-ups after 6 months of unprotected sex.

As Emily was preparing for pregnancy, she realized that maintaining a healthy pregnancy was as hard as being pregnant for an older woman. When she learned the risk of fetal chromosome abnormality increases significantly with mothers older than 35 years, she regretted delaying childbirth at this point.

As the egg quality declines, the rate of fertilization errors increases, resulting in fetal chromosomal abnormalities, such as Down’s syndrome. Chromosomal abnormality occurs in one out of 200 babies born to mothers at the age of 33, and one out of 40 at 40.

Fortunately, there are many diagnostic tests that can detect abnormalities during pregnancy, including amniocentesis (or amniotic fluid test) and chorionic villus sampling. Therefore, as long as they seek good prenatal care and genetic counseling, older women can have similar chances of having a healthy baby as younger women.

Another of Emily’s concerns are the high complication rates in older women. She heard that older women are vulnerable to high blood pressure and diabetes. She also wonders whether she can handle labor given that an increasing number of older women undergo cesarean sections due to the high complication rate.

Gestational hypertension and diabetes occur more frequently in older women, so they need to pay extra attention to their health. High blood pressure can lead to preeclampsia, while gestational diabetes can cause excessive fetal growth, increasing the risk of birth trauma if untreated.

Although chances for older women to give birth through cesarean section are higher, they should still be encouraged to go for a vaginal delivery. Vaginal delivery carries fewer complications than cesarean section, and older women in good health can safely complete this.

Today, many women delay their first pregnancy and more than 10 percent of all pregnant women are aged over 35. As they are usually told of the challenges of late pregnancy, many of them are scared off. However, most pregnancies are completed without complications and can bring about beautiful healthy babies.

Do not be preoccupied by excessive warnings and fears of complications discouraging you from having a blissful pregnancy. After all, older women are generally more mature and prepared for their baby. You may be a little older, but at the same time, have a better chance to become a great mother.

The writer is a doctor at Maria Fertility Hospital in Seoul. For further questions, send an e-mail to the writer at hyejunlee@mariababy.com, call the hospital’s English-speaking coordinator at (02) 2250-5577, or visit the hospital’s website, https://eng.mariababy.com/.