More women in Sin­ga­pore are giv­ing birth in their 40s. EVE­LINE GAN finds out what you should know about the trend, and chats with three mums about their ex­pe­ri­ences.

Young Parents (Singapore) - - CONTENTS -

But what are the dan­gers you should be aware of?

A one-in-100 chance of a Down syn­drome baby, one-third odds of a mis­car­riage and two-fold risk of still­birth.

By med­i­cal stan­dards, the risks of hav­ing a child at the age of 40 are un­nerv­ing enough to put a damper on any siz­zling baby-mak­ing plans. But more older mums are thumb­ing their noses at the gloomy sta­tis­tics.

Think 40-some­thing ac­tresses like Halle Berry and Fann Wong, both of whom de­fied sta­tis­ti­cal odds and de­liv­ered healthy ba­bies.

Then, there’s 50-year-old singer Janet Jack­son, who con­firmed her first pregnancy and showed off her baby bump in Oc­to­ber this year.

In fact, the num­ber of women con­ceiv­ing in their 40s has dou­bled over the past three decades in Sin­ga­pore. Last year, there were about nine births for ev­ery 1,000 women aged 40 to 44, com­pared to just 4.5 in 1985, ac­cord­ing to Sin­ga­pore Depart­ment of Sta­tis­tics fig­ures.

In con­trast, those de­liv­er­ing be­tween 25 and 29 years old – con­sid­ered the op­ti­mum age for moth­er­hood – have halved in the last 30 years.

But is age just a num­ber when it comes to hav­ing ba­bies?

To a cer­tain ex­tent, yes. Ad­vances in ar­ti­fi­cial re­pro­duc­tive tech­niques like in vitro fer­til­i­sa­tion (IVF) have made it pos­si­ble for cou­ples to have ba­bies later in life, espe­cially for those with fer­til­ity prob­lems, says Dr Tan Eng Loy, con­sul­tant at the depart­ment of ob­stet­rics and gy­nae­col­ogy at Sin­ga­pore Gen­eral Hos­pi­tal (SGH).

That’s be­cause IVF boosts a woman’s chances of con­ceiv­ing, re­gard­less of her age, shares Dr Yeong Cheng Toh,

con­sul­tant gy­nae­col­o­gist and re­pro­duc­tive en­docri­nol­o­gist at Vir­tus Fer­til­ity Cen­tre Sin­ga­pore.

Im­prove­ments in screen­ing meth­ods and bet­ter ul­tra­sound equip­ment also mean that ab­nor­mal­i­ties and birth de­fects in un­born ba­bies are de­tected more ac­cu­rately early in pregnancy, ac­cord­ing to the doc­tors.

A Fin­nish study has found that age, by it­self, does not pose sig­nif­i­cant pregnancy and child­birth risks for an older mum over 35.

But her risk of com­pli­ca­tions such as pre-term birth, a small baby and still­birth in­creases dra­mat­i­cally if she smokes, is over­weight or obese, or has pre-eclamp­sia or ges­ta­tional di­a­betes, ac­cord­ing to the study pub­lished in the Journal of Ma­ter­nal-Fe­tal and Neona­tal Medicine. What about re­cov­ery af­ter birth? Well, that de­pends on the woman’s health be­fore pregnancy, Dr Tan says. If an older mum is healthy and t, she may have bet­ter stamina and re­cover from labour faster than a younger mum who is less t or has other med­i­cal con­di­tions, he says.

But even older mums with med­i­cal is­sues, such as heart disease and di­a­betes, now have a bet­ter chance of en­joy­ing a smooth pregnancy, thanks to ad­vances in an­te­na­tal care. For in­stance, SGH con­ducts high-risk pregnancy clin­ics thrice weekly to en­sure that moth­ers are well-looked af­ter.


Still, there are lim­its as to what med­i­cal sci­ence can do. It can­not change the fact that a woman’s fer­til­ity takes a nose­dive af­ter the age of 35, mak­ing it harder for her to be­come preg­nant, the doc­tors point out.

“The me­dia has high­lighted many older women who have had suc­cess­ful preg­nan­cies. But when it comes to bi­o­log­i­cal ad­van­tage, there is a huge dif­fer­ence be­tween a 20-year-old and a 40-year-old woman,” Dr Yeong says. A woman in her 40s has an ap­prox­i­mately one-in-six chance of con­ceiv­ing nat­u­rally with ev­ery cy­cle, he notes.

If and when she gets preg­nant, she also faces a higher risk of mis­car­riage, Dr Tan adds.

Age is also the most im­por­tant fac­tor in deter­min­ing whether fer­til­ity treat­ments like IVF work out suc­cess­fully, Dr Yeong says. A woman be­low the age of 35 has a 60 to 70 per cent chance of be­com­ing preg­nant through IVF, but this chance falls to just 20 to 25 per cent for those above 40.

While to­day’s older mums may have med­i­cal ad­vances on their side, the risks should not be down­played. Take the odds of hav­ing a baby with Down syn­drome, for in­stance: a 40-year-old mum’s risk is 10 times higher than if she were un­der the age of 30.

“Al­though med­i­cal ad­vance­ments have helped us to de­tect un­born Down syn­drome ba­bies more ac­cu­rately, very lit­tle can be done to pre­vent them, other than con­ceiv­ing at a much younger age,” Dr Tan says.


Be­cause they may re­quire more screen­ing tests and de­tailed scans, mums who wish to ex­pand their fam­i­lies in their 40s should think about the ex­penses, nan­cial ser­vices man­ager Fong Yong Hui says.

Take non-in­va­sive pre­na­tal test­ing – a new test that screens for Down syn­drome – for ex­am­ple. Sin­ga­pore mums tak­ing the test at SGH can ex­pect to pay a sub­sidised rate of around $1,000. They can­not use their Medis­ave for it, Dr Tan ex­plains.

They may also need to be in­duced closer their due date – it is rec­om­mended that they de­liver their ba­bies be­fore 40 weeks to lower the pos­si­bil­ity of a still­birth. “All of the above are likely to trans­late to in­creased costs,” he adds.

De­lay­ing moth­er­hood also means that they will be close to re­tire­ment age by the time their kids re­quire ter­tiary ed­u­ca­tion, Yong Hui says.

With the es­ti­mated cost of rais­ing a kid in Sin­ga­pore rang­ing from $200,000 to $1 mil­lion, jug­gling Ju­nior’s ed­u­ca­tion funds and pre­par­ing for re­tire­ment con­cur­rently can be a chal­lenge.

Al­though older mums are of­ten deemed more nan­cially se­cure, she points out that this may not be true.

“Ul­ti­mately, it boils down to the in­di­vid­ual’s nan­cial habits. A 40-year-old woman who chose to live it up dur­ing her younger days may not be more nan­cially se­cure than a younger mum who has been dili­gently sav­ing since her early 20s,” Yong Hui says. “If you wish to have chil­dren later, it is im­por­tant that you start sav­ing as early as pos­si­ble.”

The num­ber of women con­ceiv­ing in their 40s has dou­bled over the past three decades. In con­trast, those de­liv­er­ing be­tween 25 and 29 years old have halved.

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