As a doctor, I thought I knew all the risks of late motherhood. But then I had a baby at 40...
LIKE every mother of a little girl, I know the day will come when I must sit my daughter down and have that conversation: the one where I urge her to respect her body and spell out the damaging impact teenage pregnancy could have on her future.
But the life lesson won’t end there. In the same vein, I will warn Darcy, now five, about the physical dangers and emotional impact of late motherhood.
I’ll implore her not to go down that route just as much as I’ll warn her about the challenges of becoming a mum too young.
Having given birth for the first time aged 40, mine will be the voice of experience. One that will ruefully admit I wish I’d had her when I was a decade younger and would have found the challenges of motherhood so much easier.
Thanks to advances in fertility treatment and increased opportunities in the workplace, it has never been easier for a woman to turn a deaf ear to the ticking of her biological clock.
Increasingly, we are delaying our families until middle age. But the unfashionable truth is that a woman’s body has a sell-by date when it comes to being able to take for granted the ability to safely carry a child. Obstetricians put this at 35.
As a doctor — I’m a GP who also uses my expertise on TV shows such as Channel 4’s The Health Detectives — I’m well aware of the medical risks of later pregnancy.
Twenty years ago, when I trained in obstetrics, an expectant mum in her 40s was a rare and troubling prospect. In fact, if a woman was pregnant and a day over 35, we couldn’t flag up the potential health risks to mother and baby, fast enough.
Maternal age remains a huge risk factor for pregnancy complications such as gestational diabetes, pre-eclampsia, high blood pressure, premature or multiple birth, difficulties in the delivery suite and various genetic disorders.
Yet, because women can, and increasingly do, become pregnant in their 40s and even beyond — be that naturally or thanks to fertility treatment — we forget that their bodies won’t necessarily be up to it.
This dangerous modern assumption that age needn’t be a bar to having a baby risks putting the health of generations to come in jeopardy.
I’m far from alone in having turned a blind eye to every red flag in pursuit of motherhood.
Statistics show that the number of women giving birth in their early to mid-20s — the optimal age for a good outcome for both mother and child — is in decline. Birth rates among over-40s now outnumber those among teenage girls.
So, while starting your family at 35 was once seen as pushing your luck, this is now the age many women only begin to seriously consider it, their energies having so far been focused on careers or enjoying a child-free existence.
And why not? Advances in neonatal care mean that poorly and premature babies can have very good outcomes. Your chances of taking a healthy child home from hospital with you, whatever your age, have never been higher.
But something has got lost in translation because as much as we look to normalise having babies later in life, the risks to the health of an older mother remain as high today as they were 20 years ago. Wilful ignorance of this fact is rife among my generation. As a GP, I certainly couldn’t pretend not to know. And yet, five years ago, I joined this growing cohort.
In retrospect, I can only think that, when the time to become a mother finally felt right, my longing for a child took over from common sense.
The reason for me delaying my family was a common enough story: I didn’t meet the right man until my late 30s. John and I married when I was 39 and started trying for a baby soon after the honeymoon. But, honestly, having a baby in my 40s is the hardest thing I’ve ever done.
Even if you come out of pregnancy and childbirth unscathed, as I thankfully did, there is no escaping the physical and emotional strain of being a middleaged new mum. I paid my dues as a sleepdeprived junior doctor, so I’ve known what it is to be truly worn out. But the unnatural, mindaltering exhaustion I have experienced since having Darcy overshadows all previous understanding of extreme tiredness. When you’re pacing the floor at 3am with a wailing baby in your arms, there’s the added anxiety of having to work out what’s wrong with someone whose only means of communication is to cry. Was she hungry, too hot, too cold or even unwell? Even as a doctor, I found the stress of trying to work all that out through bleary-eyed exhaustion unbelievably difficult.
For the first three years, our daughter was out of her cot up to three times a night, which was tough on us both.
There was never a day when one of us wasn’t desperately tired. There’s no knowing how we would have coped as parents in our early 30s, however it’s a fact that, as you get older, your capacity to cope with a lack of sleep diminishes.
When Darcy started nursery, I felt dreadfully old, dropping her off alongside mothers sometimes decades younger than me. Suddenly, my peers were women in their 20s and 30s; some were even teenagers. Having children of a similar age was all we had in common.
Even now, when I take Darcy out and she starts to play up, I feel the weight of other people’s disapproval at every turn.
I may well be imagining it, but I convince myself these strangers are looking at me and wondering how a woman my age doesn’t have better control over her own child.
It seems incredible that, despite all I’ve achieved in my career, my child throwing a tantrum in the supermarket saps so much of my confidence.
And I won’t pretend that I’m not insanely jealous of the freedoms my friends are able to enjoy now that their children are older and so less dependent on them.
These days, I routinely fall asleep on the train home from work, snoozing on a stranger’s shoulder. Once that would have been after a glass of wine too many with a girlfriend. Now, it’s because Darcy had me up at 4am wanting a glass of water and I couldn’t get back to sleep.
Meanwhile, the pals I made at university are now proudly watching their own children graduate while John and I are still at the start of our 18-year contract to raise another human being.
I point all this out not through self-pity or because I regret having my daughter. But it is a reality check for the women out there who refuse to acknowledge that having a baby in your 20s and 30s isn’t just medically wise, it makes life easier all round.
Looking back, I feel bemused horror at the risk I took with my own health — how easily things could have gone horribly wrong for me or for my child.
The fact that I sailed through my pregnancy and delivered a healthy baby represents to me nothing more than extraordinary good luck.
I’m glad I did take that gamble because, otherwise, I wouldn’t have my child — and she truly has made my life complete.
Older women like me must be more realistic about the toll conceiving will have on their bodies and their lives in general.
I’d have loved to have had another baby. I got away with it once and couldn’t possibly be that lucky a second time.
Darcy will always be an only child. And when she asks why, I will use that as a starting point for our very first conversation about the realities of being an older mum.
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