The Dangers of Later-in-Life Pregnancy

It has been known for a long time that women who leave it late to have children run the risk of increased infertility, but rarely have the dangers been put in such stark terms as it was recently by the Royal College of Obstetricians and Gynecologists (RCOG) in the UK.

The RCOG commissioned a study group to examine the impact of later motherhood, a phenomenon that is present in nearly every western country including Ireland where the average age of first- time mothers is now 31 and 33 for women who are married.

The college's conclusion that it would be better for women to have children between the ages of 20 and 35 was not new.

However, it says in emphatic terms that women are still not sufficiently aware of the dangers of leaving it into their late 30s and 40s to have children, although the issues seem to have been well documented in the mass media.

"There is an urgent need for better public information on the issues surrounding later maternity. Women should be supported, rather than constrained, in their life choices," the RCOG says.

"However, both women and society need to be aware of the possible problems that older mothers may encounter. There may also be factors facing the child which need to be addressed," it concludes.

The RCOG identified two separate problems. Three-quarters of women who try to become pregnant will do so at the age of 30. That figure falls to two-thirds by the age of 35 and continues to decline until the menopause.

The chances of conception through IVF is one in three under the age of 35, but by the time a woman reaches the age of 42, it has declined to one in 20.

The RCOG also warns that, for older mothers who do become pregnant, the chances of complications and interventions dramatically increase -- a trend borne out by studies carried out here.

Researchers at the National Maternity Hospital in Holles Street and the Rotunda Hospital in Dublin found that twice as many older mothers were admitted to the special care baby unit.

Dr Melanie Davies, a spokeswoman for the RCOG, says the warnings were well known, but not sufficiently well heeded, and a lot of women believe that infertility will not happen to them.

"My experience is that even women who are very well educated and leading fulfilled lives with good jobs do not know about the biology of conception.

"I often have people coming in to say, 'I have left it too late, I wish I'd known'," she says.

Dr Cathy Allen, a consultant gynecologist at the Merrion Fertility Clinic and at the National Maternity Hospital, says a recent study of 17,500 women across the developed world, including Ireland, showed that many women did not have a basic knowledge of fertility.

"There is no general public awareness. To me, it is confined to women's magazines and daytime television," she says.

"Those of us who work in fertility are surprised by the lack of information. As a nation I don't feel we prioritize fertility, perhaps, because in the past we didn't need to."

Dr Allen says there are many reasons for delayed parenthood, and the biggest impediment is finding the right partner.

"My advice to couples is that once the relationship is stable and the possibility of having children becomes a reality, do not delay.