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Advanced Maternal Age Explained

Chances are you may be surprised to hear this term.

At first blush, it may seem like a negative note on your medical chart.

Video Interview for YNN (now Spectrum News)

Video Interview for YNN (now Spectrum News).

Instead, we say it’s Advanced Maternal Age since you are older and wiser starting your family at age 35+.  You have choices too.

Share your motherhood story.

“Some months back I saw an article about something called ‘Advanced Maternal Age’ in a local magazine (Austin Woman).  Having had my first child at 35 and my second at 40 it caught my eye.  In my own experience I had been more preoccupied with being a Type 1 diabetic and the possible impact of this on my pregnancies than on being an ‘older’ mother.  However, when I read this article and then looked up the Maternal Age Project online I realized that being an ‘older’ first time mother had also influenced my process and experience of motherhood.  I am glad Sharon and her colleagues are taking the time to give a place for the many voices of this group.

 –Penny DeCou LCSW, Oncology Social Worker, Advanced Maternal Age Mom of 2


Dawn and Ava

Read Dawn’s Story of Advanced Maternal Age motherhood.

Serena Kirby

Featured Contributing Author of Better Late Than Never Baby.

About Risk: Comparing Apples with Apples

Serena and Her Son Riley

Serena and Her Son Riley

Serena Kirby, a professional writer and AMA mom from Western Australia contacted us this summer. Her new book called Better Late Than Never Baby includes information and suggestions not found in other sources for expectant moms over age 35. We are sharing excerpts from her book with our audience and let you how you can get your own copy.

(An excerpt from Better Late Than Never Baby by Serena Kirby ©2013)

The majority of later life mothers are more than aware of the potential for medical complications said to be associated with having a baby later in life.  Increased occurrence of chromosome abnormalities, preeclampsia, gestational diabetes, preterm delivery, low birth weight, miscarriage and caesarean, form a list that’s scary enough to turn any pregnancy dream-come-true in to a fear-filled nightmare.

Many older mothers say they are treated like obstetric time bombs.

But there’s an increasing amount of research that’s challenging the notion of risk as it relates to the older mother as she is today. Don’t get me wrong, this doesn’t mean no risk. Every pregnancy – regardless of age – carries an element of risk.
But how relevant are the statistics on delayed pregnancy and what really is the level of risk when it comes to you? 

Comparing Apples with Apples

While the research conducted three or four decades ago may have been accurate at the time, the type of women becoming older mothers today is very different than it used to be. Sure, not every woman who delays motherhood is well educated, more financially stable, career orientated and healthy, but research does show that this stereotype has a basis of fact.In the middle of the last century, when the term ‘elderly primigravida’ was coined to describe women over 35 embarking on their first pregnancy, having a baby over 35 was not only less common but was also occurring for very different reasons. Fertility problems, previous infection or illness (such as tuberculosis) all played a part. Many babies were unplanned and or born as a last child to a mother who had a number of previous children, which in itself can make pregnancy risky. Nowadays the delay in motherhood can often be accidental (due to circumstances) or deliberate (due to career and financial choices). 

Today’s older first time mothers are also more likely to be healthier than their predecessors because of better nutrition and the avoidance of serious infections.

Because of these changes to the characteristics of mothers over 35, studies from previous decades are no longer relevant and researchers and experts alike are asking for more up-to-date investigations to be done.  Only then can the true level of risk and probability (as it relates to today’s older mother) be fully known.In fact, first time mothers over 35 who are healthy and who have never had any fertility problems or pre-existing medical conditions have yet to be fully studied.
So if you’re concerned about the scary statistics surrounding later life motherhood consider this advice:

  • Always look at the date of the statistic’s source.
  • What, if any, were the inclusions or exclusions of factors that affect fertility – weight, previous medical conditions, number of previous children etc.?
  • The health of women in the general population is constantly improving. A snapshot of later life pregnancy and associated complications, as they are today, will not show up in studies for several years to come.

Remember, that every woman is different and what may be a risk factor for one woman may not be relevant to you. Please know that the majority of women who have babies over age 35 have uncomplicated pregnancies and healthy babies.

Serena Kirby had her first (and only baby) at age 43. She is a freelance writer and playwright who lives in Western Australia with her 7 year old son. Her book, Better Late Than Never Baby, is available on Amazon, iTunes and via her website.

Serena and Riley at His Birth

Serena and Riley at His Birth



7 More Tips on Fighting Fatigue

Fatigue Section of  Better Late than Never BabySerena Kirby, a professional writer and AMA mom from Western Australia contacted us recently. Her new book called Better Late than Never Baby includes information and suggestions not found in other sources for expectant moms over age 35. We’ll share excerpts from her book with our audience and let you how you can get your own copy.

Serena Kirby

Serena Kirby, Writer and AMA Mom

7 More Tips on Fighting Fatigue (Part 2, a condensed excerpt from Better Late Than Never Baby by Serena Kirby ©2013)

  #1 Eat Up, Eat Well Input always affects output so good nutrition is important in keeping up your energy levels and battling fatigue. If you’re breastfeeding, nutrition carries an even greater importance, and it’s a good idea to eat as if you’re still pregnant.  Drink, drink, drink lots of fluids – at least 10 cups a day when pregnant and at least 13 cups when breastfeeding. You also need good nutrition and energy-generating foods to help your physical recovery from the birthing process (natural or caesarean) and to boost your immune system. It’s particularly important to make sure you’re getting enough iron in your diet so you don’t become anemic (one of the most common fatigue-causing medical conditions for new moms).  Your daily iron demand increases nearly 10-fold from the start of your pregnancy, but research shows that less than 25 per cent of women start their pregnancies with enough stored iron to meet their increasing nutritional needs. As such, by the end of the pregnancy, a large number of women are iron depleted if not anemic. If left untreated, the condition continues and often worsens in the weeks after giving birth, and the result is overwhelming fatigue. If you can’t get all the iron and other goodies you need in your diet, talk to your doctor or midwife about vitamin and mineral supplements.

#2 Hormones and Nutrition
If you’re an over-forty mom and feeling continually tired and moody, your fatigue may be being worsened by the prelude to menopause – perimenopause. Remember that during this time your body and your hormone levels are changing (as if puberty, pregnancy and breastfeeding wasn’t enough for one lifetime). To find out if perimenopause is contributing to your fatigue, speak to your doctor about having a blood test to check your hormone levels, but know that they are not completely accurate in showing smaller, subtle changes.  A more advanced and accurate method is the saliva sample test but not all doctors use it so you’ll need to call around to find one that does.

#3 Exercise
As strange as it sounds exercise is actually an excellent way of beating fatigue. You may be thinking, “Hell, I don’t have enough energy to get out of bed let alone run around the block”, but the truth is exercise has been proven to be highly effective in reducing fatigue. Whilst pushing the stroller around the block is good for your physical well being, many mothers suggest that exercising without your baby has the added bonus of providing a chance to truly switch off and be off duty.  You can let your mind wander without being disrupted by a child demanding your attention (yet again). Plan to exercise three to four times a week, preferably in the morning when you have more energy, and block out some time for exercise without your child. What to do with the baby? Most gyms have a childcare facility or ask a relative or friend to babysit.  Or go out early before your partner goes to work (you’re up anyway!).
#4 Conserving Energy
On the flip side of using energy to exercise is the saving of energy around the home.  Organize your home with items and systems that make life easier. Think of the home – especially the nursery – as a workplace (it’s where you’ll do most of your work in the first few months anyway) and spend time making sure you have everything you need exactly where you need it. Review and update your needs every few weeks because, as the baby grows so to will your routines and needs.

5 Suggestions for Fighting Fatigue

Better Late Than Never BabySerena Kirby, a professional writer and AMA mom from Western Australia contacted us recently. Her new book called Better Late than Never Baby includes information and suggestions not found in other sources for expectant moms over age 35. We’ll share excerpts from her book with our audience and letyou how you can get your own copy.

Serena Kirby

Serena Kirby, Writer and AMA Mom

5 Suggestions for Fighting Fatigue (Part 1, a condensed excerpt from Better Late Than Never Baby by Serena Kirby ©2013) 

#1: Get Support

Countless experts state that support is essential in beating tiredness and fatigue.  But as the issue of fatigue is often downplayed and overlooked, the support a new mother receives (from her partner and others) may not actually be as adequate or as long lasting as may be required.

As today’s family unit has become increasingly smaller, more isolated (physically and socially) from extended family and more self-sufficient, the ready-made support network found in many other countries is lacking.  The result is that many older mothers have little or no support base on which to draw and she is left to primarily fend for herself.

This is a far cry from the support available in many Eastern and European countries where there is a tight extended family and a cultural understanding and expectation of pitching in and helping when a new baby arrives. The old African proverb that ‘it takes a village to raise a child’ is still alive and well in many countries.

In China, for example, there is a support practice known as zuo yuzi, which involves a month of confinement after the baby is born. During this highly protective period the new mother is cloistered at home and given high levels of support from relatives. The mother is not allowed to work and is discouraged from getting out of bed (now you’re talking!) as any energy-sapping activity, other than looking after herself and her baby, is considered bad for her health and could in fact do her unthinkable harm in future years. A form of zuo yuzi is adopted in many other Asian countries and while experts say[i] our western culture would make it difficult to emulate, they agree the idea holds definite merit and benefits.

In the absence of zuo yuzi, good advice comes from Australian researcher Carol McVeigh who has argued that women really do need to address the issue of support, where and how to get it before the baby is born, and that support should be considered part of the childbirth education process.[ii] She goes further to suggest that ‘actively enlisting’ help is a skill women should be taught while pregnant.

As such, why not develop a list (then double it) of the support you think you may need and who is available to help. Talk to each person about the issue of fatigue, and the importance of support, and come to an agreement on how and when they can provide assistance. Be specific (write it down if you have to) otherwise all your planning is likely to go out the window (quickly followed by your energy) when the baby arrives. Don’t forget to think past the first six weeks post birth – remember fatigue has a nasty habit of increasing, rather than reducing, over time.

#2 Offers of Help

Change the way you think about accepting help and even practice saying ‘yes’ in front of the mirror. Make it a personal goal to say ‘yes’ whenever the word help is mentioned.

#3 Put ‘Self Care’ on the list

Being a mother is a relentless job and many days during the early months will feel like Groundhog Day. The repetition of feeding, changing, holding and soothing your baby dulls your senses and numbs your mind – all of which fosters fatigue.   Finding time for yourself is so rare that it’s no wonder you lose track of who you are – let alone remember what day it is.

It is also a mother’s instinct to put the care of her baby and family before her own, but many studies show that this is often to her own detriment. Taking regular time out and time away from your baby is important. It may be coffee with a friend, a walk, reading a book, enjoying some pampering or simply resting and doing nothing at all. Being off duty helps relieve stress, breaks the repetition of Groundhog Day and gives you a sense of self. It lets your body and mind rejuvenate and rest.

Remember to think of ‘self-care’ as being an essential item, not as something you’ll do if and when you have time.  And, by making a standing booking to take time for self care (at least two to three times a week even if you’re working outside the home) you won’t have to repeatedly ask your partner, or someone else, to care for the baby. Everyone will know that there are set times on certain days when you are not available to be with the baby.

[Read more…]

Recommended Books

Better Late Than Never Baby by Serena Kirby

Review by Sharon MunroeBetter Late Than Never Baby

Serena Kirby, a professional writer and advanced maternal age mom from Western Australia has written an up-to-date reference book on some of the top issues we face as older mothers. In an easily digestible format, she covers many key topics with a bit of humor, including some areas not covered in many books: the “only child” and things to consider as many AMA moms do have one child; the mature-age dad and implications for the family since few of us are married to young men; and understanding fatigue, a common ground issue that many of us share and some help in overcoming it.

Most importantly, Serena is on the wavelength as our Project: asking readers to consider “what really is the level of risk (in pregnancy) when it comes to you” and supporting them with“…you are not alone (and having a child means you rarely are).”

Serena contacted us and we are so glad she did! Her Facebook page is a great way to learn more about her work. Her 2013 book can be ordered here and can be purchased as an eBook or as a paperback that is shipped internationally.

Ready: Why Women Are Embracing the New Later Motherhood by Elizabeth Gregory (2012)

Review by Sharon Munroe

Dr. Elizabeth Gregory’s revised edition expands on her ground-breaking research on the trend of Ready_By_Elizabeth_GregoryNew Later Motherhood. The 2012 Ready clearly defines the demographic trend and its implications for women, their families and society. The trend continues up as more younger women are focused on their education, career attainment and being with the right partner prior to adding children into their lives. The latest edition provides valuable commentary on the negative media coverage associated with the trend that highlights the infertility challenges that women may face.

Personally, her research and writing has helped me better understand the economic impact of the decision I made to have my first child at age 40. Since that time, I have added two more children in our family through pregnancy and adoption and now write about my own experiences and those of other older mothers. My labor of love is helping the growing number of “advanced maternal age” women, ages 35 or better, who waited until they were “ready” to overcome barriers and find resources for conceiving, a healthy pregnancy, childbirth and beyond through The Advanced Maternal Age Project

Click here to buy the 2012 edition

The Essential Over 35 Pregnancy Guide by Ellen Rose Lavin, PH.D.

Review by Sharon Munroe, Founder of The Advanced Maternal Age Project

The Essential Over 35 Pregnancy GuideEllen Rose Lavin, PH.D, wrote a very different type of primer covering many key areas of becoming a mother later in life and having a healthy first pregnancy. Early on she tells us about her own experience with childbirth at 41 and takes a sympathetic yet comprehensive approach. Her book, written in collaboration with Samuel H. Wood, M.D. covers many key topics around both becoming pregnant and being pregnant at age 35 or later. Of note, she acknowledges that “age is not necessarily the best standard by which to judge who will have a textbook pregnancy and who will face obstacles.” Unlike many similar books published in the same timeframe early to mid 200os), she openly talks about the myths about having a child after 35 and the labels older mothers receive, among them Advanced Maternal Age and Elderly Primigrvida. This book is a must read for a balanced view of what’s ahead for the older would-be mom.

Click here to buy the current edition

Birth as an American Rite of Passage by Robbie E. Davis-Floyd

Review by Sharon Munroe, Founder of The Advanced Maternal Age Project

2723001.110Robbie Davis-Floyd has a unique voice as a cultural anthropologist, midwife, educator, author and mother. Birth as an American Rite of Passage highlights the trends that continue: pregnant women are often considered patients and medical interventions in prenatal and maternity care is pervasive. Frequently obstetricians are trained with technocratic and not humanistic models. Many of us have witnessed this first hand, particularly if we were of Advanced Maternal Age, the sisterhood of women age 35 or better. We were labeled high risk following our pregnancy test and before understanding our complete personal health histories. (I write about my experience with this on our website.) For women of all ages, Ms. Davis-Floyd’s examples of electronic fetal monitoring in labor and laboring in a supine position, which are the hospital standards across much of the world, are truly impediments for the best birth for many women. She reminds us that caregivers’ attitudes and ideologies about childbirth have a direct outcome on the women they work with. Ms. Davis-Floyd adds important perspectives on how women are cared for in other countries, including throughout Latin America and Europe and the practice of midwives. Her book is compelling and should be required reading for caregivers and the women who seek to become mothers with their support.

Riding the Infertility Roller Coaster by Iris Waichler, MSW, LCSW

Review by Sharon Munroe, Founder of The Advanced Maternal Age Project

rollercoasterWhat a rich resource! I discovered Riding the Infertility Roller Coaster two years after my experience with secondary infertility and am amazed at both the depth and quality of information that Iris Waicher shares with her audience. With over 30 years of clinical experience plus her personal experience of trying to conceive at age 45, she speaks to the top concerns that couples are facing and shares others’ stories and solutions. Chapter 12 of the book focuses on Building a Support Network, which is one of the biggest challenges we face when we have a fertility challenge since the topic is so sensitive and personal. Family and friends may or may not offer the kind of help we need. Support, encouragement and information are the keys to maintaining courage and achieving success. Iris’ expert voice and those of other experienced and compassionate professionals are vital to couples striving to bring a child into their families. I hope that others will find Iris’ book to be a valuable tool in their journey.

Hot Flashes Warm Bottles by Nancy London, MSW

Review by Sharon Munroe, Founder of The Advanced Maternal Age Project

hotflasheswarmbottlesI found this 2001 book still very relevant in 2012. Written by one of the authors of the first edition of Our Bodies, Ourselves (one of the original books on women’s health that I read as a teenager coming of age), I found comfort in Nancy London’s content. Some of the topics covered such as honoring our choices to work full-time, part-time or to be full-time mothers, the fatigue of a daily schedule with young children, and our choices in becoming mothers on our own, through the help of a fertility specialist or through adoption are the same choices we still contemplate today. The Journey Book sections and ideas for support group discussions are inspiring and thoughtful. Thank you for being a pioneer again, Ms. London!

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