What is the Advanced Maternal Age Project?

Our mission continues. Our goal is to provide unique support to women and couples who made the choice to start their family at age 35 or better. All at no charge. It’s our nonprofit’s work.

Mid-life pregnancy and motherhood is a growing trend in the developed world. It is not going away.

Enjoy our site filled with women’s stories, expert voices and information to make the best choices for you.

  • Is there something you still need?
  • What other resources should we make available?

We’d love to hear from you. Write Us at info@advancedmaternalage.org. Follow us on Twitter for news about the trend.

What Was Your Experience?

Share Your Story with Our Nonprofit to Help Other Women. Donations Support our Research and Publishing.

Our research team continues to capture longer, more in-depth stories from advanced maternal age mothers like you. Our Nonprofit is bringing them to our international audience in narrative form, along with audio clips and photos of the women and their families. If you became a mother for the first time at age of 35 or later, we’d love to hear your story! We are now scheduling for individual sessions for in person and telephone interviews. Please write us as a first step.

Want to know more about our organization and how you can fund our work?

For all inquiries, please contact us at info@advancedmaternalage.org

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Choices Around Work

 This is the column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Marcia Clark

Marcia Clark, Life and Legacy Coach

Q: I am 40 and pregnant with my first child who is due in March. I am having a hard time determining how much time to take off of work when baby comes. I love my work and am eligible for 3 months off. Being away from work for that long has both its pros and cons. How should I go about considering this important decision?

Our Expert who responded is Marcia Clark is a Legacy and Life Coach based in Austin, Texas and a Board Member of the Nonprofit Advanced Maternal Age Project.

A: First of all, congratulations! What a wonderful time in your life. Enjoy each moment!

How fortunate for you that you have a job you love. But I also know just because you love it doesn’t make the decision any easier…and possibly harder. Often times until we are faced with a situation it is difficult to know how we will react or what we really want. Some questions I have for you to consider are as follows:

  1. What are you most afraid of?
  2. What are you most excited about?
  3. When do you have to make the decision?
  4. What flexibility do you have, if any?
  5. What would it do for you to wait until the baby comes to make the final decision?
  6. How might you look at it differently after the baby comes?
  7. If you could create the ideal situation, what would it look like?

One of the tools I use with my clients is the Pain Gain Chart from where I received my coaches training, IPEC. It is a very helpful tool when trying to decide between two choices. I call it the dimensional “T” chart as it can offer much deeper insights. You can also continue to use it to “drill down” with each decision you make.

Here is how it works:

  1. On a piece of paper write across the top Pain and Gain.
  2. Then along the side write the two choices you are faced with. In your case, “Return to Work” and “Don’t Return to Work.” This will create four quadrants.
  3. Now begin within each quadrant and record the first thoughts that come to mind WITHOUT much reflection. i.e. the Pain of Returning to work in the top left quadrant, the Pain of Not Returning to Work in the lower left quadrant, continue with the Gain Sections.

See what enfolds for you. Often times you will discover things you had not thought of, one quadrant may emerge dominant, a clear decision may emerge, or a totally different solution may come to you.

Sometimes what blocks us is the pressure that we are making a decision that will have to last forever. Allow yourself the freedom to revisit your decision in the future. Life is about choice and endless possibilities. Whatever choice you make will be the right one for you! And that is what matters. Wishing you all the best!

Marcia Clark offers a complementary session in person or by phone to those who are interested in receiving life coaching and creating plans for their legacy. Contact her at coachingbyclark@gmail.com

Selecting a Midwife

This is the column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Kelly Hamade, CNM

Kelly Hamade, CNM

Q: I am 37 and considering having a midwife deliver my first child and would like to know how best to select one that is a good fit for me and my husband. What questions should I ask them?

Kelly Hamade is a Certified Nurse-Midwife with OBGYN-North and Natural Beginning Birth Center in Austin, Texas. She has 3 children, 2 born at home and 1 in the hospital. 

A: Choosing a health care provider during pregnancy is a big decision. As with most things, one size does not fit all and it is always a good idea to weigh your options carefully. When considering a midwife, you should be aware that there are different types of midwives and their scope of practice, experience and education may vary. Midwives also attend deliveries in a variety of settings including home, birth center and hospital. Many work independently while others are employed in a group practice.

As you interview prospective midwives, some general points to consider include her training, education and experience, options for location of delivery (home, birth center or hospital), if they share an office rotation or call schedule with other providers – can you meet the other providers, insurance coverage and fees. You might also ask about requirements for prenatal childbirth education, length and frequency of prenatal visits, pain-management options for delivery and follow-up care after delivery. Discuss your desires surrounding your pregnancy and childbirth experience and inquire about their philosophies.

Childbearing women who are under a midwife’s care generally have normal pregnancies without complications. Midwives are trained to recognize complications and variations of “normal” and often collaborate with other providers such as obstetricians, maternal-fetal specialists, chiropractors, massage therapists and lactation consultants. Talk with your prospective midwife about your risk factors. During the interview process, you may wish to disclose your age and any other concerns that may impact your pregnancy and labor. Inquire about any relative policies, protocols or guidelines that may affect your care. You may wish to research your options for genetic testing and find out which tests are offered, and which are recommended based on your age. Additionally, what other types of prenatal tests are offered or recommended based on your circumstances? Ask which conditions you are at increased risk for and how you will be screened. Find out the midwife’s policy in the event that a high-risk condition develops during your pregnancy, delivery or post-partum period. Are there other providers in their practice that are available to co-manage those complications or would you need to transfer to another group? Good luck and best wishes on your journey!




We’d love to see your question. Write Us!

MYTH Busting on Pregnancy

From Recoverymama.com, Dr. Linda Shanti's Blog

From Recoverymama.com, Dr. Linda Shanti’s Blog

Since becoming a mom at an advanced maternal age, licensed clinical psychologist Dr. Linda Shanti’s passions have expanded to include supporting women during pregnancy and postpartum. She writes and holds groups and individual sessions for women exploring how pregnancy and motherhood changes one’s body, emotions, and identity. She is based in San Francisco.

In her blog RecoveryMama she recently posted on some of the myths women commonly hear regarding pregnancy:





  1. It is a glowing time.
  2. All pregnancies are a choice that is wanted and/or planned.
  3.  Having a child will create a happy family/marriage/partnership.
  4. All pregnancies result in live births.
  5. Only straight women under the age of 35 who are the biological mothers and married to men have happy and healthy babies.
  6. All mothers and fathers will be happy that they are having a baby.
  7. There is a right amount of weight to gain.
  8. Eating disorders do not happen during pregnancy, due to the “protective factor” of the baby.
  9. Only un-medicated vaginal births are good and the birth plan is a straightforward process.
  10. Depression does not occur during pregnancy.

Sharing Our Perspectives: Christine’s Feedback


Lydia, who is 7-weeks old now and doing great.

Christine from Florida found our site through a Google search for “Advanced Maternal Age.” Her doctor repeated it so much that she wanted to know what the big deal was. She felt the need to research possible risks etc. because he made it sound like a little bit of a “disability”.  She is 37.

I decided to wait to have children because I never felt I was quite ready due to problems in relationships and financial struggles. I didn’t feel it was fair to try to care for someone else when my life wasn’t quite on track. I struggled to pay bills and keep my head above water. I am not one who accepts charity and was adamant that I would not be on assistance.

Once I was married and had a good job it just happened to be later than anticipated. I was married with a good job and finally felt the time was right.
I thought it would happen quickly but we struggled a little to conceive. It took 7 months before we got that positive test. I had an uneventful 8 months. No symptoms- very little movement and a regular work routine.

I experienced minor bleeding at 31 weeks and was put on bedrest and disability. The next 3 weeks were uneventful. At 34 weeks I had a major bleed and pre-term labor. I had to deliver by emergency c-section. My daughter was born in respiratory distress and struggled to maintain normal functions for the first day.

After that she was a trooper and did everything she was supposed to do to get out of that NICU. She was there for two weeks. She is perfectly healthy now and has had no ill effects from her premature birth. I myself was born at 24 weeks gestation so her early arrival was sort of a family tradition.

Lydia is 7-weeks old now and is doing great! (Her photo is shown (right).)

Share your thoughts – we’d love to hear from you

Natural Labor Induction with Acupuncture

Sadie Minkoff

Sadie Minkoff L.Ac., FABORM

This is the column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Q: I read that some women use of acupuncture to induce labor as an alternative to pitocin after 39 weeks of gestation. How does this work and is it safe?

Sadie Minkoff, L.Ac., FABORM and team at Sage Acupuncture in Austin specialize in Reproductive Acupuncture and Chinese Medicine. 

A: Acupuncture is often used as a safe and drug-free method for encouraging labor to commence. In fact, several studies have shown that acupuncture intervention is effective in facilitating a more efficient birth.

Labor induction, defined as when labor is “initiated artificially with drugs,” is actually a misnomer when used to describe how acupuncture works. Acupuncture supports the natural unfolding of the birthing process rather than an exogenous intervention forcing the body to do something it would not otherwise do.

  • In our experience, the best results come when acupuncture is used as a pre-birth treatment, preparing the body for labor gradually with one treatment a week starting at 36-37 weeks gestation.
  • This is the perfect time to reduce stress, and support energy and stamina for labor. Treatments are tailored to each individual woman’s body and pregnancy history, with a focus on ripening the cervix and positioning the baby optimally for labor.

As background, a 2004 observational study looked at the effect of pre-birth acupuncture (Medical acupuncture 2006 May; 17(3):17-20). Data on 169 women who received pre-birth acupuncture were compared to local population rates for gestation at onset of labor, incidence of medical induction, length of labor, use of analgesia and type of delivery:

  • In the acupuncture group comparing all caregivers (including midwives, OBs and specialists) the following were the overall statistics: 35% reduction in the number of inductions (for women having their first baby this was a 43% reduction) and a 31% reduction in the epidural rate.
  • When comparing midwifery only care, there was a 32% reduction in emergency caesarean delivery and a 9 % increase in normal vaginal births.
  • There was no statistical difference in the onset of early labor in those women receiving pre-birth acupuncture.

We’d love to see your question. Write Us!

National Cost for an IVF Cycle

Write Us with Your Question! Here’s a recent one we received.

Q: My husband and I are considering adding to our family. I am 42 and we have twins. I prefer not to have another set of twins. What are the costs for IVF using my own egg (roughly)?

Natalie Burger, M.D.

Natalie Burger, M.D.

Response from Natalie Burger, M.D., Texas Fertility Center:

A:  The national average for the cost of a fresh IVF cycle is $10,000 plus the cost of medication, which itself can range from $3,000 to $6,000.  As each situation is unique, some patients/couples may require additional IVF treatment steps that may add cost.

For instance, technology now allows us to genetically test embryos so that only chromosomally normal embryos are transferred into the uterus.  This increases the chance of successful pregnancy and significantly lowers the chance of miscarriage. This additional testing may add an additional $4,000 to $5,000 to the overall cost.

We’d love to see your question! Write Us with Your Question!

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



Proactive Fertility Planning

This is the column where our readers can write in with their questions. We’ll field the questions to one or more experts in the subject and post the responses typically within 2 weeks. Write Us with Your Question!

Q: I am 30 and starting a doctoral program soon, which I know is at least a five-year commitment. I am not yet married and know that I would like to complete my degree and be married prior to starting my family. Having never been pregnant before, what evaluations and tests can be performed to test my fertility?

Natalie Burger, M.D.

Natalie Burger, M.D.

Response from Natalie Burger, M.D., Texas Fertility Center:

A:  It is common for women these days to put off family plans until they become more settled in their career and life.  However, it’s important to not ignore the fact that, as we get older, we have fewer good eggs left.

Checking an AMH (antimullerian hormone) level is a easy way to give you information on your relative egg quantity – i.e. do you have a lot or only a few eggs left.  If the test shows a low result, it’s important to talk with a fertility specialist promptly to understand your options.  This blood test can be done on any day of your menstrual cycle and even if you’re on the birth control pill.

To safeguard your fertility, it’s important to also continue regular exams with your gyn provider, who can monitor you for any new gynecologic issues.  Also, avoid smoking as this can prematurely diminish your egg count.  Practice safe sex so that you don’t expose yourself unnecessarily to infections that can cause scar tissue.

Overall, it’s important to be proactive when thinking about fertility – this will help you to optimize your chances when you are ready to start a family.

We’d love to see your question! Write Us with Your Question!

Thankful for a Choice and Creating Your Own Legacy


Marcia Clark

Marcia Clark, Legacy Coach

By Marcia Clark

My mom had my baby sister when she was 41.  Back in the 1960s this was amazing and uncommon. Was she scared and did the doctors put fear in her of all the things that could go wrong? Did they suggest that she should end the pregnancy?  For sure!  But my Mom and Dad decided to go forward. And what a gift my little sister was and perfectly healthy. My mom had crippling arthritis prior to that point and it went into remission and never returned due to that pregnancy.

When my sister was born I was 12, my brother was 15, and my older sister was 18. We

Marcia with Her Parents and Siblings as Adults

Marcia with Her Parents and Siblings as Adults

had our very own living “doll” to play with.  And that is not an exaggeration. We loved having her around.  We adored her.  My brother carried her around the halls of the high school showing her off, she was the mascot for my cheerleading squad, and my older sister would get asked if she was her daughter. It all felt so special. Our family had a unique story. So I know firsthand what a joy a child can be at an older age…from a sister’s perspective.  I am so incredibly thankful for the choice my parents made.

My “little” sister is now 46 and I can still remember it all like it was yesterday.  The legacy created by my parent’s choice lives on in each day of my life. And will continue long after I am gone in the stories, the memories, our children, and their children.


What does Legacy mean to you?  Are you living your legacy now? Will it last into the future?

Most people I have talked to think Legacy it is what we leave behind after we are gone.  I would like to suggest that you consider creating and building your Living Legacy now…..AND have it continue as a Lasting Legacy. We each have the opportunity to create our unique Legacy. 

Legacy Living includes how you structure your life personally and professionally to create and capture memories, pass on your values and traditions, put documentation and financial planning in place, etc.  This creation will flow into your Lasting Legacy has it has many of the same pieces. It is a process that ebbs and flows with life’s transitions.

Life’s many possible transitions have a way of impacting our choices.  When we get married, a child is born, kids go off to college, when we are empty nesters, get divorced, illness strikes, retirement, or if we are planning for when we are no longer here. Each phase has unique qualities and challenges to consider.  Each event can make us stop and think about who we are, what our life is all about, and what will our legacy be.

One of the biggest transitions we make is when deciding to start a family, either through birth or by adoption. 

Bringing a child into one’s life is truly a life-changing event in ways beyond what they could have imagined.  And for those who make this choice later in life it can bring up some unique challenges and opportunities.

While your finances may be more stable at this stage of life, and your experience and wisdom are vast, how will having a baby impact your life?  There are many considerations:

  1. What about your career?
  2. How will your personal life be impacted?
  3. What sacrifices will either of these choices entail?
  4. What about the choice of timing and the “biological clock?”

You may have a shorter time with your children so what advanced planning do I need to do?   So often times planning for the future can take on an even deeper meaning and can be more time sensitive.

Here are just a few things to consider while you are creating and building your Living and Lasting Legacy:

  1. What values, traditions, thoughts, and moments do you want to pass along?
  2. How do you want to capture all of them?
  3. What skills do you want to share?
  4. What parts of you do you want to be remembered?
  5. Who do you want to have an influence on?
  6. What documentation will you need to secure your legacy? A Will, Guardianship, Power of Attorneys, Directive to Physicians are some examples.
  7. How will you structure your financial picture?

PlanSome considerations:

Do you need a college fund, want to create a charity, build a wing on a hospital, pass on your business? How will you be taken care of through life’s transitions? The possibilities and options are unique to your family.

All of this thoughtfulness and planning lays the foundation for turning your Living Legacy into a Lasting Legacy bringing you peace of mind, contentment, and joy knowing you have planned for your family now and into the future.

What footprint do you want to leave on your family, your community, your world?   

It doesn’t matter what you do, he said, so long as you change something from the way it was before you touched it into something that’s like you after you take your hands away. The difference between the man who just cuts lawns and a real gardener is in the touching, he said. The lawn-cutter might just as well not have been there at all; the gardener will be there a lifetime.” 
Ray BradburyFahrenheit 451

Marcia Clark is a Legacy and Life Coach based in Austin, Texas and a Board Member of the Nonprofit Advanced Maternal Age Project. She offers a complementary session in person or by phone to those who are interested in creating plans for their own legacy.