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.

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

 

 


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.

Preparing Your Body for Fertility

Sadie Minkoff

Sadie Minkoff L.Ac., FABORM

If you are reading this post, it is probably because you are preparing to grow your family in your thirties or early forties. In spite of what you may have heard, this is a great time in life to become a parent and more and more people are choosing to do so. In fact there is some evidence that, although it may not be as easy to conceive as for our younger counterparts, women of advanced maternal age may have more success than was originally thought. So how can you optimize your chances? Chinese Medicine is one of the best ways to support fertility.

Often women hear about positive experiences with Chinese Medicine from their friends and family, from a support group, or from their doctors.

Treatment with Chinese Medicine involves a combination of receiving acupuncture, shifting lifestyle habits, and learning what you can do to optimize the potential to conceive and carry a healthy baby.

Why Acupuncture?

Acupuncture techniques have been proven to regulate the hypothalamic-pituitary-ovarian axis. This may improve the health of ovaries and their hormone production, a concern for women of advanced maternal age. It may stimulate blood flow to the uterus (by inhibiting uterine central sympathetic nerve activity), increase serotonin, and decrease stress. Often your practitioner will also prescribe medicinal herbs to facilitate this process. The combination of acupuncture and herbs has a synergistic effect.

The idea of changing our habits may seem daunting, but things can shift in a remarkable way with some relatively simple changes. Everyone knows that eating better makes us healthier, but there are some specific things that we can do to optimize our health and fertility. Focusing on changing one’s diet is part of the equation.

Chinese Medicine focuses on paying attention to the entire mind, body and spirit as a whole. Consider the following:

  • What makes you happy?
  • What is fun for you to do?
  • Tap into your creativity.
  • Take walks in nature.
  • Move your body. Exercise releases endorphins which help to keep a more positive focus when life gets difficult.
  • Do something regularly to take care of yourself and give yourself the attention that you deserve. That could mean receiving a massage, going dancing, journaling, or painting. Meditation, yoga, and/or tai qi are avenues for stress and anxiety reduction, as well as for the simple act of being with oneself.

[Read more…]

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.

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Our Wish List for Healthcare Providers

Bill of Rights

Women who are 35 or better with their first pregnancy have some wishes to share with their healthcare providers, including obstetricians, midwives and nurses. We consider this to be a request, but candidly, it is almost a “bill of rights” that all pregnant women need to get these things for both support and comfort.

 

 

  1. Treat us as women first and patients only when we need medical attention and supervision. Women have been having babies for thousands of years. Many of our grandmothers had healthy children after age 35 and 40.
  2. Carefully review our medical histories before you discuss our risk factors. This is especially the case for those who have been seeing you for gynecological care for many years.
  3. Do not warn us of risk factors unless they are our personal medical problems. There is enough literature on high-risk pregnancies.
  4. Provide us with the option for tests and sonograms that are not routine for all pregnant women. We want the choice to have more or less prenatal care beyond the basics.
  5. Listen to our questions and present multiple points of view when possible, referring us to additional reading and resources where available.
  6. Share ideas and resources for any challenges we face, including those that complement the care you are providing.
  7. Comfort us and remind us that we are pregnant women, strong and capable no matter what barriers we face to a healthy pregnancy.

Existing Research on Advanced Maternal Age and Risk Perceptions (Part 1.)

Literature Review in ProgressAs we are preparing to conduct our own primary research on the barriers to a healthy pregnancy for women over age 35 and the resources they use, we have done a literature review and will share highlights here and in upcoming posts.

In an article published in 2012 from the BMC Journal of Pregnancy and Childbirth, researchers conducted interviews aiming to identify risk perception and coping mechanisms utilized by a group of 15 Canadian women between ages of 35-44 in the last trimester of their pregnancy (Bayrampour 2012). The study found that in the cases were the women’s previous medical history were absent of risk and conflict, almost all of the mother’s over 35 expected to have a healthy pregnancy. In the cases were women had experienced previous health conflicts in regards to their maternal health, such as complications in their pregnancy, previous unsuccessful attempts trying to have a child, or unfavorable test results, they typically saw their age and overall pregnancy as a risky situation (Bayrampour 2012).

A similar study was published just this year in Sweden. In the study, researchers examined differences in risk perception between mothers both younger and older than age 32. The study showed that the older group of mothers were more likely to consider their pregnancy as being worse than first expected when compared to younger mothers (Aasheim 2013). These reactions were tapered however whenever the older group of mothers were able to deliver through medical interventions such as a cesarean section. These women typically responded more positively to their pregnancy experiences when compared to the younger group (Aasheim 2013).

Some of the other pertinent studies that have been conducted in this area include a 1999 British study that found the majority of a population of 107 advanced maternal age women to perceive their age as a risk towards a healthy pregnancy.

A more substantial study conducted in Australian identified themes in advanced maternal age women’s perceptions towards their advanced maternal age label that included the desire for medical assurance and a struggle to negotiate potential risk adverse behavior (Windredge and Berryman 1999; Carolan 2005).

One of the main findings in all of these articles is that it many women of advanced maternal age perceive their pregnancy as risky.

Commentary from the AMA Researcher: Many things affect this perception though, and it is important to keep these things in mind whenever your own perceptions are formed.

  • Women who have had previous medical issues typically will see themselves as more of a risk when compared to women who have had little to no previous medical concerns.
  • Among these perceptions of risk, some women may only worry about their specific medical plan of treatment while others may experience more of an overall state of anxiety that concerns every aspect of their condition. The level of variance in perception and response is normal.
  • Although women of advanced maternal age may show more signs of risk perception, the variety of their experiences and medical readiness ultimately create a more complicated picture than the current research shows.

Of the existing research that has been published on advanced maternal age issues, very few research articles aim to examine the personal perceptions and psychological responses women experience surrounding the risks of an advanced maternal age pregnancy. Very few U.S. studies have been conducted to date.

Advanced Maternal Age and Children’s Adult Health

Child's Health

Most discussions of children’s health with regard to mothers who conceive after the age of 35 revolves primarily around the child’s health either during the pregnancy or in infancy. While these are extremely important, it is also important to consider the long-term health prospects of all children.

Throughout The Advanced Maternal Age Project, many of the stories our contributors have shared mention preparedness obtained from waiting to have children in establishing the finical means and physical and mental mind-set to be able to effectively care and provide for a child.

This particular preparedness and maturity helps to create a stable environment for a child to grow up and can have many positive effects on the child’s health later on in life

. A study from the Max Planck Institute for Demographic Research published in 2012, examined 18,000 mothers and their children’s health in adulthood within the U.S. In this particular study, women’s education and life expectancy where factored into the statistical analysis of the effects of maternal age on children’s adult health.  Both of these factors had a positive effect on the health outcomes for children.

For example,  children born of mothers who where before the age of 25 and more specifically, between the ages of 15-19 years old were more likely than any other age group to be diagnosed with a greater number of ailments and diseases within adulthood. For women over 35, children’s health within adulthood was stable. The study proposed more pointedly that the higher education levels and subsequent socio-economic status of mothers past the age of 35 had a tremendous effect on the health of their children later on as long as the mother lived to average life expectancy. Parents of much younger ages typically do not have the life experience or immediate finical prospects that are usually accumulated over longer periods of time. Because of this, the environment in which the child is born may not lend itself in facilitating the proper health and wellness benefits that are more easily obtained by parents who have more adult-life experience.

This particular perspective and academic study leads to a discussion about the non-physiological factors that play into children’s future health expectations. Education and finical stability are both tools that are more readily utilized by mothers over 35 years of age. Both of these factors are important to consider whenever thinking about the long-term health expectancies of children. The more prepared women are in personal education and work experience as well as the accumulation money and assets, the more likely it is that the child will be able to be raised as a healthy individual. Although this idea is not groundbreaking, it can get lost in the conversations regarding health concerns. The actual socioeconomic preparedness of a perspective mother should be considered equally important as her age when thinking about future-life implications for the child.

Talk of the Nation – NPR Covers Prenatal Testing and Being Over 35

Just as we were thinking about this topic and writing a recent post with a story about prenatal genetic testing, National Public Radio (NPR) was covering it as well on Talk of the Nation (5/30/13).

There are many considerations about having the testing done as well as how to proceed once you know the test results. Fortunately today more tests are available, including a less-invasive one, a first-trimester blood test.

One of the participants in the radio program, Ayelet Waldman, an author and mother from Berkeley, CA shared her story and here’s an excerpt:

“During the course of the pregnancy, I actually turned 35. And the pregnancy books and my doctor all said that 35 was sort of this magical moment. It was the moment when your chance of having a baby with a genetic abnormality, specifically Down syndrome, trisomy 21, outweighed – were greater than the chances of losing the baby to the amniocentesis…”

Read the Full Transcript or Listen to the Radio Program Online on NPR.org.

How do you feel about prenatal testing? Did you do it for a pregnancy after age 35? We’d enjoy hearing from you.