Advanced maternal age. Geriatric pregnancy. Elderly primigravida.
If you’re over the age of 35 and trying to conceive (TTC), you’ve probably heard one or several of these terms thrown around by your doctor. Yes, if you’re over 35, you might as well call it quits - it’s all downhill from here...or at least that’s what this popular messaging seems to convey.
Advanced maternal age = AMA. You know what other medical abbreviation is AMA - against medical advice? Coincidence?
There is so much malarkey going on when it comes to women in their 30’s giving birth these days that I just can’t take it any longer. This insanity needs to stop.
As you guys probably know by now, before I became a nutritionist, I was a banker and a consultant for about a decade. And, during that time, I did a ton of research and I built a lot of models. Like a lot. And so, when it comes to challenging these very pervasive messages that we’ve been hearing about women getting pregnant in their 30’s and 40’s, I thought it was time to break out the big guns - the data. Here goes:
The OECD (Organisation for Economic Cooperation and Development) has an incredible Family Database that provides data on family outcomes across 35 OECD countries, including fertility rates. Unfortunately, it doesn’t have data on non-OECD countries (e.g., in Africa, much of South America), which is a bit of a bummer, but we’ll work with what we’ve got!
Of particular interest for us is their data on “fertility rates by women’s age at childbirth”. Now, remember, this does not take into account how many women are trying to get pregnant at any given age, but just the number of births per 1000 women in each age group (e.g., 15-19, 20-24, 35-39).
So, what did we find out?
First of all (and maybe unsurprisingly), the highest fertility rates, on average, occur in the 30-34 age group.
Second (also maybe unsurprising), there is a wide variety in birth rates across countries. For example, in that same 30-34 age category, Netherlands had the highest birth rate at 132 births per 1000 women and Bulgaria had the lowest birth rates at 68 births per 1000 women.
Third, the drop off in birth rates from age 30-34 to age 35-39 is ~50% and from age 35-39 to age 40-44 is ~80%. Basically, women aged 35-39 are having 50% fewer babies than women aged 30-34 and women aged 40-44 are having 80% fewer babies than women aged 35-39. But again, this does not take into account pregnancy attempts, only outcomes.
Finally, and most importantly, there is one country that has a significantly higher than average number of babies born to women aged 35-39. Where? I know you all want to know.
For women aged 35-39, Ireland’s birth rate is 97.2 births per 1000 women. And here’s the kicker - that’s basically equal to the fertility rate in the US for women aged 30-34 (98.7 births per 1000 women). Yes, you read that correctly. The fertility rate for 35-39 year old Irish women is essentially equivalent to the fertility rate for 30-34 year old American women.
This begs the question: What is really driving the difference between the higher birth rate countries (like Ireland and the Netherlands) and lower birth rate countries (like Bulgaria)? And before you chalk it up to genetics, read this post first.
Regardless, the bigger take-home point here is this: you are not doomed to a childless existence the moment the clock strikes midnight on your 35th birthday. So stop the freaking insanity! The data really does suggest otherwise...and if you stick around here long enough, you just might begin to question the BS you're being told too.
The real reason that pregnancy risk goes up as you age is because the probability of health problems also goes up as you age. And yes, there are natural effects of aging, but even those can be moderated somewhat by lifestyle.
And, as we find pockets of the world that defy the “conventional wisdom” that fertility precipitously drops at age 35, we can take comfort in that fact. Is Ireland an outlier? Absolutely...but it shows us what’s possible. And, I suspect that there are many similar examples among the countries that we don’t even have data for.
Maybe for a moment, rather than focusing on of all the horrible tragedy that can occur when you have a baby later in life, let’s instead take a moment to appreciate the benefits of having children later in life - you are likely more highly educated, financially stable and emotionally grounded. In fact, one study in Sweden even found that “individuals born to older mothers, including those at the oldest ages, are taller, remain longer in the educational system, are more likely to attend university, and perform better on standardized tests than their siblings who were born when their mothers were younger”. How about them apples?
So, let’s just all take a collective sigh of relief. It’s not as bad as others have made it out to be. You’re going to be just fine...and so are your babies.