How Many Babies Were Born in 2018 to Women 45 and Older

The United States is in the midst of a baby bust as birth rates fall in every age group of women except for one: women in their 40s, according to government statistics released this week.

While most babies are born to women in their 20s and 30s, the continued rise of older moms reflects a long-term shift to delayed childbearing.

And it reflects the experiences of women such as Karla Webber, 44, of Dunwoody, Ga. She had her son Grayson 18 months ago after one lost pregnancy and six rounds of fertility treatments costing nearly $100,000.

Before marrying her husband at age 37, Webber said, "I choose my career, frankly, over everything … But once I was in love and I found this amazing man, I was all about starting a family."

Births among women ages 40-44 have been rising since the early 1980s and kept rising in 2017, even as the overall U.S. birth rate fell to a record low, the U.S. Centers for Disease Control and Prevention said in its latest report. Births in women older than 45 held steady.

Women ages 40 to 44 had 114,730 of the 3.8 million babies born in 2017; women 45 and older had 9,325.

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Medical professionals who see older women seeking pregnancy say the factors driving the continued trend include:

• Careers: Many women in their 20s and 30s are completing educations and starting careers. They feel unready, financially and otherwise, to have babies, said Eve Feinberg, assistant professor of reproductive endocrinology and infertility at Northwestern University Feinberg School of Medicine. Studies suggest women maximize their lifetime earnings by delaying motherhood.

• Partners: Some women wait a long time "to find the right person to have a baby with," Feinberg said.  By 40, they may go ahead with or without that perfect partner, said psychologist Andrea Mechanick Braverman, a clinical associate professor of obstetrics and gynecology, psychiatry and human behavior at Thomas Jefferson University in Philadelphia.  And some women in their 40s who already have children want more — with new partners, said Christos Coutifaris, chief of reproductive endocrinology and infertility at the University of Pennsylvania.

• Optimism and determination: Many women have confidence — and sometimes overconfidence — in their own continued fertility or the ability of doctors to help. "They see all of these celebrities having babies in their 40s and 50s, and they think they can overcome all odds," Feinberg said. Exhibit one: Janet Jackson, who gave birth to a boy in early 2017 at age 50.

It is true that fertility doctors can offer older prospective moms more help today than in the past. But biology still imposes limits.

A woman's natural ability to become pregnant begins a steep decline around age 37, reaching odds of less than 10% a month by age 40, according to the American College of Obstetricians and Gynecologists.

When women undergo in vitro fertilization with their own eggs, the chance of having a baby in each attempt falls from 41.5% before age 35 to 12.4% at ages 41–42, the college says. After age 44, the success rate is just 1%, which is why the vast majority of women who have babies after that age, celebrities included, are using eggs from younger donors, Feinberg said.

Using donor eggs increases success rates to those of younger women. But it means giving up a genetic link to the child and paying more for the procedure.  One work-around — freezing one's own eggs at a younger age — is catching on among some women.

Webber said she and her husband, Eric, 35, ultimately conceived their son with a donor egg and "we couldn't be happier." In fact, she said, they plan to try for a second child with frozen embryos created from the same donor's eggs and her husband's sperm. She said she expects to get pregnant easily.

But many women showing up in fertility clinics in their 40s have unrealistically high hopes, fertility doctors said.

"They just have no idea they should have gotten on the ball sooner," Feinberg said.  She said the number of women having babies in their 40s is almost certainly swamped by the number who would like to.

Many women also may not know pregnancy becomes riskier as they age, putting strain on their hearts, lungs and kidneys, said Coutifaris, who is president of the American Society for Reproductive Medicine. Because of those risks, fertility patients are carefully screened, and most clinics will not treat women past 50, he said.

"The good thing is that maternal care has dramatically improved," reducing complications for those who do get pregnant, said Zev Williams, chief of reproductive endocrinology and infertility and associate professor of obstetrics and gynecology at Columbia University Medical Center.

Not every prospective mother in her 40s needs fertility help. While more than 100,000 women older than 40 now give birth each year, just 5,000 to 6,000 of those births appear to result from IVF  procedures, Coutifaris said. Unknown additional numbers are using fertility drugs and other techniques, he said. But many births to older women clearly occur without a fertility doctor's assistance, he said.

"It's amazing how many people just get pregnant the old-fashioned way," Braverman said.

But those are not always the people who want to get pregnant. According to the Guttmacher Institute, one-third of pregnancies in women older than 35 are unintended — a reminder that birth control remains important for those who do not want to be a part of the aging mothers' trend.

Recent research from the Pew Research Center shows that, as of 2016, 86% of U.S. women had given birth, one way or another, by their early 40s.  Whether women are having all the children they want is a matter of debate.

And what happens after the birth, for older women and their families? That seems to be mostly a good-news story, Braverman said.

"The few studies that have been out there have suggested that older parents do well," and so do their children, she said.

 "The cards are stacked against women for delaying childbearing from a biological perspective, but from a social perspective, they are not," she said. "They get rewarded, financially and otherwise, for waiting."

In a better world, she said, women would have "the social supports to make the decisions about career and family building in the same way that men do." Then, she said, the choice of when to have children would be "a true choice."

How Many Babies Were Born in 2018 to Women 45 and Older

Source: https://www.usatoday.com/story/news/2018/05/19/childbearing-why-women-40-s-having-more-babies/624028002/

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