Sunday, May 18, 2008

Births to women over age 40 soaring, and so is birth rate (and so is autism)


Births to women over age 40 soaring, and so is birth rate
By ANNE CONSTABLE The Santa Fe New Mexican
Article Launched: 05/18/2008 11:30:17 AM MDT

SANTA FE, N.M.—Barton Bond is looking forward to coaching his son's football team. His wife, Joyce, can't wait to sew Halloween costumes when their children are old enough to go trick-or-treating.
The Bonds sound like typical new parents, but they're not.

They've been married 32 years, but have no other children. Barton has retired from one job and now teaches part-time at Central New Mexico Community College. Joyce is just two and a half years away from retirement from her job as marketing manager for the city of Santa Fe.

Last July, she gave birth to triplets, Jayci Clare, Dallas Witt and Marie Patrice.

At a time when most people their age would be looking forward to being grandparents, they are feeding, changing and burping their merry trio.

At 53, Joyce is part of a new, growing demographic. Births to women over age 40 are soaring and so is the birth rate.

In obstetrical terms, a woman of 35 is considered to have reached "advanced maternal age." And a woman over 40, well, she might be scaling 13,000-foot peaks or swimming laps three times a week, but her eggs are senior citizens. Her biological clock has virtually stopped.

A woman's fertility starts to decline around age



27. According to the American Fertility Association, the chance she will get pregnant is 20-to-30 percent per cycle until her 30s and by age 40 falls to 5 percent.
But many women are lengthening their childbearing years through assisted reproductive technologies such as fertility treatments, egg donation and in vitro fertilization, in which egg cells are fertilized by sperm outside the woman's womb and then implanted in her uterus.

In 1995 and 2006, for example, the number of babies born to women 40 to 44 grew from 67,250 to 105,476. And the number of babies born to women older than that increased from 2,727 to 6,958, according to the federal Centers for Disease Control's National Vital Statistics System.

The birth rate of the women 40 to 44 grew by 45 percent in that time, and the birth rate for the oldest group doubled.

More babies are born to women having their first child over age 40 as well. The number of these births increased from 20,096 in 2000 to 24,284 in 2006.

"There's a lot more you can do. The biologic clock has changed," said Jim Thompson, a fertility specialist with the Center for Reproductive Medicine in Albuquerque.

Women in their late 40s and even their early 50s can have babies using donor eggs or embryos so long as they have a healthy uterus, Thompson said.

Artificial insemination and in vitro fertilization become less efficient, however, because of the declining quality of a woman's eggs, he said. Women in their mid-40s have a 60 percent chance of getting pregnant with an egg donor, compared to 1 or 2 percent with their own eggs.

Pregnancy carries a higher risk among older women who are more likely to experience complications such as pregnancy-induced hypertension, high blood pressure, placental separation and low birth weight.

"That being said," Thompson said, "most women do fine in their mid- to late 40s, even their early 50s."

The Bonds' living room in their home is full of baby equipment. Jayci and Dallas are swaying back and forth in their swings. Marie is bobbing in a walker. Nobody is crying.

"We're running out of room," said Joyce as she surveyed the multiple pieces of baby equipment.

Her mother was 45 when Joyce was born. "I loved having an older mother. I felt that my brother and I (who is six years older than Joyce) kept Mom and Dad young," she said.

But Joyce and Barton, who is 55, "didn't suddenly sit down at the kitchen table and say, 'Let's have babies in our 50s.'"

Life happened. A new job, a move, illness in the family, Joyce's hormonal imbalance, Barton's bout with cancer—all intervened.

"There was always a life event when we got serious about having children," she said.

When they were finally ready, their ages were against them. Joyce was one year shy of the cutoff age for patients at the Center for Reproductive Medicine when three embryos were implanted in her uterus in January of 2007. If this didn't work, she figured, "it was not meant to be."

When she found out she was having triplets, she said, "I didn't know whether to laugh or cry."

Her pregnancy went well, but like many high-risk moms, she spent the last month before the birth in the hospital where blood flow in the umbilical artery of one of the babies was tested daily.

The babies were born by emergency caesarian section on July 25 at 29 weeks and three days. Each was a little over 2 pounds. All the children are thriving.

Joyce, who returned to work full time, gets the babies up in the morning and gives Marie a treatment for her lungs. By the time she returns home, the triplets are ready to go to sleep for the night. "I want to be in their vision in the morning and the evening when they go to bed," she said.

Barton, who teaches film two evenings a week in Albuquerque, cares for the babies during the day with the help of the family's Bolivian au pair, Teresa Villarroel. Volunteers from Many Mothers visit weekly to give Villarroel a break.

Joyce's hair was gray during her pregnancy, and in the hospital, she was sometimes mistaken for her children's grandmother. The news took many family members and friends aback. "What are you thinking?" they wondered.

But Joyce and Barton are relaxed about raising children into their "golden years."

"I wouldn't do it if I didn't think I could," said Joyce.

"We are going to be older when they're in their teens," she said, "But I'm just trying to stay young. I don't consider myself the typical grandmotherly type."

Barton is clearly over the moon.

"I'd rather hold a baby than anything. That's the best part of the whole package," he said. Cuddling Dallas, he talks to his son about the Cubs and the Kansas City Chiefs. "We lay there. That's the best."


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