Despite advances, delaying childbirth may still come at a cost

THE reasons women postpone having babies are complex – and include the availability of safe and effective contraception, preferring to be in a stable relationship with a supportive partner, wanting to build a career and achieve financial independence, or enjoying the freedom that family life may potentially compromise.

It is a universal challenge that the best years for having babies coincides with the best years for establishing a career and the trend towards later maternity appears to be strongest among women with better educational qualifications. While delaying pregnancy and parenting until a couple achieve financial security seems wise, there is no doubt that it also comes with difficulties.

Women need to be aware of how fertility and pregnancy outcomes change with age, and that their decision to postpone pregnancy may in turn have financial implications.

Although women are healthier than ever, biology can still determine destiny. The decline in fertility and increased risk of pregnancy complications with age remain.

Biologically, the optimum period for childbearing is between 20 and 35 years of age. At the age of 30, 75pc of women will conceive naturally within a year. This falls to 66pc by 35 years and 40pc by age 40.

The risk of chromosomal abnormalities, such as Down Syndrome, increases with age, from one in 950 at age 30 to one in 100 at 40 years.

Many couples turn to IVF and other assisted reproduction techniques but these techniques cannot compensate for the effect of age on a woman’s eggs. The live birth rate for women under the age of 35 undergoing IVF is approximately 30pc. This rate falls to between 5pc and 10pc for women over 42 years of age.

In addition to the huge emotional and social stress that infertility and embarking on assisted reproduction carries, these treatments also come at a considerable financial cost.

Currently in Ireland a single cycle of IVF costs approximately €5,000. Couples are usually advised to budget for more than one cycle.

Women should be supported in their decisions of whether or not to have children and when to plan childbearing.

There are many advantages to postponing pregnancy, from greater financial stability to increased satisfaction with parenting.

However, while the unflattering term ‘elderly primagravida’ (a woman who becomes pregnant for the first time after 34) is now defunct, delaying having a family may still come at a cost.

Dr Aoife Mullally, Clinical Fellow in Obstetrics & Gynaecology, Coombe Hospital

 Irish Independent