Jayne Rose Gacheri
2 December 2006
column
Nairobi — Any woman today can flaunt her jeans and high heels with abandon because she is free to make her own choices.
She decides how she wants to live and charts her career path and marriage life. The same goes for motherhood and for the first time in Kenyan history, the number of births to every 1,000 women in their 30s is almost exceeding that of women in their 20s. Is it right to delay motherhood and what are the effects?
I am sentimental about this topic, myself having broken the "child-bearing rules" to get a second baby quite late in life. After close to a 20-year break, I felt it was time to have another baby.
But to be on the safe side, I discussed the issue with my gynaecologist, who tested me for abnormalities and assured me that everything was okay. He told me I could deliver healthy babies up to the age of 45. This made me relax, which was probably the reason I got pregnant three weeks later!
Delaying having a baby
But my doctor gave me the condition that I had to maintain a healthy lifestyle and consult him regularly.
But when I failed to have an ultra-sound scan at three months, the doctor was alarmed, since he told me the tests could have been taken to Germany for scrutiny. To cut a long story short, I gave birth to a bouncing baby girl through normal delivery three years ago.
I believe many women can relate to my story. Most have sweated over the right time to have a baby especially in these fast-paced times, where taking a maternity break could pull down your career or leave you with a glaring financial dent.
Another reason is personal choices where most women are planning to fit into their own life scripts. On the other hand, many women are familiar with the health risks associated with delayed pregnancy.
Baby Maureen Wangui
Betty Kilinda, 35, planned to have her first baby in her 30s because she wanted to be well-grounded in her career. Although her husband was ready for a family, Betty had a job she enjoyed and it required long hours and frequent travel.
"Delaying having a baby enabled me to move ahead professionally and I have no regrets," she says, adding, "My experience makes me believe that even if you conceive in your 30s, your health, energy, and fertility will still be at their optimal levels."
Elderly primilgravida
But Ann Argut was not so lucky when she conceived in her late 30s after finally clinching Mr Right. She miscarried after six months, which her doctor attributed to declining egg quality.
She gave it another go and now with close medical observation, Ann is in her seventh month of pregnancy.
"I am happy to have a baby now since I am capable of taking good care of it," says Ann.
Magdalene Njue, who had her baby at 45, recalls feeling "dead-beat" and had to sleep every afternoon during her pregnancy. She also gave birth by caesarean section, but has no regrets.
"I had been trying to get pregnant for many years and this was a blessing," says Magdalene.
Thirty-five is said to be a woman's red-flag age for childbearing. But women are increasingly taking "risks" by giving birth even in their 40s.
The medical term for women who conceive after 37 is elderly primilgravida, which means that nature has marked you out as a mother and biologically, it makes sense to give birth below this age.
It is said a woman's best child-bearing age is 18 to late 20s. Interestingly, this is the age at which one least wants to conceive because they have not yet settled in life. On the other hand, societal pressure makes many women anxious about the right age to have a baby.
Peak childbearing years
In the West, a woman can have her eggs extracted and frozen while she is still young and healthy, to be retrieved later when she wants to have a baby. Conception can then be done through artificial insemination or surrogate motherhood.
Dr Frank Kagema, a consultant obstetrician and gynaecologist at Nairobi Women's Hospital, says age does have an impact, but this should not prevent you from getting pregnant if you really want to.
"The problems that could arise can be managed with good prenatal care and counselling," he says.
The medic says the age considered right is between 20 and 35.
"These are the peak childbearing years and most women consider it the right time to give birth. However, several births have been recorded among women in their 50s," says Dr Kagema.
Records at most local hospitals indicate that many women give birth by their 21st birthday.
But the average age is inching up, with most women shying away from giving birth below the age of 25.
There is a general medical theory that the younger you are, the smoother your pregnancy will be," says Dr Kavoo Linge, another consultant obstetrician and gynaecologist.
Kagema and Kivoo say when a woman is young, her eggs are healthier and it is easier to conceive.
Lower risk of birth defects
In addition, high-quality eggs translate into a lower risk of birth defects.
"At 25, the likelihood of getting a baby with Down's syndrome is one in 1,250 and the chances that you will miscarry are also minimal," says Dr Kavoo.
Dr Kagema says women in their 20s are also more likely to have a smoother time recovering from a birth.
"The older you are, the harder it is to bounce back," he says.
Doctors also say about 80 per cent of women in their 20s give birth vaginally, compared to 40 per cent in their 30s and 43 per cent in their 40s.
"Normal delivery is more common in younger women because they have more muscle tone in the uterus and abdomen, which makes pushing easier," says Kangema.
He explains that the female pelvis and birth carnal stop growing at the age of 21, which is why it is an opportune age to give birth.
"The pelvis has finally matured and is ready for child- bearing," says the medic.
Between 15 and 39 years, the womb releases about 500 eggs.
"Nature has planned that the best eggs are released by age 35 and a woman should have stopped giving birth by then," says Kagema.
It becomes more difficult to conceive after 35
After 35, it becomes more difficult to conceive because this is the age when diseases that affect the egg such as hypertension, diabetes and thyroid problems creep in.
At this age, smoking and drinking also affect reproductive health.
"Once you turn 35, your pregnancy will be monitored more closely," says Kagema.
One reason for this, he says, is that the risk of birth defects rises at 35 and chances of your baby being born with Down's syndrome is 1 in 80.
One way of controlling the condition is going for screening, which also reveals other chromosomal abnormalities.
But Kavoo says women giving birth in their late 30s need not go into a panic.
"About 95 per cent of women who undergo prenatal testing deliver healthy babies. Thirty-five is simply the age experts agree more tests and monitoring should be done," he says.
But he agrees that having a baby at this age can be exhausting.
"There is a simple reason why footballers do not compete after 40; they just don't have a physical advantage and energy reserve anymore. The same applies in childbearing," jokes Kavoo.
"First-time mothers over 40 are more likely to develop high blood pressure and four times more likely to develop diabetes during pregnancy than those in their 20s," he says.
The same age group is eight times more likely to suffer a condition in which the placenta is implanted low in the uterus, sometimes over the cervix, impeding delivery.
"This condition can cause complications but can be prevented with a caesarean delivery," says Kagema.
'Problems are mainly psychological'
He says C-sections are more common in older mothers, since they may suffer from other problems like fibroids.
Other problems are diabetes, cardiovascular diseases, hypertension, haemorrhage and dysfunctional labour.
But the medics concur that if a woman is naturally fertile and healthy, she can conceive easily between 37 and 39, although statistics show it is an uphill battle from 37.
On the plus side, older women experience morning sickness less.
"Their placenta is smaller and produces fewer hormones, including the one that causes nausea," says Kavoo.
Jane Kaiberia, a psychotherapist at Daystar University, argues that the problems associated with late motherhood are mainly psychological.
"Older women are wiser and look after themselves better," says Kaiberia.
She adds that women in their late 30s and 40s are financially established and when they have babies, they take time to enjoy them.
So if you want to give birth after 35, it is alright but co-operate fully with your doctor if he recommends tests and close observation. It will be for your own good.
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