Becoming a mum at an older age was in the news again today. I guess I'm tuned into noticing pregnancy and parenthood stories in the news - a combination of living and breathing these issues in both my home and work life (and also working with a very efficient press team at NCT!). But it does seem like these stories are prime fodder for press activity - single research studies draw significant coverage, even when they don't add anywhere near sufficient evidence to change policy or practice. Add a celebrity into the mix, and we have big news ...
More than 2,000 babies were born to mums over the age of 45 in England and Wales in 2015, and I'm sure everyone of those mums are relieved to have not had the press attention that Janet Jackson received this week. Was it fertility treatment? Is it safe? How will she cope with teenagers in her 60s? If she isn't thinking all of these things over, then the celebrity following is doing so for her.
There are many complex social, professional and financial reasons why a woman might choose to have a baby later in life. And for many women this doesn't feel like a real choice - they have only just settled with a partner who they feel ready to start a family with. Or have experienced fertility issues for many years, before what feels like a miracle happens. Or perhaps have experienced previous loss or abuse or mental illness or economic or housing uncertainty which meant that pregnancy was just unthinkable at an earlier time. It is not for us to judge. But it is the reality for many.
Research tells us that there are increased risks associated with older age at pregnancy. Data from the UK Obstetric Surveillance System (UKOSS) compared outcomes in women aged between 48 and 61 of age to a comparison group of women aged 16 to 46. All women gave birth in UK obstetrician-led maternity units between July 2013 and June 2014. Older women were more likely to have complications of pregnancy such as gestational diabetes or high blood pressure, and a preterm birth. They were also more likely to experience placental complications or heavy bleeding after birth, to need a caesarean section, and to be admitted to intensive care.
Women of older age were also more likely to have conceived following fertility treatment, to be overweight or obese, to have pre-existing medical conditions and to be carrying a multiple pregnancy. These factors explain the increased risk of many of the complications observed.
Whilst women should be free to choose when to start a family based on their personal circumstances, there is little that can currently be done to reverse the underlying biological factors that lead to reproductive ageing. Of the 48 to 61 year old age group in the UKOSS study, 78% were conceived by in vitro-fertilisation, compared to 4% in the group aged 16 to 46.
The Birthplace in England study showed greater risk of intervention and adverse outcomes with increasing age in women who didn't have any known medical or obstetric risk factors prior to the onset of labour, and there was no age at which there was a step-change in risk.
But it's not just about age - we know there are increasing numbers of women giving birth who have health problems or complicated pregnancies for a whole range of reasons. Whatever your age, whatever your circumstances - pregnancy and early parenthood can be a time of great challenge.
What matters is that every woman is able to access safe, high quality maternity services which recognise and adapt to her individual needs. That she is able to prepare and be informed and be supported in the many decisions that are needed along this most personal of journeys. That she is not isolated or fearful or judged. That she has a support network around her, and an advocate by her side.
And, if she's Janet Jackson, that she can continue her journey to parenthood without the additional complications of the celebrity lens.
Note: Here I am discussing this story with Helen Blaby on BBC Radio Northampton (23:50 in).
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