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Millennials are waiting longer to have kids, but what does that mean for the biological clock?
- More 30-something women are having babies than ever before.
- However, fertility declines with age, making it more difficult to get pregnant and increasing the risk of medical complications.
- Getting pregnant at an older age may also increase mental health risks, but experts are unsure about the exact relationship between the two.
- There are also benefits to having a baby later in life, like being more financially and emotionally prepared.
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The US birthrate is the lowest it's been in 32 years - and that's not the only change in birthing patterns happening right now.
For the first time, more 30-something women are having babies than women in their 20s, a difference that grew in 2018, according to a 2019 report from the Centers for Disease Control and Prevention.
But what about that infamous biological clock? As Dr. Sherry A. Ross, women's health expert and author of "she-ology," told Business Insider, it's "alive and well."
So what does that mean, physically and mentally, for the increasing number of women who are having kids later in life? Business Insider talked to three experts to find out.
The physical risks
The whole basis of the biological clock is that, as a woman ages, so do her eggs and thus her fertility.
The ideal age to get pregnant is when fertility peaks, Dr. Ross said: between ages 20 and 24, when genetic abnormality risks and maternal and fetal complications are at an all-time low. According to Ross, women ages 20 to 34 have an 84% of getting pregnant. That's compared to those ages 35 to 40, who have a 75% chance of getting pregnant.
A woman's ability to have a baby begins declining "gradually but significantly around age 32," according to the American College of Obstetricians and Gynecologists. After age 35, fertility declines quickly and the risk of miscarriage and difficulties conceiving rise, the experts said.
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Fertility declines with age.
"After 37, fertility declines at an [increasing] pace, so that by the time a woman is between 40 and 45, her fertility has decreased by as much as 95%," Dr. Ross said. "The ticking of the biological clock becomes louder at 40, and by 45, it can be deafening along with pregnancy complications."
In fact, women over age 35 are at 20% to 30% more risk for genetic abnormalities, high blood pressure, diabetes, pre-term labor, and cesarean sections; this increases to over 50% at age 40, according to Dr. Ross. There's also a higher likelihood of miscarriage or stillbirth, whether due to genetic or health problems, or unexplained reasons, Dr. Dorothy Fink, deputy assistant secretary for women's health and director of the office on women's health at the US Department of Health and Human Services, told Business Insider.
The mental effect
The increased physical risks that come with having kids later in life are clear, but what about mental health risks? Patients and physicians commonly misperceive mental illness, and it's still not taken as seriously as other medical conditions during pregnancy, according to Dr. Ross.
While mental illness is often diagnosed in women of all ages during and after pregnancy, more than half (52%) of women over age 40 suffer from depression and anxiety during pregnancy, Dr. Ross said, citing data from the National Center for Biotechnology Information. Mothers over age 40 are three times more likely to suffer from depression when compared to women ages 30 to 35.
But Dr. Alyssa Dweck, a gynecologist in New York City, said she's unsure whether the risk of depression and anxiety is elevated due to pregnancy, age, or both.
"With age might come other life stresses such as illness, aging parents, and work-related stress and responsibilities," she said, adding that potential assisted reproductive efforts - such as IVF or donor eggs - and the pregnancy risks that come with trying to conceive at a more advanced age may increase mental health risks. "[It's] hard to tease these issues apart."
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Experts say the relationship between mental health and having babies at a later age isn't entirely clear.
And while some studies show older mothers have a higher risk of mental health concerns, others show no link, Dr. Fink said. According to the National Institute of Mental Health, there's a higher risk of mental health concerns in women giving birth for the first time, women with health complications, women who undergo fertility treatments, and mothers of children with health problems.
A mother's depression is also associated with lower than average birthweight and pre-term deliveries, as well as problems in children such as impaired cognitive development, according to Ricardo F. Muñoz, a professor of clinical psychology, in an article for Nature.
"Since those risks tend to affect older women at higher rates, it is hard to say if age has a strong effect," Dr. Fink said. "All women giving birth are at risk for mental health concerns, particularly depression and anxiety, and older women may experience them at higher rates for various reasons."
The benefits of having children later in life
But giving birth in your 30s isn't full of only downsides. While women in their 20s might have less chance of medical ailments, women in their 30s might be better off financially and experientially, Dr. Dweck said.
Research also shows that moms who first gave birth in their early 30s report higher energy, better fitness, and fewer aches and pains compared to moms who first gave birth in their early 20s, Andrea Schmitz and Benji Jones previously reported for Business Insider.
And, according to Jenn Sinrich for Parents, studies show that older moms are more likely to be emotionally prepared and more likely to live longer. Studies also indicate benefits for the child, she wrote, such as decreased risk of accidental injuries and a higher likelihood of being better educated.
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Older mothers are more likely to be emotionally and financially prepared for a baby.
Many women are able to have kids in both their 20s and 30s, according to Dr. Fink. "Have a conversation with your healthcare provider about your medical history and your personal risk factors for complications in conceiving or carrying a pregnancy to term," she said, especially if you're a woman with conditions such as endometriosis and/or fibroids.
She added: "Also, stress can impact infertility ... identifying stress and de-stressing is not easy, but something that all women should think about!"
