WUNRN
15/06/2009
UK - Royal
College of Obstetricians and Gynaecologists
MEDICAL STATEMENT ON LATER MATERNAL AGE
There is a
growing trend in the UK for childbearing to occur at a later time in women’s
lives1. This trend is reflected in countries in Western Europe2,
in Australia3, New Zealand4, Canada5 and the
United States of America6.
The reasons
motherhood is postponed are manifold and complex. Common reasons include:
the availability of safe, effective contraception; to pursue further education;
to build a career; to achieve financial independence, and to be in a stable
relationship with a supportive partner.
Women should
be supported in their decisions of whether to have children or not and when to
plan childbearing. However, they also need to know how fertility and pregnancy
outcomes change with age. Biologically, the optimum period for childbearing is
between 20 – 35 years of age. Most women will get pregnant. Within a year, 75%
of women aged 30 and 66% of women aged 35 will conceive naturally and have a
baby7. After this, it is increasingly difficult to fall
pregnant, and the chance of miscarriage rises. At this stage, women may
resort to fertility treatment, sometimes with multiple embryo implantations to
improve their pregnancy success rate. Figures show that the live birth rate for
women aged less than 35 undergoing IVF is 31%. This rate falls below 5% for
women over 42 years of age8. In some cases, older women have
travelled abroad to countries with lax regulations for IVF treatment, to
improve their chances of becoming pregnant by acquiring donor eggs from younger
women.
Most
pregnancies will result in a healthy baby. However, adverse pregnancy
outcomes also rise with age, and women over 40 are considered to be at a higher
risk of pregnancy complications9. For these reasons, the Royal
College of Obstetricians and Gynaecologists (RCOG) and doctors would encourage
women to consider having families during the period of optimum fertility.
There is an
urgent need for better public information on the issues surrounding later
maternity. Women should be supported, rather than constrained, in their
life choices. However, both women and society need to be aware of the possible
problems that older mothers may encounter. There may also be factors facing the
child which need to be addressed.
As more
women have babies at a later age, there are implications for the way that such
women are cared for in the NHS. Later maternal age is an emerging public
health issue and organisations such as the RCOG, NICE and the Centre for
Maternal and Child Enquiries (CMACE) must work together with the Department of
Health to tackle these new challenges. More research into the social
consequences of later maternity is needed to help inform healthcare policy.
15
June 2009
NOTES
In response
to growing concern over the rising incidence of later maternal age in the UK,
the RCOG convened a Study Group to discuss the issues. The Study Group
has produced Consensus Views which can be found
here.
The RCOG has
also recorded a podcast with some of the members of the study group. To
listen to the podcast, please click
here.
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