Who knew getting back together with an ex would work out so well? Music artists Ashanti and Nelly rekindled their romance in 2023 after a 10-year hiatus, and recently announced a pregnancy and engagement for April 2024. This will be Ashanti’s first child and Nelly’s fifth.
At 43 and 49, they prove that it’s never too late to fall in love, and more importantly, it signals a dramatic cultural shift where people are having children at a later age.
While the number of people giving birth under age 30 has been steadily declining, the number of people giving birth in their 40s has been increasing. This figure increased by 6% in 2022 compared to 2021, according to the latest statistics from the Centers for Disease Control and Prevention (CDC). The birth rate for women aged 45 and over increased for the first time since 2016, with births increasing by 12%.
Obstetric nurse Tina Bitancol said she’s noticed an increase in her own workplace. “There’s a term in the obstetric community: AMA, which means ‘advanced maternal age’ – 35 or older,” she explains. “But now, I’m hearing another term more frequently: vAMA, which means ‘very advanced maternal age.’ Early in my career, I only heard the term a few times over an extended period of time, but now I hear it more frequently.”
Why pregnancies after 40 are on the rise
There are several possible reasons for this change. According to the Pew Research Center, the 2008 recession accelerated the shift to older childbearing ages, along with women becoming more educated and participating in the workforce.
Bitangcol says he feels a growing drive to be creative and successful in life. The desire to “do it all” requires dedication, hard work and above all, time.
“You start to see this group of people putting their family obligations on the back burner to work hard and put all their effort into their goals,” Bitangcol explained. “This doesn’t leave much space for their children.”
There are also concerns about the current economy and inflation rate, with consumer prices expected to rise 3.5% from March 2023 to March 2024, according to the U.S. Bureau of Labor Statistics.
“Others may be delaying having children because they are saving up to buy a home, trying to pay off student loans, or looking for job or income stability before deciding to start a family,” Bitangcol added.
Additionally, people are delaying marriage and partner-hunting, which could affect their decision about when to have children. Another Pew Research Center report found that the main reason is that people simply aren’t finding partners who have “what they’re looking for.”
What to consider when getting pregnant after 40
Natalie Crawford, MD, a dual-certified fertility specialist and co-founder of Fora Fertility in Austin, Texas, says she’s also seeing an increase in her patients starting families later in life. Of course, it’s entirely possible to have a healthy pregnancy later in life, but there are some factors to keep in mind.
“Our biggest concern is when people want more than one child but aren’t ready to start trying until they’re in their late 30s or early 40s,” Dr. Crawford says. “As we age, fertility declines, making it harder for people to have the family size they desire.”
It is well known that egg quantity and quality begin to decline with age.
“Women are born with a lifetime supply of eggs, and lose a large number of them each month,” explains Dr. Crawford, “Furthermore, our eggs reside in the cavities of the ovaries and remain there for the rest of our lives. They absorb wear and tear from their environment, and chromosomal abnormalities increase (or egg quality declines) as we age.”
There are a few other things to consider: A 2020 study found that people over 40 are at higher risk for pregnancy-induced hypertension, gestational diabetes, pregnancy-induced hypertension, and needing a C-section. There’s also an increased risk of miscarriage and premature birth. Interestingly, the chances of having twins also increase dramatically as you get older.
Research shows that 40-year-olds have a 44% chance of conceiving within the first year, compared with 85% for those under 30. According to the American College of Obstetricians and Gynecologists, once you reach 45, “your chances of conceiving naturally decrease.”
For this reason, Dr Crawford’s biggest piece of advice for anyone over 40 who wants to start a family is to get an fertility evaluation promptly, which includes a full medical history, testing of ovarian reserve, uterine and fallopian tube anatomy, and semen analysis (if using a partner to conceive) so that medical professionals can intervene early if any issues are detected.
The great news is that for those having trouble conceiving, there are options, including in vitro fertilization (IVF). Surveys show that 18% of people aged 35 to 44 have used such fertility treatment services, as have 7% of those under 35.
It’s no wonder that more and more people are freezing their eggs at a younger age: One study found that between 2010 and 2016, the number of people freezing their eggs in the United States increased by 880%.
The use of donor eggs is one increasingly popular fertility treatment that can increase the chances of successful conception. It is important to note that all of these options can be cost prohibitive for many people.
For future pregnancies, Bitancol says health care providers will likely monitor patients more closely, especially in the third trimester, to make sure everything is going as expected. “You often see things like ultrasounds and non-stress tests to check for patients with vAMA,” Bitancol says.
Despite all the risks and setbacks, the trend towards later childbirth isn’t a big concern for Dr Crawford, who simply advises people to track their cycles, understand ovulation and make sure they’re in the optimum state each month.
“It’s not impossible to get pregnant in your 40s, but it’s important to understand your menstrual cycle, track your ovulation, and make sure there aren’t any other factors that may be affecting your ability to conceive,” says Dr Crawford.
