Late Bloomers

Rising divorce rates, two-career households, delayed marriages, increased cost of living -- many families are postponing children. The result: "late life families." While benefits exist: financial stability, maturity and experience, there are potential problems to consider: health risks to the mother, generation gaps, aging parents becoming a responsibility -- or considered a burden -- for their own adult offspring.Dr. Lawrence Devoe, Chairman, Dept. of Obstetrics/Gynecology, and Director Of Maternal-Fetal Medicine, MCG, says shifting in maternal age over the past two decades is a very distinct phenomenon based upon a significant increase in the number of U.S. women between 35 and 50: up by 12 million since 1982. By the year 2000, it is estimated that 10 percent of U.S. births will be to women over 35, the recognized advanced maternal age.Dr. Devoe cites several major reasons for delaying childbirth. "It is no secret that for most women, conventional relationships are the rule," he says. "They find a partner, marry, create a home, develop a family. This is still the norm. Delays can occur if the prospective mother hasn't found a suitable partner. She may be ready for children, but the husband is not."One-fourth of surveyed women have a professional career on the rise and, as their business develops, they aren't ready for a child. A smaller group sat down, determined the expense of raising a child, projected college costs, can't afford or don't have the resources, and don't want a child they aren't able to pay for. Ten percent-plus have real infertility."Amongst medical risks in older women -- and population at large -- are high blood pressure, awry blood pressure, increase in diabetes, and chronic illnesses. Dr. Devoe notes that, "As men and women age, if you took a look at all these together, they contribute to significant increase in risk for maternal mortality. Gauging 100,000 live births, the rate is 24 per 100,000 up from 8 per 100,000 for mothers in their 20s." There are also obstetric concerns during pregnancy, such as risk of abnormality, fetal distress, need for C-section and risk of operative complication. Dr. Devoe points to a statistically increased risk of Down's Syndrome: a 1 in 190 chance for women over 35 versus 1 in 1200 for women age 25. Factor in rarer chromosomal abnormalities, and the risk becomes 1 in 100.On the other hand, he points out benefits, albeit non-medical ones. "Wisdom does not always accrue with age," he remarks, "but as many women get older, complete their character development and wisdom bank, they exercise better judgment. Their educational and economic levels are higher -- thus greater material benefits. They have more experience, a likelihood of a more enriched home environment, and are capable of providing much more informed parenting; things can't be dismissed with the back of the hand. "We notice a lack of skills in younger mothers, whereas 30-40 percent of my practice is women over 35 and I see the dynamics. They have fewer children, and more investment in those they've got. Some women are burned out at 25; some 35-year-olds have high energy, so age is not a guarantee of being able to chase a two-year-old in the mall. The data of healthy lifestyle is clear-cut: good physical lifestyle and keeping the body in shape. These things are good about delaying childbirth, although how this tips the balance remains to be seen. In many situations I've dealt with, it is very clear that the woman made a decision to delay, has all the preparation and fires every shot at raising a good citizen."These arguments appear rational and preferable to the parents, but what about the effects on the child? Having one's mother constantly mistaken for your grandmother can be unsettling at best; explaining your actions to someone 40 years your senior is like communicating in a separate language. Is this the consequence of age span or are the problems perpetuated by who, rather than how old, the parent is?Dr. Geriann Lioi, Licensed Professional Counselor and Board Certified Medical Psychotherapist, specializes in women's issues, depression, personality disorders, and post-traumatic stress. She believes the key to a healthy parent-child relationship lies in self-image. "If a mom views herself as different, she will be. It's in the attitude of the individual," she explains. "Obviously, as we get older, metabolism slows, energy is lessened, but at the same time, attitude is what we choose it to be, not necessarily what culture chooses for us. A mom who opts to have a child late will have the maturity to know that, at times, she will be more tired than in her 20s, but she also has more experience and wisdom to bring to the parenting role. It is all in how a mom, and a dad, see themselves."From a child's point of view, we still see our parents as being of a different generation, not understanding, thinking what we go through is unique. We have a difficult time believing they went through it too. It has been shown in society that the more things change, the more they stay the same. Kids think their parents don't understand because they were born adults!"Of course, there are exceptions. Singer/songwriter Greg Boerner is the youngest of nine children. His mother and father were 42 and 37, respectively, when he was born and he calls them "Two of the hippest parents around." He distinctly recalls the moment he became aware of their seniority. "When I was in kindergarten, my mother told me she was 'Sweet 16' and I believed it. In fourth or sixth grade, she picked me up at a friend's house and his sister said, 'Is that your grandmother?' I knew her hair was gray and someone else's mother's wasn't, but I didn't know why until someone said, 'Your mother must be older if your oldest sister is 18.' That justified it for me. My mom got married in her late 20s, and that explained a lot as well."Boerner admits some embarrassment as a child, speculating that it stemmed from typical adolescent desire to "fit in." The self-consciousness faded when he understood the age difference with his eldest sibling, and he says, "As a teenager, I was so comfortable about who they were and who I was that I respected them more than ever." Now, he gives it no thought.Instead, he is quick to point out that his mother, 71, recently won a Walkathon and hits the track daily. She and his father, 66, are "full of energy," weren't shy about patronizing clubs to cheer him on when he played in rock bands, and can often be found at the front table when he performs. "They have always taken an interest in what I do," he notes. "When I was young and thought volume was the key, they put up with my guitar and stereo, and would even ask if the television downstairs was bothering me. Knowing how much I love music, my father would buy me rock and roll magazines, read them himself, and recommend articles on, for example, John Mayall, because he knew I was a fan. Today, I'll come to their house and he will have clipped out an article about B.B. King for me."Attorney John Claeys, 46, says he always loved children, but fatherhood never factored into his big picture...until he married Melinda, 35, four years ago. The Claeys have one daughter, Caitlin, who is almost three, and found out Thanksgiving that a second child is on the way. "I never truly believed or knew what this was all about," he admits. "Everyone said, 'You need to have children; they change the way you look at the world.' I thought, 'Sure -- no more spontaneous trips to the beach, needing babysitters, you can't just pick up and go.' That's not what they meant. Your responsibility and obligation is to nurture, protect, and take care of the child. It changes your life, brings new meaning, redirects and gives you a better view, makes you a better spouse. If you truly love your child, it's important to maintain a coherent family because you want her to grow up in a sound living environment, know what it is to give and receive love, protect her from the slings and arrows of life's indignities. (With a brother or sister), she'll have someone to help her face this battle down the road."Claeys sees many advantages to entering parenthood late. "At 26, I was still getting my law degree," he reasons. "First year law students I knew who married - 60 percent were divorced before law school was over. I was not a good marriage candidate. I would not have been a good husband, let alone a good father. Now, my practice is established (Melinda also works, at Club Car) and, although as it grows, the more time it takes, I am financially sound and it supports my family in a style better than it would have even 10 years ago. I have more patience now than 20 years ago. At 46, you don't have to go out every Friday night and close down a nightclub."Despite joys and benefits, one inevitable fact remains: an older parent's time may be up while their child is young, and that child will possibly assume the role of caretaker. Dr. Lioi terms this, "The sandwich generation, often torn in different directions: caring for our parents, spouses, own children; determining where and how to prioritize."It is, says Dr. Devoe, "The spectre around the corner. Even though the average age of U.S. women increases up to high 70s and low 80s, and you can expect to be around when they're the age you were at their birth, the issue is how long can someone parent effectively? It does not stop after their teens. There are continued needs. The good news is life quality and longevity have improved enough for most women to be effective parents through the most critical years, through college. Yes, there are risks of malignancies, especially uterine, breast, and lung cancer, heart disease -- all things that bump up after 50. It's a real concern that can't be minimized."Claeys isn't worried about his ability to deal with a teenager, but fatherhood has introduced mortality. "The world is much more complicated," he reasons, "and you need to be involved in your child's life even through their 30s. I'll be in my 70s by then, close to 80 before I see grandchildren. I want to be there when they marry, when they have problems as adults. This has made me face the fact that I will die, leave these children behind me. I want to make sure they're prepared for what's ahead. I'm afraid I won't be there to get them past that stage. Other than that, I have no fears."Boerner isn't as concerned about caretaking as actual loss. He shares an example of his mother's zest for life, how he turned to his wife, Stephanie, and asked, "What am I going to do when she's not around? I don't want to think about losing them," he says. "I know it will happen someday, but I get choked up just telling you this."One can argue physical and emotional aspects all day, states Dr. Devoe, but "Even very poor pregnancy candidates, despite your best advice, will take the gamble. The urge to reproduce is overwhelming in some patients and, regardless of all levels of risks and the best medical advice, if they are bound and determined to have a child, they will do so. You're talking not so much about reason, but emotional issues. It's something that's wanted and no explanation is necessary. Reason doesn't apply to cases like this. Pregnancy might impact her health, the child might not survive - that's known, but you can't compel a patient to follow your advice. Look at smokers."Things we can focus on are screenings for disorders after establishing medical background. But again, this is an elective process and although many 35-year-old women recognize the risks, up to 50 percent decline testing. The tests will most likely tell you everything is fine, but the opposing view is chromosomal problems such as Down's, which can't be fixed at present. So they'd rather not change their approach, which is, 'I'm going to take care of this child no matter what, so what's the point of knowing?' From time to time, we get down to exactly that dialogue. I sit back as the objective third party and say, 'Here's the data; you make the call.'"Some women, hell-bent about reproducing, turn to assisted techniques from in vitro to hormone treatments post-menopause to enable embryo transfer."This is definitely a niche-type deal," says Dr. Devoe of the latter. "The overwhelming majority of women 55 and up aren't interested in having more children. There are just as many reasons for doing this as there are people who have done it. The philosophical argument is: just deciding it can be done doesn't make it right. I hope adults who put themselves in this position are responsible enough to consider what is the greatest interest to themselves, the child, and society. There are no simple answers. I've had patients who had assisted reproduction beyond the age of ability to have children on their own, but it's still a very small part of the practice of even a high-risk specialist."Greg and Stephanie Boerner, both 29, have a two-year-old son, Jacob, but don't rule out a late-life sibling. One of Greg's sisters just had her first at age 41, and his parents unquestionably lead by example. "Where will we be at 40?" he ponders. "More mature, certainly, and perhaps ready for another child, if we've not had one yet. If anything, my parents are more of an inspiration every day. I see what they've done, what they can do, and I can't imagine who could have done a better job. Their age and experience helped shape me into what I am today."

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