Late-in-life pregnancy: more women are waiting longer to have their first child

MARSHA Wilks Stewart is part of a trend. At 44, Stewart became a first-time mother--something that more middle-aged African-American women are doing successfully.

Both Stewart and her husband, Chris, were pleasantly surprised when she became pregnant "Three pushes and he was out" she says of her son, Chris Paige Stewart II, who turns 8 in November. Their healthy baby boy was the result of a normal pregnancy without complications. "I worked up until the last day of the pregnancy and took one day off because I felt like he might come," says Stewart, a substitute teacher in Atlanta, who went through natural childbirth without drugs.

Today more African-American women are having children, especially' first babies, after age 35 and well into their 40s, which is defined as "advanced maternal age" by medical professionals. According to the National Center for Health Statistics 2003 data, the birth rate for women aged 30 to 34 increased by 4 percent; for women ages 35 to 39, there was a 6 percent increase; for women 40 to 44, the birth rate rose 5 percent.

The reasons that more women decide to delay motherhood can vary. One other reason is that women are putting off marriage and children to establish their careers. Others simply wait for the right mate. "As a Black woman, it's hard to find a suitable person to go through this with," says Cynthia Craig, 45, who's expecting her first child any day now. Craig says she had some difficulty conceiving and originally was scheduled for a cesarean section, which was canceled because of an earlier problem that has since corrected itself.

Even married women with a history of fibroid tumors or other pre-existing medical conditions find themselves facing pregnancy setbacks, which can include decreased fertility, which makes conception more difficult. "After 35, the likelihood goes down 20 percent for getting pregnant," according to Dr. Natalie Achong, an obstetrician/gynecologist and assistant professor at the University of Connecticut. "Once you are 35, things tend to drop off. As a physician, I try to remain optimistic and offer hope to my patients."

However, there are some women who feel that age is not a factor when trying to conceive. "I don't believe that stuff they say about your eggs drying up," says Vinni O'Neal-Hartsfield, who had her son, Jacob Rian O'Neal-Hartsfield, at the age of 46. Hartsfield says she was busy establishing her music and investment banker businesses during her 20s and 30s and delayed having children. She and her husband, who was 60 at the time of their son's birth, were often jokingly compared to biblical late-in-life parents Sarah and Abraham. "God is ready when He is ready to bless you," she says.

That's the way Miranda Mack McKenzie, 50, director of community affairs for Anheuser-Busch, Inc., in Atlanta, sees it as well. She was the oldest person in the delivery room when she had her first child, Terrence, 11, a healthy and active boy. "People would often ask me, 'Oh, is that your grandbaby?' says McKenzie, who stays on-the-go with her son by riding bicycles, playing soccer and basketball. "It keeps you more active," she says.

While many late-in-life pregnancies are problem-free, there can be difficulties regarding older women who have pre-existing medical conditions. High blood pressure, diabetes and obesity are among conditions that can further complicate a pregnancy, according to medical experts. Women over age 40 are more likely to have miscarriages and have more cesarean sections during childbirth. Other risks include having a child with certain genetic disorders, including Down syndrome.

Consider the case of Anese Adams of Chicago, who was 36 years old when she gave birth to twin girls. Adams, who had made the decision to carry the babies for her best friend of 30 years, Cynthia Rice, learned after taking a blood test that one of the fetuses had a heart defect that is common in infants born with Down syndrome. Kisha Johnson, a genetic counselor at Rush University Medical Center in Chicago, who was part of Adams' team of health care providers, alerted her to the possibility of a genetic disorder. When the twin babies--Payton Noelle Adams-Rice and Phoenix Isryelle Adams-Rice--were born in May, one of the infants was diagnosed with Down syndrome, which is more common in babies born to older women.

"The pregnancy went very well," says Adams, who has a 16-year-old and a 7-year-old. She elected not to have an amniocentesis (a procedure which screens for birth defects, but has a risk of miscarriage). And she also applauds the medical staff for helping her through the pregnancy. "The doctors were very compassionate. From the very first test, they made sure to give me tons of information and explained everything. They also answered my every question," says the woman who will serve as godmother to the twins that she gave birth to.