Women are now electing to delay childbirth for many reasons. Between 1970 and 1996, the rate of first births has more than doubled among those 30-39 years old and has increased about 50% in women 40-44 years old. I am frequently asked how old is too old to start or continue a family.

The most publicized risk of the older mom is the risk of Down's Syndrome. At the age of 35, there is a 1:350 risk of this, and at 40, there is a 1:100 risk. An amniocentesis draws off some of the fluid around the baby for genetic tests. If desired, any woman 35 or older can evaluate for genetic abnormalities. There is also the Triple Test (TT) which revolves around a hormone called alpha-feto-protein. If this hormone is low it can signal Down’s. The advantage of the TT is it is just a blood test, but it is not as specific as an amnio, which is much more invasive.

Recent studies that have shown that in the over all picture, the risk of poor pregnancy outcome is not appreciably increased in the older mother. This means that you are as likely to end up with a healthy baby as a twenty-year-old, but getting to that point can take more work.

These studies indicate, women over 30 are more likely to have a cesarean section delivery than those who are younger. Women who were over thirty-five are at an increased risk for certain complications in their pregnancies. Those who were especially at risk for toxemia and gestational diabetes were those women both over 35 and over weight.

The risk of a low birth weight infant (less than 5.5 pounds) is actually lower between 35 and 40 than for women in their twenties. The risk again increases after the age of forty.

The overall conclusion of these articles was that with good prenatal care a healthy pregnancy could be anticipated, but close observation and monitoring of the pregnancy was required to deal with the more frequent maternal problems.

So, if you think your biological clock has run down, I hope his article can wind it up again.