My niece Kathi Snyder, of Indianapolis, gave birth to her first-born child, a girl named Avery, on Oct. 29, 2016.

Kathi’s successful pregnancy seems commonplace in that childbirth is a natural occurrence (3,978,497 births were registered in the United States in 2015, according to National Vital Statistics Reports). A single factor, however, differentiated Kathi’s childbirth experience from many others — her age. She was 42 years old when she gave birth to Avery.

Women have historically given birth well into premenopausal years, a way of life that fell out of favor by the 1960s, due largely to the availability and public acceptance of contraceptives.

Statistically, women’s attitudes toward giving birth early in their reproductive years has now shifted toward postponing pregnancy as long as possible. Birth rates among women in their 30s to age 44 are the highest since the 1960s: birth rates for women aged 30 to 34 (101.5 births per 1,000 women in 2015) rose one percent from 2014 (100.8 births per 1,000), and birth rates for women aged 35 to 39 ( 51.8 births per 1,000 in 2015) rose two percent from 2014 (51.0 per 1,000). Birth rates for women age 40 to 44 (11.0 births per 1,000 in 2015) rose four percent from 2014 (10.6 births per 1,000), and birth rates for women aged 44 to 49 (0.8 births per 1,000 in 2015) rose six percent from 2014 to 2015. 754 births were recorded for women aged 50 and over in 2015, an increase from 743 births recorded in 2014. Birth rates among teens and women in their 20s, on the other hand, have been decreasing in recent years.

More women are delaying pregnancy to pursue educational and career opportunities, to meet suitable partners, or to achieve other goals that parenthood might hinder.

Postponing pregnancy can deliver a wealth of problems, however, for the older, first-time mother.

Infertility, for one, can thwart a would-be mother’s attempts to become pregnant. Upon becoming pregnant, older women may experience health issues such as miscarriage, stillbirth, hypertension, gestational diabetes, preeclampsia, or breast cancer if hormone replacement therapy is administered.

Late-life pregnancy can also cause babies to be afflicted with chromosomal abnormalities, such as Down Syndrome.

Healthy before Avery’s birth, Kathi experienced health complications during her pregnancy, namely an increase in blood pressure.

“I could feel it when my blood pressure spiked,” Kathi says. “I also have O Negative blood, which required a shot to kill off my Rh antibodies because they can attack the baby if the baby has a positive blood type.”

Avery also experienced health problems during delivery.

“She had jaundice that would not clear up,” Kathi says. “There are many babies born with jaundice, but typically their bilirubin levels come down and they are fine. Her levels got to almost critical levels. I did not realize how serious this is until after we were sent home. They had to send me a device called a bili-blanket which delivers a special blue light to bring the levels down. She had to be on this for three days after we got out of the hospital, which was extremely stressful.”

Kathi says that she was scared that she would miscarry throughout the pregnancy.

Because of Kathi’s blood pressure problem, her 28.5 hour labor was induced. She also received two epidurals, the first of which failed.

Kathi advises other women who are considering having children late in life to do so, if they must.

“Make sure you have a strong support system, stay in the hospital as long as you can, sleep every time you get the chance, and restrict the number and duration of hospital visits. Start reading books and taking classes now,” says Kathi. “Don’t worry about what others think. Don’t worry that you’ll be considered ‘geriatric’ (a term applied to pregnant women over the age of 35, also referred to as ‘advanced maternal age’). I would have to say that technology is amazing nowadays, and if you want to have kids, do it.”

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