Children at Age 50: A Cut-Off Age for Childbirth?

You can't argue the fact that when it comes to childbirth -- men have it EASY. My wife and I read about the New Jersey woman who -- at age 60 -- recently gave birth to twins. When I casually mentioned to my wife, "See honey, we still got time to have more kids..." she didn't exactly grab me by the collar and throw me down on the bed.

Now maybe this is the maternal part of my male ego, but I admit it -- I would love having another child. But two things tend to interrupt this train of thought: First, I'm not actually "having" the child -- I'm only planting the seed, laying the pipe, saddling up the mule, or however you want to put it, and second, I'm not sure I can really cozy up to the idea of being in my early 60's by the time my child wants to borrow the keys to the car. Additionally it's my wife who has to deal with morning sickness and sleeping on her side and everything else that I -- as a guy -- can give moral support to during the 9 months leading up the big event.

Maybe it's me. Maybe I'm old fashioned in my thinking: According to an article published in the Nov. 4, 2005 issue of the New England Journal of Medicine, the past decade has seen a remarkable shift in the demographics of childbearing in the United States: Consider: the number of first births per 1,000 women 35 to 39 years of age increased by 36 percent between 1991 and 2001, and the rate among women 40 to 44 years of age increased by a remarkable 70 percent. Additionally, in 2002, 263 births were reported in women between 50 and 54 years of age.

So how old is too old -- especially when it comes to having children?

According to an article in pregnancyandbaby.com, it's one thing for women (and also men to a degree) to think that if they go to the gym, eat healthy, take vitamins and really take care of themselves properly, then they should be able to have a baby. But the argument here really deals with two types of health: general health and reproductive health. According to webmd.com, a woman can be 50 years old and be in great shape and very health, but her reproductive health -- that is her fertility -- is going to decrease with age no matter how well you take care of yourself.

According to pregnancyandbaby.com, many childbirth programs do use a cutoff age which is usually arbitrarily determined by a couple's doctor. If a program has a cutoff age of 45, can the doctor tell the 46 year old that her risks are appreciable different from the 45 year old? They can't.

The most a doctor can do -- according to webmd.com -- is to inform patients and their partners about the potential risks and allowed to make their own decisions about treatment just like they do in all other areas of medicine.

When it comes to women over 45 (or 50 or even older) the big question about pregnancy remains: does she or doesn't she?

Sciencedaily.com points out that an older woman who wants to attempt pregnancy using her own eggs can reduce the risks associated with older eggs by attempting pregnancy using in vitro fertilization with preimplantation genetic diagnosis (PGD). PGD can screen out most of the chromosomal abnormalities which may occur in older eggs. What's more, compared to in vitro fertilization without PGD, the chance for pregnancy can be increased 15 to 20 percent and the risk for miscarriage decreased by 50 percent or more. The risk for delivering a baby with Down Syndrome can almost be eliminated.

Speaking of DS, according to the New England Journal of Medicine, at the age of 49, the incidence of Down Syndrome (Trisomy 21) is 1 in 11, with an overall risk for chromosomal problems of 1 in 7. Most chromosomal aberrant eggs are unable to be fertilized. The majority of those that do manage to become fertilized result in a spontaneous miscarriage, or fail to implant altogether. Recent statistics bear this out: For women under age 20, 12 percent of pregnancies will result in miscarriage. The overall risk of miscarriage in women over 40 jumps to approximately 75 percent.

Certainly, being 50 years old today is a lot different than being 50 years old a few decades ago. And modern science can help women -- especially pregnant women overcome a variety of hurdles over the course of a typical nine-month term.

Like I said -- when it comes to having kids -- men have it easy. But by gosh if my wife wakes up tomorrow and has the need to make more babies, who am I to argue?