August 12th, 2009 
First-time mothers are getting older across the country and around the world, according to new federal data released today that show the average age of new moms increased to 25 in the USA and 29 in several countries, including Japan and Switzerland.
The report from the National Center for Health Statistics on this trend in delayed childbearing compared statistics from 1970 and 2006. In the USA, it found dramatic increases in the average age during the 1970s and 1980s and a less dramatic but steady rise since.
The average age increased in all states and the District of Columbia and for all racial and ethnic groups. In 2006, Massachusetts, at 27.7 years, had the highest average age at first birth and Mississippi had the lowest at 22.6 years.
Elizabeth Gregory, director of the Women’s Studies Program at the University of Houston, says there are many reasons for the increase in age at first birth. She says the birth control pill, which debuted in the 1960s, allowed people to plan their families. Also, Gregory, 51, says increases in longevity have allowed people to start families later and “expect to be around to take care of them.”
For her 2008 book Ready: Why Women Are Embracing the New Later Motherhood, Gregory, an English professor, interviewed 113 moms who had first children later in life. She says many cited getting their education and getting established at work as reasons for a delay.
“They had to get to the point where they were making a decent salary and had the clout to negotiate a family-friendly schedule and not lose their seniority,” says Gregory, who had her first child at 39 and adopted a second daughter at age 48.
The proportion of first births among women age 35 and older increased nearly eight times between 1970 and 2006. In 2006, about 1 out of 12 first births were to women of 35 years or more, compared with 1 out of 100 in 1970.
At the same time, first births to mothers under age 20 dropped. Only 21% of first births were to teen mothers in 2006, compared to 36% in 1970.
However, the USA’s high teen birth rate is the reason the overall age at first birth isn’t as high as other developed countries, says T.J. Mathews, a co-author of the report.
Data from the United Nations Demographic Yearbook for 2006 shows that the teen birth rate in the USA was more than eight times higher than the birth rate in Japan, seven times higher than in Denmark and Sweden and more than three times as high as in Canada. The data compiled by the United Nations Statistics Division is based on annual questionnaires to more than 230 national statistical offices around the world, which include basic data on population trends, births, deaths, marriage and divorce.
The teen birth rate in the USA increased 3% in 2006, ending a 34% drop in births among women ages 15-19 from 1991 to 2005. Even with that long period of decline in the teen birth rate, Sarah Brown, CEO of the National Campaign to Prevent Teen and Unplanned Pregnancy, says the new report illustrates how much more needs to be done to address the problem of teen pregnancy and teen births.
The federal report also found that among racial and ethnic groups in 2006:
- •The oldest average age at first birth (28.5 years) was to Asian or Pacific Islander women.
- •The youngest (21.9 years) was to Alaska Native women.
- •The age of 26.0 for white women at first birth is older than the average for the U.S. population at 25.0.
- •The average age at first birth for black women was 22.7 years.
- •The average age for first-time mothers was 23.1 years among Hispanics.
Related
- Having a baby when you’re over 40?
Lee Robinson wasn’t all that excited about having a baby, It’s not that she didn’t want one, it’s just that she and her husband, Claude, were happy with their busy lives in Thomson, Georgia, where she’s a high school teacher and he’s a caterer.
Life rolled merrily along until one day, at age 44, Robinson discovered to her great shock that she was pregnant. When not one but two pregnancy tests confirmed the news, she plastered herself to the internet to figure out how risky this pregnancy was for her and her baby.
What she found online wasn’t comforting. A slew of statistics about the high risks of birth defects for the baby and pregnancy-related diseases for her scared the wits out of her.
“I’d be less than normal if I didn’t think this was pretty severe, life-threatening stuff,” Robinson says. “All kinds of things run through your mind.”
These days, more women are finding themselves in Robinson’s situation. The birth rate for women age 40-44 increased 4 percent in 2008 from 2007, according to the Centers for Disease Control and Prevention. Contrast that to the birth rate for women below age 40, which went down as much as 3 percent from 2007 to 2008.
“Whatever can go wrong goes wrong at an increased rate for a woman who is older starting pregnancy,” says Dr. Alan Fleischman, medical director for the March of Dimes.
So just how scary is it for a woman over 40 to have a baby? We asked physicians at the March of Dimes and the American College of Obstetrics and Gynecologists to set the numbers out for us.
Higher risk of miscarriage
- At age 20: 1 in 10 women
- At age 35: 1 in 5 women
- At age 40: 1 in 3 women
- At age 45: 1 in 2 women
Noncancerous tumors called fibroids and endometriosis, the abnormal growth of the lining of a woman’s uterus, can lead to a miscarriage.
Higher risk of any chromosomal disorder
- At age 20: 1 in 526 births
- At age 30: 1 in 385 births
- At age 40: 1 in 66 births
- At age 45: 1 in 21 births
Women are born with all the eggs they’ll ever have. As a woman ages, her eggs also age.
Higher risk of Down syndrome
- At age 25: 1 in 1,250 births
- At age 30: 1 in 1,000 births
- At age 35: 1 in 400 births
- At age 40: 1 in 100 births
- At age 45: 1 in 30 births
- At age 49: 1 in 10 births
As a woman ages, the risk of delivering a baby with Down syndrome increases. Down syndrome is a genetic disorder often caused by an error in cell division. There are multiple types of Down syndrome, and the exact cause is not known.
Higher risk of gestational diabetes
- At age 20: 22 in 1,000 women
- At age 25: 36 in 1,000 women
- At age 30: 51 in 1,000 women
- At age 35: 67 in 1,000 women
- At age 40: 84 in 1,000 women
Pregnancy stresses the body, requiring the pancreas to produce more insulin. In older women, having a baby can trigger diabetes during pregnancy.
Higher risk of preeclampsia
- At age 20: 38 in 1,000 women
- At age 25: 37 in 1,000 women
- At age 30: 36 in 1,000 women
- At age 35: 39 in 1,000 women
- At age 40: 48 in 1,000 women
“Women as they get into their 40s may also have some hypertension already,” Fleischman says. “And if they do, they have a higher risk of that being exacerbated during pregnancy.”
Advantages of being an older mom
Working women who have children later in life are often able to spend more time with their families because they’re in a better position to negotiate flexible schedules, according to research by Elizabeth Gregory, author of the book, “Ready: Why Women Are Embracing the New Later Motherhood,” and director of the Women’s Studies Program at the University of Houston.
“Women report that the clout they’ve established at work in the years before they have kids gives them a bargaining chip that they wouldn’t have had” at an earlier stage of their career, Gregory says.
Plus, women who wait to have children make more money and are better able to provide for their families, according to Gregory’s analysis of 2000 census data.
Gregory looked at women in their early 40s and found sizable salary differences based on when they’d had their children. She found that those who’d had babies in their mid-20s had salaries in the mid-$40,000 range, but those who waited to have babies until their mid- to late-30s had salaries that averaged in the $70,000 range.
The reason, she says, is simple. “Once kids arrive, it’s much harder for women to continue to climb the career ladder, so if they start having babies earlier, they tend to get stuck down on the ladder,” she says.
Last week, Robinson gave birth to a healthy boy named Price, and now she and her husband are thinking about having another child, even though she’s 44 years old.
“It’s really overwhelming to think I never thought I was going to be a mom,” Robinson says. “We’re both just absolutely in love with this little baby.”
- Obese Women Have Increased Pregnancy and Postpartum Risks
Women who are obese during pregnancy are at increased risk for preterm birth, preeclampsia, gestational diabetes, cesarean delivery and postpartum weight retention, according to data presented today.
Kimberly K. Vesco, MD, MPH, obstetrician-gynecologist at Mount Talbert Medical Office and Kaiser Sunnyside Medical Center, presented data on pregnancy outcomes and postpartum weight retention for 5,551 normal-weight women and 3,110 obese women included in an HMO database.
Weight gain at one year defined the difference between baseline weight during pregnancy and weight at 300 to 420 days postpartum.
Mean baseline weight was 131 lb for normal-weight women vs. 214 lb for obese women. Mean gestational weight gain was lower among obese women compared with normal-weight women (22 lb vs. 32 lb; P<.001). However, 33% of obese women gained more than 10 lb at one year postpartum compared with 22% of normal-weight women (P=.0001).
Obese women had an increased risk for preterm birth (10% vs. 8%), preeclampsia (15% vs. 6%), gestational diabetes (8% vs. 3%) and cesarean delivery (36% vs. 20%; P<.001).
Further, infants born to obese women had a higher mean birth weight when compared with infants born to normal-weight women (P<.001).
Study results also revealed that obese women were more likely to smoke (7% vs. 10%), have a diagnosis of depression (7% vs. 11%) and hypertension during pregnancy (9% vs. 22%), and have diabetes (1% vs. 5%; P=.0001) compared with leaner women.
“There should be inquiries to prevent weight loss among obese reproductive-age women, particularly those planning a pregnancy,” Vesco said during the oral presentation. “In addition, programs should be developed to limit gestational weight gain during pregnancy and to assist with weight loss after delivery.”
- Herbal use common among pregnant women in U.S.
Roughly 1 in 10 pregnant women in the U.S. expose their unborn baby to herbal products, according to a new study.
This finding is potentially concerning, researchers say, given that data on the safety of herbal use during pregnancy is lacking. Furthermore, the prevalence of exposure was highest in the first 3 months of pregnancy, a critical period of development.
“If we assume that our study sample was representative of the 4.2 million births each year in the United States, our findings project that 9.4 percent, or potentially 395,000 U.S. births annually, will involve exposure to at least one herbal product during pregnancy,” lead author Dr. Cheryl S. Broussard, from the Centers for Disease Control and Prevention in Atlanta, told Reuters Health by email.
The findings, reported in the American Journal of Obstetrics and Gynecology, are based on data from 4,239 mothers in the National Birth Defects Prevention Study who delivered infants with no major birth defects from 1998 to 2004. The 10 study centers were located across the U.S.
Overall, 462 (10.9 percent) of the 4,239 mothers reported using herbal products in the 3 months before or at some point during pregnancy. The prevalence of herbal use anytime during pregnancy was 9.4 percent. The prevalence during pregnancy was highest (6.9 percent) during the first trimester.
Excluding the 86 mothers whose only use of herbs involved herbal teas, the prevalence of herb exposure before or during pregnancy was 8.9 percent.
The most commonly reported products used early in pregnancy were ginger, which has been shown to help ease morning sickness, without side effects to the unborn child, and ephedra, an herbal stimulant that was banned in the U.S. in 2004 after reports linked it to heart attacks, strokes and at least 155 deaths.
The products used most often throughout pregnancy were herbal teas and chamomile, which has also been shown to ease morning sickness.
Herb exposure was more prevalent in women older than 30 and with more than 12 years of education. Of the 10 states studied, Iowa had the lowest rate of herbal use (5.4 percent) and Utah had the highest (16.5 percent).
“The fact that use of herbal products was greatest during the first trimester raises concerns about fetal safety, because this is a critical period of fetal organ development,” Broussard noted.
“Providers should inform patients that it would be prudent to err on the side of caution regarding use of herbal products just before and during pregnancy because little is known about their potential risks.”
- September is Infant Mortality Awareness Month
September is Infant Mortality Awareness Month. As a country we are failing our babies miserably. Too many never make it to their first birthday. An estimated 2 million babies die within their first 24 hours each year worldwide, and the United States has the second worst newborn mortality rate in the developed world, according to a recent report by Save the Children.
Diving into the report’s stats only darkens the picture: American babies are three times more likely to die in their first month than children born in Japan, and newborn mortality is 2.5 times higher in the United States than in Finland, Iceland, or Norway. Only Latvia, with six deaths per 1,000 live births, has a higher death rate for newborns than the United States, which ranks near the bottom of industrialized nations, tying with Hungary, Malta, Poland, and Slovakia with five deaths per 1,000 births.
Although the newborn mortality rate in the United States has fallen in recent decades, it continues to disproportionately affect people of color, especially African Americans. Only 17 percent of all U.S. births were to African American families, but 33 percent of all low-birth-weight babies were African American, according to the report.
Indeed, the statistics on black babies are the most dismal of all. African Americans have 2.3 times the infant mortality rate of non-Hispanic whites. Black babies are four times as likely to die as infants due to complications related to low birth weight as non-Hispanic white infants. Other sobering statistics from the CDC:
- African Americans had 1.8 times the sudden infant death syndrome mortality rate as non-Hispanic whites, in 2005.
- The infant mortality rate for African American mothers with over 13 years of education was almost three times that of non-Hispanic white mothers in 2005.
This last statistic shows that education does not help protect black babies from poor birth outcomes like it does other ethnic groups, and poses a unique question about how to reverse the tide and save more black babies.
One of the theories being put forth by researchers is that black women tend to enter pregnancy unhealthy and overstressed and cannot reverse years of unhealthy habits and unresolved stress in the 40 weeks of pregnancy. The result is babies who are born too soon or too small – both avoidable outcomes. “In countries where mothers do well, children do well,” Charles MacCormack, president and CEO of Save the Children, said in a written statement accompanying the report.
As a country we have to figure out how to address this problem. Obviously teaching black women – and all women whose pregnancies are at risk in this country – to live healthier, less stressful lives isn’t going to happen overnight. And I don’t expect the government to figure out how to save our babies, or at least, I’m not willing to wait that long. As mothers, whose lives are all interconnected, we have to figure it out.
I’m going to fight it with the stories I write, the issues I bring up, and the positions I take. I’m also going to fight it with my pocketbook. This month at MochaManual.com we’re donating 50 percent of all our sale proceeds to the March of Dimes to further their research to help all of us have healthier babies. If you want to help me help us, click here to shop our line of maternity and new Dad tees, baby Onesies, gift baskets, and Mocha Manual books to help a worthy cause or just make your own donation to the March of Dimes.
- Mothers’ High Blood Sugar in Pregnancy is Linked to Children’s Reduced Insulin Sensitivity
Children of mothers whose blood glucose (sugar) was high during pregnancy are more likely to have low insulin sensitivity-a risk factor for type 2 diabetes-even after taking into consideration the children’s body weight, a new study shows. The results will be presented Tuesday at The Endocrine Society’s 92nd Annual Meeting in San Diego.
“We know that children born to women with type 2 diabetes or gestational diabetes, or who have high blood sugar during pregnancy are at risk of becoming diabetic themselves. This study suggests that the children’s increased risk appears to be due, at least in part, to their prenatal exposure to relatively high maternal blood glucose,” said study co-author Paula Chandler-Laney, PhD, a postdoctoral fellow at the University of Alabama at Birmingham.
Chandler-Laney and her colleagues studied 21 children ages 5 to 10 years and measured the children’s sensitivity to insulin, the hormone that regulates sugar in the blood. They also evaluated the pregnancy medical records of the children’s mothers to determine maternal blood sugar concentration during the oral glucose tolerance test.
The researchers found an inverse association between maternal blood sugar during pregnancy and the child’s insulin sensitivity, meaning that the higher the mother’s blood sugar levels during pregnancy, the lower her child’s insulin sensitivity. Low insulin sensitivity is a major risk factor for type 2 diabetes.
Obesity lowers insulin sensitivity, but the children’s reduced insulin sensitivity was independent of their amount of body fat, the authors reported.
In addition, children exposed to high blood sugar levels in the womb also were more likely to have exaggerated insulin secretion after a meal, independent of their reduced insulin sensitivity. Relatively high insulin secretion is also associated with increased risk for later development of type 2 diabetes, Chandler-Laney explained.
None of the children had high blood sugar, but puberty would further lower their insulin sensitivity, she noted.
“High maternal blood glucose during pregnancy may have lasting effects on children’s insulin sensitivity and secretion, potentially raising the risk for type 2 diabetes,” Chandler-Laney said. “Obstetricians, pediatricians, and pregnant women should all be aware of the potential far-reaching consequences that elevated blood sugar during pregnancy can have on children’s health.”
