Between family and career
In the early 90s, women in Russia on average became mothers for the first time at 23 years old.
Now this figure is already 27 years. The number of first children born very late, at 50 years of age and older, is especially growing. In 2020, Russian women over the age of 50 gave birth to 258 children, in 2020 - 296. And not just children, but first-borns. This is a unique situation: never before have women been able to control their reproductive choices so freely. “The decision to postpone having a child is primarily related to the mother’s level of education and how career-oriented she is,” explains Alexander Sinelnikov, professor at the Department of Family Sociology and Demography at the Faculty of Sociology at Moscow State University. “She understands that with a small child, she may not be hired for a more profitable job.” If she is already working, she will be afraid that having a child will interfere with her career advancement. There are more than enough reasons for such fears.”
It's not just about career, but also about greater demands - for personal freedom, independence, and the quality of relationships with a partner. “In Soviet times, a couple’s life together, as a rule, began only after the wedding,” adds Alexander Sinelnikov. — Now getting married and starting a family has become a process that is quite extended over time. The couple moves in together and begins to live together, renting some housing. Then, after a few months or years, they register the marriage. And after this, not all spouses immediately decide to have their first child. Many are putting it off for a few more years.”
The tendency to postpone motherhood to a later date exists in all developed countries. In the European Union today, 43% of women become mothers at the age of 30–39 years. The latest to have children is in Spain and Italy: more than half of women decide to become a mother after thirty, and 7% after forty. Moreover, surveys show that the desire to babysit a baby does not decrease with age. But the opportunities are diminishing.
Pregnancy after 30 years: pros and cons
Today our expert is a leading employee of the Department of Endocrinological Gynecology of the Scientific Center for Obstetrics, Gynecology and Perinatology of the Russian Academy of Medical Sciences, Doctor of Medical Sciences. Professor Svetlana Yureneva
Is this a problem or the norm?
Most women living in large cities, at least those who are actively involved in careers, often decide to have their first child after the age of 30. With this, the obstetric term “starparous” has not gone away. Is giving birth to your first child after 30 a problem at the present stage or the norm?
– I think this is a problem. We must not forget that women, unlike men, have a strictly defined period allotted for reproductive function. And nothing has changed in nature yet. Of course, with age, the quality of eggs decreases and, accordingly, the ability to become pregnant also decreases. Therefore, if a woman decides to take this step after 30, the first thing she needs to do is contact a gynecologist and check her ovarian reserve. Today we have such opportunities. This includes ultrasound diagnostics, when we look at the number of follicles in the ovaries, and it is possible to accurately determine the ovarian reserve hormone (it is called anti-Mullerian hormone).
This analysis will help determine that if one woman needs to hurry up, then another may postpone pregnancy for some time. It is very important to know when your mother stopped menstruating. Because the daughter often repeats the mother’s situation in the reproductive sense.
At what age is it best to give birth to your first child?
– At 20-25 years old. This is the best age. It's no secret that as we age, we develop additional diseases that can affect the course of pregnancy. And, as I already said, with age, the ovarian reserve, that is, the ovarian reserve, decreases, and the quality of the eggs decreases. And, unfortunately, if a woman realizes it very late, it is not always possible to have her own child genetically. Even with all the modern technologies. If we cannot obtain a high-quality egg, then there is only one way out - a donor egg.
Despite the advances of science, healthy children are much more often born to young mothers. I would like to wish all young women to think seriously about this issue, because a healthy child is the most important happiness in life.
Quit smoking and start getting enough sleep
Well, what if it didn’t work out at 25? And at 27 it didn’t work out. And now we’re already in our thirties... Everything is there. Have money. There is a career. This is an important point. Everyone wants the best for their child and is already preparing for the fact that - now, it already exists, this is the best! This is what I can give to a child! How, after all, should you start preparing for pregnancy after 30 years? Where should you start?
– The first thing you need to find out is what reserves there are. That is, what balance of time does this woman have? Second, a healthy lifestyle is not a secret. Quitting bad habits such as smoking, alcohol abuse. You need to normalize your life. Despite all her busyness, a woman should get enough sleep. She must be physically active. She should eat healthy food. Because genetically modified foods negatively affect the quality of the egg and this can also affect the outcome of trying to get pregnant. And, in my opinion, it is advisable to plan pregnancy in advance. If a young woman today wants to postpone pregnancy, the gynecologist should offer her a way out to preserve her reproductive health longer.
If a woman does not give birth on time, the risk of developing many gynecological diseases increases. Such as uterine fibroids, internal endometriosis and others. Therefore, today, the most physiological approach to this situation is the competent use of hormonal contraceptives, which allow - and this has already been proven - to reduce the risk of many gynecological diseases, even oncological ones (such as endometrial cancer, ovarian cancer). There is work that shows that hormonal contraceptives allow a woman to maintain her ovarian reserve. That is, even slightly extend the reproductive age.
Another problem is how quickly can you plan a pregnancy if a woman has taken hormonal contraceptive pills?
– The latest generation of contraceptives allow you to plan a pregnancy almost immediately after stopping the pills. Gynecologists call this the rebound effect. That is, after the ovaries have rested, just in the first 3 withdrawal cycles, there is the greatest likelihood of high-quality ovulation and pregnancy. Therefore, we even warn our patients when they stop medications, either they should be protected, or this is the best time for pregnancy.
Who should go to a geneticist?
Are there genetic studies that will preventively show the possibility of some mutations, the likelihood of congenital diseases?
- Some, yes. But not everyone. If we are dealing with elderly parents, then they are offered research already during pregnancy. We talked today about premature ovarian failure. So, it is known that about 10% of such women have genetic mutations associated with the female X chromosome, and this can be determined. If the mother has such a situation, then we need to look at whether such mutations will occur in her daughter or not? If a boy is born, then with a certain mutation he may develop dementia. As women age, the frequency of spontaneous miscarriages and non-developing pregnancies increases. Today we have the opportunity to genetically analyze abortions and see that a very large part of these failures are associated precisely with genetic disorders in the embryo. Therefore, nature refuses everything that is incompatible with life.
So for older parents, genetic consultation is advisable. Because the risk of such disorders increases with age. Therefore, young parents are always preferable.
Moreover, the age of men plays a lesser role. It matters in terms of the risk of some genetic changes in the fetus, and in terms of the implementation of reproductive functions, of course, a woman is more sensitive, because she has a strict, clear, definite period of opportunity to realize her main function. By the way, if the age difference between spouses is more than 10-15 years, then the risk of problems increases.
Does later mean less?
And here lies the first pitfall of the postponement strategy: the couple risks having fewer children than planned, and even being left without children at all. And not only because of physiological reasons. With age, life does not become easier, and we are no longer so easy-going. Surveys in Spain show: after 35 years, more and more women are forced to give up motherhood “for economic reasons” or because they cannot integrate a child into their rhythm of life.
According to Albert Esteve, director of the Center for Demographic Research at the Autonomous University of Barcelona, the biggest influence on the decision not to have children is economic factors - lack of job security, low wages and difficulties with housing. The picture is similar in Russia. According to a survey by Mail.ru Children, the main factors that will significantly influence a childless couple’s decision to have a child are an increase in benefits and housing assistance from the state.
Although here everything is not so clear. Alexander Sinelnikov believes that it is not so much the living conditions themselves that are important, but our attitude. In other words, how willing we are to put up with discomfort. This is already a question of values. “Some people can earn a lot, but want even more,” the expert emphasizes. — For others, freedom and travel will come first, and family will come second. This affects both the decision to have children and the satisfaction with this step.”
Where to lay the straw
If a woman is healthy, then childbirth at 35–37 years old will not bring her any harm. Another thing is that by the age of forty, we usually accumulate some diseases: blood pressure can rise, chronic gastritis can torment, a lady can gain excess weight if she has a sedentary job... But the solution here is simple: before planning the birth of a child, you need to be examined and get some treatment. During pregnancy, this will be difficult and sometimes impossible to do.
For example, gastritis makes the beginning of pregnancy very difficult. In order for the baby to be born healthy, the expectant mother sometimes has to take various medications, but with gastritis they are poorly absorbed, and some medications cannot be prescribed at all - an ulcer will develop.
Jumps in blood pressure can provoke placental abruption and then the baby’s nutrition will be disrupted.
Question answer
How to provide first aid during childbirth? Instructions And you need to get rid of excess weight, it is especially unpleasant if your waist is already more than 80 cm in volume. The fat that accumulates in the abdominal area is hormonal. Perhaps you have disorders that require the intervention of an endocrinologist. The level of the male sex hormone testosterone may be increased. But a woman who wants to conceive a child does not need such an increase, it disrupts the cycle, prevents the follicle from developing normally and prevents pregnancy. Obese women must definitely control their weight so that toxicosis does not occur in the second half of pregnancy. So you need to prepare for the upcoming conception at least 3-4 months in advance. Start with a gynecologist
A consultation with a gynecologist, if you are consciously planning a pregnancy, will benefit any woman, and it is absolutely necessary for a late-parous mother.
Tell your doctor how you have protected yourself all these years. If you have had the IUD in place for a long time and there is inflammation, you need to carry out antibacterial therapy; it will be too late to do it during pregnancy. If the cycle is disrupted, the endometrium will most likely be thin and defective; it needs to be restored.
IUD for pregnancy, pros and cons →
At the age of 35, women's menstrual cycle changes slightly. The body gradually begins to prepare for the decline of reproductive function. An excess of estrogen appears, which can cause endometrial hyperplasia. This disease often affects nulliparous women. No matter how offensive it may be for women, nature has programmed us for procreation, for a repeated cycle: pregnancy - childbirth - feeding... If the program is not completed, gynecological problems arise. They need to be eliminated.
And the most unpleasant situation is that if there were abortions, then the period of preparation for pregnancy will take more than 3 months. It is necessary to carry out antibacterial therapy to restore the endometrium and blood flow. Sometimes you have to stimulate ovulation. And if you can’t get pregnant naturally, you can do IVF - artificial insemination.
Lifestyle – habitual
Does the expectant mother need any special rest before conception? Does she need, as some people think, to sleep off and not work... Hardly. A woman’s cycle is determined by nature and goes on its own.
Although you can rest in advance so that you don’t have to go anywhere for 9 months or fly on an airplane. A woman with late pregnancy does not need this, she needs to be closer to her doctor.
But if she smokes, it is advisable to quit. All studies conducted in the USA, Europe, and in our country show that mother’s smoking has a very bad effect on the child. In women who smoke, fetuses die three times more often than in non-smokers. Nicotine metabolites, which are formed in the mother’s body, poison the child. Babies from smoking mothers are often born small, with intrauterine growth retardation, and then it can be difficult for them to study at school.
Before pregnancy, it is important to heal your teeth - while carrying a child, a woman loses a lot of calcium. It is useful to take courses of vitamins and minerals. Otherwise, a woman can lead a normal life. And believe that everything will work out for her. Now even at the age of 53 they give birth to their first children, albeit with donor cells. And at the age of 35–37, a woman can give birth herself without problems.
