More women in Singapore are giving birth in their 40s. EVELINE GAN finds out what you should know about the trend, and chats with three mums about their experiences.
More women in Singapore are giving birth in their 40s. EVELINE GAN finds out what you should know about the trend, and chats with three mums about their experiences.
A one-in-100 chance of a Down syndrome baby, one-third odds of a miscarriage and two-fold risk of stillbirth. By medical standards, the risks of having a child at the age of 40 are unnerving enough to put a damper on any sizzling baby-making plans. But more older mums are thumbing their noses at the gloomy statistics. Think 40-something actresses like Halle Berry and Fann Wong, both of whom defied statistical odds and delivered healthy babies.
Then, there’s 50-year-old singer Janet Jackson, who confirmed her first pregnancy and showed off her baby bump in October this year. In fact, the number of women conceiving in their 40s has doubled over the past three decades in Singapore. Last year, there were about nine births for every 1,000 women aged 40 to 44, compared to just 4.5 in 1985, according to Singapore Department of Statistics figures.
In contrast, those delivering between 25 and 29 years old – considered the optimum age for motherhood – have halved in the last 30 years. But is age just a number when it comes to having babies? To a certain extent, yes. Advances in artificial reproductive techniques like in vitro fertilisation (IVF) have made it possible for couples to have babies later in life, especially for those with fertility problems, says Dr Tan Eng Loy, consultant at the department of obstetrics and gynaecology at Singapore General Hospital (SGH).
That’s because IVF boosts a woman’s chances of conceiving, regardless of her age, shares Dr Yeong Cheng Toh, consultant gynaecologist and reproductive endocrinologist at Virtus Fertility Centre Singapore. Improvements in screening methods and better ultrasound equipment also mean that abnormalities and birth defects in unborn babies are detected more accurately early in pregnancy, according to the doctors. A Finnish study has found that age, by itself, does not pose significant pregnancy and childbirth risks for an older mum over 35.
But her risk of complications such as pre-term birth, a small baby and stillbirth increases dramatically if she smokes, is overweight or obese, or has pre-eclampsia or gestational diabetes, according to the study published in the Journal of Maternal-Fetal and Neonatal Medicine. What about recovery after birth? Well, that depends on the woman’s health before pregnancy, Dr Tan says.
If an older mum is healthy and fit, she may have better stamina and recover from labour faster than a younger mum who is less fit or has other medical conditions, he says. But even older mums with medical issues, such as heart disease and diabetes, now have a better chance of enjoying a smooth pregnancy, thanks to advances in antenatal care. For instance, SGH conducts high-risk pregnancy clinics thrice weekly to ensure that mothers are well-looked after.
TICK TOCK, THE BIOLOGICAL CLOCK
Still, there are limits as to what medical science can do. It cannot change the fact that a woman’s fertility takes a nosedive after the age of 35, making it harder for her to become pregnant, the doctors point out. “The media has highlighted many older women who have had successful pregnancies. But when it comes to biological advantage, there is a huge difference between a 20-year-old and a 40-year-old woman,” Dr Yeong says. A woman in her 40s has an approximately one-in-six chance of conceiving naturally with every cycle, he notes.
If and when she gets pregnant, she also faces a higher risk of miscarriage, Dr Tan adds. Age is also the most important factor in determining whether fertility treatments like IVF work out successfully, Dr Yeong says. A woman below the age of 35 has a 60 to 70 per cent chance of becoming pregnant through IVF, but this chance falls to just 20 to 25 per cent for those above 40. While today’s older mums may have medical advances on their side, the risks should not be downplayed.
Take the odds of having a baby with Down syndrome, for instance: a 40-year-old mum’s risk is 10 times higher than if she were under the age of 30. “Although medical advancements have helped us to detect unborn Down syndrome babies more accurately, very little can be done to prevent them, other than conceiving at a much younger age,” Dr Tan says.
THE PRICE OF BEING AN OLDER MUM
Because they may require more screening tests and detailed scans, mums who wish to expand their families in their 40s should think about the expenses, financial services manager Fong Yong Hui says. Take non-invasive prenatal testing – a new test that screens for Down syndrome – for example. Singapore mums taking the test at SGH can expect to pay a subsidised rate of around $1,000.
They cannot use their Medisave for it, Dr Tan explains. They may also need to be induced closer their due date – it is recommended that they deliver their babies before 40 weeks to lower the possibility of a stillbirth. “All of the above are likely to translate to increased costs,” he adds. Delaying motherhood also means that they will be close to retirement age by the time their kids require tertiary education, Yong Hui says.
With the estimated cost of raising a kid in Singapore ranging from $200,000 to $1 million, juggling Junior’s education funds and preparing for retirement concurrently can be a challenge. Although older mums are often deemed more financially secure, she points out that this may not be true. “Ultimately, it boils down to the individual’s financial habits.
A 40-year-old woman who chose to live it up during her younger days may not be more financially secure than a younger mum who has been diligently saving since her early 20s,” Yong Hui says. “If you wish to have children later, it is important that you start saving as early as possible.”
The number of women conceiving in their 40s has doubled over the past three decades. In contrast, those delivering between 25 and 29 years old have halved.
SOME THINGS ARE BETTER WITH AGE
Tjin Lee, 42, is an entrepreneur. Her kids, Tyler and Jake, are aged three and one, respectively. Follow her on Instagram @tjinlee.
Tjin waited until she was almost 40 to have her first child – five years after she and her husband John Lim got married in 2008 – but she has no regrets. The founder and managing director of Mercury Marketing and Communications thinks she would not have enjoyed motherhood as much if she had been a younger mum trying to carve out a career.
“Even before I had kids, I always knew that I would not want to be a full-time working mum. I want to be there to catch my child’s every milestone – his first word, first step, first smile,” she says. “That decision was partly influenced by seeing how my older sister would try to disentangle herself from her crying kid whenever she went to work.
I was 26 at the time, and I remember thinking that’s not the motherhood I want.” Now a seasoned businesswoman, Tjin has the privilege of working around her kids’ schedules. While motherhood has transformed her life, it certainly has not dampened her business acumen. In fact, being a mum has inspired her to start several family-oriented enterprises, such as Crib Society and Trehaus, both which empower women to juggle family and a fulfilling career.
The former is a social enterprise that connects women entrepreneurs looking for co-founders to launch a business, while Trehaus is a co-working space with childcare facilities. Tjin urges women not to be afraid of starting a family at a later age. “As an older mum, you’re probably able to give a lot more, in terms of your time and experience. To be honest, I’m a much more confident person now at 42 than I was at 28, and that has positively influenced my parenting style,” she says.
FIRST-TIME MUM AT 42
First-time mum Samantha Lim, 42, is a senior executive manager. Her baby, Arvin, is nine months old.
Pregnant for the first time at age 41, Samantha Lim was well-aware of the risks of health complications. What she wasn’t prepared for was the stigma attached to being an older mum. Some people expressed disbelief that she could conceive naturally so late in life, while others wondered aloud if her baby would be born healthy. “I don’t know whether to laugh at or cry over what they said,” says Samantha, who struggled with infertility for years.
Not that those snide remarks matter to her now that her baby has arrived hale and hearty. Little Arvin is hitting all his development milestones. In fact, he seems more alert and advanced than other babies his age, his proud mummy shares. Against the odds, Samantha conceived Arvin naturally after six years of infertility, which put a strain on her marriage.
Before she became pregnant, she underwent surgery to unblock a fallopian tube and remove 1kg of tiny fibroid lumps. She also tried traditional Chinese medicine treatments to boost her health. Despite the numerous challenges she faced, Samantha’s recovery after childbirth was smooth-sailing. She was up and about a day after her caesareansection delivery, and raring to go home by the third day.
Undaunted by her age, she intends to try for another baby so Arvin can have a sibling. “My advice to older mums struggling with infertility is don’t give up,” she says. “With medical advances these days, having a baby after the age of 40 is not an impossible hope.”
STILL GAME TO TRY FOR A BABY BOY
Dolores Au, 41, is the CEO of a family F&B business and the co-founder of e-commerce site Mummyfique. She is pictured here with her two younger daughters – Charlotte, two years, and Laura, nine months old. She has another three daughters aged 17, seven, and four. Follow her on Instagram @ dollywolly88.
Dolores’ most recent pregnancy with Laura wasn’t an easy one. She recalls having to take hormone pills and was hospitalised at 30 weeks due to early contractions and bleeding. Post-childbirth, it took her a longer time to recover. “When I delivered Charlotte via caesarean section, I bounced out of bed the next day and ask my doctor to discharge me on the third day,” she says. “With Laura, the wound hurt so much, I opted to stay for five days.”
She also suffered massive hair loss and is still undergoing treatment. She even lost a tooth due to her dwindling calcium stores, and found her pre-baby energy level only after six months. Even so, Dolores doesn’t think age is entirely to be blamed for the complications, or that it was her fourth caesarean-section delivery.
“It may be due to the fact that my last two C-section deliveries were too closely spaced, within 1½ years, and my body did not have time to recover,” she says. In fact, she wants to try for a baby boy, probably in a year’s time. “I love the idea of having a large family with many kids running around during special occasions like Christmas and Chinese New Year,” says Dolores, who grew up in a close multigenerational extended family.
She also has a four-year-old stepdaughter. She feels that age and experience have made her a better multitasker and a wiser mum. “Some things haven’t changed, like how I’m still quite the disciplinarian,” she says. “But I find that I’m a less stressed mum now. As I get older, I actually juggle family and work better than when I was just a mum of one.”
A woman below the age of 35 has a 60 to 70 per cent chance of becoming pregnant through IVF, but this chance falls to just 20 to 25 per cent for those above 40.
You’re 40. Now what?
Here’s what older mums should do to minimise pregnancy and childbirth risks, Dr Tan Eng Loy from SGH shares.
If you’re trying for a baby
● See your doctor to ensure you have good control of any existing medical issues like diabetes or heart conditions.
● You may have to adjust your medication so it doesn’t affect your chances of becoming pregnant or your unborn baby’s health if you conceive.
If you’re pregnant.
● Make a gynae appointment as soon as your home urine pregnancy test kit shows positive results, around five to six weeks, so you get proper antenatal care.
● Stay up-to-date with screening tests such as those for Down syndrome and detailed ultrasound scans. You will also be checked for gestational diabetes, usually done between 24 and 28 weeks.
If you’re in your third trimester.
● Closer to your estimated due date, at around 39 weeks, you may be induced for labour to lower your risk of a possible stillbirth. Discuss this with your doctor.
