Joy of parenthood for the over-40s.
Text: Noƫmi Kern
Advanced parental age involves both medical risks and social challenges. What do couples, children of older parents, and healthcare professionals think about these issues?
People in Switzerland are having children later and later in life. In 1971, the average age of a mother at childbirth in Switzerland was 27.7 years — and there is no data on the age of fathers. In 2022, mothers were on average 32.3 years old and fathers 35.2 years old at childbirth. It is no longer unusual for women to become mothers over the age of 40.
There are many reasons why people might delay having a family: gaining a foothold in working life, perhaps pursuing a career, traveling the world, not feeling ready to take on responsibility for a child, or having not yet found the right partner.
Having children later in life has its advantages: You are more established, have more life experience and, in many cases, are in a better financial position. As we age, however, our fertility decreases and there is a greater risk of complications during pregnancy for mother and child.
Medically assisted reproduction can help couples start a family when they are unable to do so naturally — and midwives, doctors and nurses have experience in caring for older women during labor. There are also certain social aspects that come into play in the case of advanced parental age. As well as the legal conditions attached to medically assisted reproduction, and the medical considerations, there is also the question of social norms. So, is a decision to have children later in life justifiable?
The question of responsibility.
This is the subject of a research project at the Institute for Biomedical Ethics at the University of Basel (IBMB) in collaboration with the Bioethics Institute Ghent (BIG) at Ghent University, Belgium. Nathalie Neeser, a doctoral student at the IBMB, interviewed couples who wanted to satisfy their desire to have children with the help of medically assisted reproduction — or had already successfully done so. At least one of the parents in each couple was 40 years old or older, and healthcare professionals and children of older parents were also asked about their views. “The responses are intended to reveal how parenthood over the age of 40 is perceived in society. In the coming years, this situation is likely to become increasingly common,” says Neeser.
Considerations of the risks of late parenthood primarily focus on the woman — which is sensible from a medical perspective. When it comes to ethical and social aspects, however, men are equally affected. “Most of the interviewed couples reflected carefully and gave much thought to what it means to become a parent at their age,” says Neeser. Many people were worried about whether they could live up to the responsibility of caring for a child and could support them appropriately into adulthood, asking themselves questions such as: Will we even be around to share in certain phases of their life?
“Although respondents had concerns about advanced parental age, many did not feel that they were too old for it,” explains Neeser. Their arguments generally began with “yes, but” — for example, when thinking about the future. In an interview, one father said: “It may well be the case that you’re not as fit at 70, but I do a lot of sport and look after my general health.”
When asked whether they had experienced unpleasant responses from their social environment, most respondents also answered in the negative. The responses of some women, however, made it clear that society considers the question of children to be settled at some point. Several interviewees reported that people in their work environment and circle of friends were surprised that they were pregnant at their age, having assumed they no longer wanted to have children. One respondent even thought that she wouldn’t have been promoted if her managers had known that she hadn’t ruled out starting a family.
Double sandwich generation.
What is it like for children when their parents are already older? The interviews with now-adult offspring in this situation revealed that they didn’t believe it was fundamentally a bad thing — although some remarked that, unlike their contemporaries, they had no grandparents, let alone great-grandparents.
The generational question comes up in several respects in the case of late parenthood. On the one hand, older parents may not be able to leave grandparents in charge of their children and are therefore more reliant on childcare places. On the other hand, they find themselves sandwiched between caring for their children and their own parents. These conflicting priorities can also be passed down to the next generation: When the children of older parents reach an age where the question of starting a family comes up for discussion, their own parents may already be in need of care. Accordingly, these offspring need to consider whether they really want to have children of their own in that situation or whether they prefer to wait a while.
This also means that couples who have children later in life might never have grandchildren themselves. “Some interviewees found it difficult to abandon the idea of becoming grandparents,” says Neeser.
Technology is no guarantee.
Social developments also affect people working in the healthcare sector: midwives, gynecologists and specialist physicians in fertility and medically assisted reproduction. They accompany couples, sometimes for years, and witness their hopes and disappointments firsthand. “In the interviews, they reported not only the huge joy experienced when things finally work out but also the pain of couples whose desire to have children goes unfulfilled despite fertility treatment — and they stressed that medically assisted reproduction is no guarantee of having a child,” says Neeser. “Some even took the view that, instead of another round of treatment, those affected needed psychological care in order to let go of the desire to have children.”
Based on all of the interview responses, one conclusion the research team came to, was that there ought to be changes to sex education in schools: “At present, this is first and foremost about contraception. There’s no mention of the fact that, on the flip side, there’s also a limited time window for pregnancy.” Apparently, many couples were surprised to learn that a pregnancy over the age of 35 is considered a geriatric pregnancy even though the mother is still young from a social perspective.
Original publication
Nathalie Neeser et al.
Building a family at advanced parental age: a systematic review on the risks and opportunities for parents and their offspring
Human Reproduction Open (2023), doi: 10.1093/hropen/hoad042
More articles in this issue of UNI NOVA (May 2024).