Whether you’re thinking of planning for a first baby or extending your family further, late motherhood is very conceivable.

Continual advances in modern medicine mean increasing numbers of women have been able to delay first-time parenting until they’re over 40. With surrogacy, in-vitro fertilization (IVF), and private adoptions, many women can decide to enjoy career stability first and start a family later.

“As long as a woman has a uterus, she may be able to get pregnant,” says Laurence Jacobs, MD, a reproductive endocrinologist with Fertility Centers of Illinois in Chicago. “Probably at any age we can stimulate the lining of the uterus with estrogen and progesterone to make it suitable for pregnancy.”

Eggs Age Along with YouScience may be on your side, but it’s important to be aware of the risks involved in delaying motherhood. A woman’s fertility peaks around age 28 and then drops every year after. “Many women at age 36, 37 or 38 think they have plenty of time. They don’t,” says Robert Straub, MD, a reproductive endocrinologist with Reproductive Biology Associates in Atlanta, Ga.

In fact, even with the help of a fertility center and state-of-the-art reproductive technology, many women over 40 face the sobering reality that they can’t get pregnant with their own eggs. Not only do you have fewer eggs as you get older, the ones you have aren’t that fresh. Your ovaries shed the healthiest eggs when you’re young and the more defective, less viable eggs as you age. Because of this, the success rate of IVF is only 10 percent for a 43-year-old woman, says Peyman Saadat, MD, medical director and founder of the Pacific Reproductive Center in Beverly Hills, Calif. By 45, that rate drops to between zero and 1 percent.

What’s more, if you beat the odds and conceive with your own eggs naturally or via IVF, you risk miscarrying or giving birth to a child with Down syndrome or another chromosomal abnormality because of the poor quality eggs. At age 35, roughly 33 percent of a woman’s eggs are abnormal. By age 40, that percentage jumps to 50 percent. By age 44, it’s at 90 percent. Because of these odds, few centers offer IVF to women older than 44 unless she agrees to use a younger woman’s eggs.

IVF provides older mothers with the opportunity to have a biologically related child, but only if they are younger than age 44, says Saadat.

In its simplest form, IVF involves using drugs to stimulate the ovaries to produce more than one egg. These eggs are then surgically removed (“retrieved”) and mixed with sperm in a laboratory.
The resulting embryos are either implanted into a woman’s uterus or frozen for later attempts.

Using Donor EggsIn IVF with donor eggs, the fertility center screens the donor to ensure she’s a good candidate, both physically and emotionally. Information such as eye color, skin tone and ethnic and educational background can be used to try to match a donor’s background to the recipient’s.

If you are attempting pregnancy with an egg donor, once you choose your donor, the center mixes 10 to 15 of the donor’s eggs with your partner’s sperm, while you take hormones to stimulate your uterine lining to secrete the nutrients needed for an embryo to grow. By the seventh week of pregnancy, the placenta (the specialized organ that nourishes the fetus) makes its own hormones, and you no longer need additional hormones.

Success rates of IVF with donor eggs vary from 50 percent to 70 percent regardless of age, notes Jacobs. But few centers offer the procedure to women older than 50, citing ethical reasons. Women who have a baby at age 50-plus will be caring for teenagers in their late 60s. Furthermore, little is known about the effects of pregnancy on women who are more than 50 years old woman, or the effects of age on the uterus as the place to nurture a baby.

Understand the Risks Getting pregnant is just part of the story, however. The longer you wait, the more dangerous it can be—for mother and baby.

Older moms are at increased risk of developing pregnancy-induced diabetes and high blood pressure, as well as preeclampsia, a dangerous condition that can result in liver and kidney damage, and, in rare cases, death of the mother and/or baby.

Also, older women are taking on parenthood when their peers are considering early retirement. With achy joints and aging bodies, they assume a role that requires many sleepless nights and lots of heavy lifting. Instead of having an extended family that can offer help, older moms often find themselves caring not only for their children, but for aging parents, too.

What older parents lack in energy and strength, however, they often make up for in patience and dedication. “It’s so intentional at this age,” says Nancy London, manager of www.mothersoverforty.com. “It’s not like you are 20 years old and thinking, ‘Oops, I got pregnant.’ You usually have put some effort, and often your life savings, into it.”

Choosing Surrogacy If you’ve had a hysterectomy or have medical problems, such as high blood pressure, diabetes or heart disease, IVF with donor eggs isn’t a possibility. Your only remaining option to have a genetically related child is surrogacy.

With surrogacy, couples use their own sperm and eggs (in some cases donor eggs) to create embryos that are implanted into a younger woman’s uterus. This surrogate mother carries the baby to term and then turns it over to the couple to raise. As you might imagine, surrogacy raises numerous sticky issues.

Meet with a reproductive rights attorney before doing anything, advises Brette Sember, an attorney and author of the Complete Adoption and Fertility Legal Guide. “Surrogacy is not legal everywhere, so it’s important to choose the state where you enter into the contract carefully,” says Sember.

Adoption OptionsIf IVF has been ineffective, is too expensive or not appealing for other reasons, you could consider adoption. Bear in mind, though, that some U.S. agencies set an age limit of 40 for adoptive parents. If you’re over 40, you may be able to adopt a child from another country. China, for example, offers adoption only to parents over 30 and sets no maximum age.

Adopting an older child from the foster care system is another option. “State agencies are desperate to place these children in homes,” says Sember. Although many parents want the experience of raising a baby, adopting an older child won’t tax your aging back with lifting, carrying and bending. Don’t forget, eighteen years is a long time; adopting an older child reduces this.

No matter your age and no matter how you become a mother, one fact is almost certain: You’ll love your child as your own, even if you are not genetically related.

Choosing Pregnancy Or Not

If you don’t want to get pregnant, you need to use contraceptives for 12 months after your last period. If you are considering a late-in-life pregnancy, follow these steps to increase your chances of success:

• Cut out vices. That means alcohol, cigarettes and caffeine (not to mention any “recreational” drug use). In addition to reducing your fertility, these substances may also raise miscarriage risk and harm the developing fetus.
  
  
• Get in shape. Labor and delivery—and the subsequent 20-plus years of parenting—require a great deal of physical strength. Specifically, work at exercises to strengthen your abdomen and core. This helps prevent back pain during and after pregnancy.
  
  
• Find an outlet for stress. Stress may reduce your chances of getting pregnant, trigger preterm delivery and intensify labor pain.
  
  
• Maintain a healthy weight. Obesity both decreases your chances of conception and raises your risk of pregnancy complications, such as gestational diabetes and high blood pressure.
  
  
• Take a daily vitamin All women of reproductive age should take a multivitamin with 4 mg of folic acid in it to help your baby develop normally if you conceive!

“I always wanted to be pregnant”

It’s the same story every time Utah native Marla Reed* goes to the grocery store. Pack up the stroller and the toys, put her two-year-old in his car seat and drive off. Getting to the store is the only smooth part of the journey though. Once she’s inside, mayhem could break loose.

“Sam* loves grabbing hold of anything he can get his hands on. Once he wrecked an entire display of cereal boxes,” says the 47-year-old Salt Lake City resident. On days like that, Reed admits she feels too old to be a mom. “Sometimes I think ‘Why did I do it?’ But then he smiles, and I know I made the right choice.” Reed had her son in her mid-40s.

“I always wanted to be pregnant, but we just kept putting it off. Then one day, I realized I wanted a baby more than anything.” Now, focusing on her new role as mother, Reed has left her high-powered management job to be a stay-at-home mom. “I’ve learned to joke about it. Before they ask, I say to people, ‘I know what you’re thinking, and the answer is no, I’m not his grandmother!’”

Reed and her husband didn’t want to risk using her own eggs, and her fertility doctor advised her to look for a donor who looked like them. “You wouldn’t believe the amount of profiles we read just to find the right one,” she recounts. But being patient was the right thing to do.

“When Sam was born, I cried,” says Reed. “He had my husband’s rosy lips and almond-shaped eyes and my nose. I’m so grateful and blessed to have this opportunity to be a mom at my age.”

* Names changed for privacy reasons.