Let me assure you that the babies are making their physical presence felt now! I can no longer wear my jeans without undoing the top button when I’m sitting down (and sometimes when I’m standing up). I’ve bought one of those waistband extender things, but I didn’t need it before I went on holiday, so I didn’t pack it. I certainly need it now…
Anyway, this week’s baby update comes from babycenter.com.au:
Crown to rump, your baby is around 9 centimetres long and weighs 43 grams. The body is now growing faster than the head. This week, its parchment-thin skin covers itself with lanugo (ultra-fine, downy hair that usually disappears before birth). Though eyebrows are beginning to grow and the hair on top of the head is sprouting, this hair may change in both texture and colour after birth.
About now, the fetus can grasp, squint, frown, and grimace. It may even be able to suck its thumb. Researchers believe these and other movements probably correspond to the development of impulses in the brain.
It’s good to hear that their bodies are catching up with their heads on the growth front. Just think of it – two hairy, grasping, squinting, frowny, grimacing babies, maybe even sucking their thumbs at this very minute! How sweet.
The babies’ growth is certainly requiring a lot of fuel and energy from me – I seem to be eating nearly all of the time, and I would happily sleep for every second hour if I could. And it sounds like I should be taking it easy as much as possible – according to babycenter.com.au, older mothers can have all sorts of additional complications to worry about…
It is unfortunately true that simply by being older, a woman has had more chance to develop medical disorders such as diabetes, hypertensive disorders or fibroids, which can affect pregnancy and birth. The incidence of pre-existing conditions rises from 5.5 per cent in the under 29 age group, to 11.8 per cent in the over 35s. Studies on the effect of age on childbirth also report an increase in the frequency of pregnancy complications such as high blood pressure, pregnancy-induced diabetes, bleeding in the third trimester, and low lying placenta The incidence of pregnancy complications rises from 10.43 per cent for women aged 20-29, to 19.29 per cent for women aged between 35 and 39 years.
And things can be equally worrisome for older mothers like me when it’s time to give birth:
Women of 35 and over are more likely to have induced labour, diagnosis of fetal distress, epidural anaesthesia, or forceps or ventouse delivery, and virtually all studies agree that the rate of caesareans rises with maternal age, though again this rises with private care, regardless of age (Roberts C, Tracy S, Peat B, 2000, BMJ). However, this increase does not appear to be connected with any specific problem. There is a question mark over how much of this intervention is necessary, and how much is caused by a general perception that ‘older’ mothers are ‘high risk’. Once the course of nature is interrupted by one intervention, others frequently follow in what is known as a ‘cascade of intervention’, so as in pregnancy, if you want to give the physiological processes of birth a chance, be well informed, prepared to ask questions and seek a second opinion if you are not satisfied with the first.
There is however, one small but serious risk to the babies of more mature mothers. Inexplicably more babies die, in utero, right at the end of pregnancy in this group of mothers – 1 in 440 pregnancies of women aged 35 or more, as opposed to 1 in 1000 for younger women. For this reason carers are often more vigilant of the mature mother in the final weeks of pregnancy.
More frequently there is a general expectation of complications, which in itself can cause stress to the mother. An increased risk of complications, however, does not mean complications will necessarily arise.
It’s not all bad news, however. During pregnancy:
On the plus side, older mothers have some physical and psychological benefits over their younger counterparts. Women in their 30s or 40s might lead a healthier life-style; they understand the needs of their bodies, look after themselves better in terms of exercise and nutrition. Studies have shown that mature women have more positive perceptions of their bodies, and that they more readily tolerate the symptoms of pregnancy. At this age too, a woman has more confidence to know what she wants, and enhanced people skills to get it.
As Tristan can testify, I’ve been using my enhanced people skills and confidence to ask for snacks.
And during childbirth:
Despite the real, perceived or potential risks, all studies agree that the actual outcome for the baby is every bit as good as that for younger mothers, as shown by the Agpar scores which assess a baby’s well-being immediately after birth, and the on-going checks through childhood.
On the psychological front, older mothers may again have an advantage. One study shows that they have less fear of helplessness and loss of control than younger women. Also the years can give greater stamina and courage.
On the other hand, I imagine that a younger mother could have heard fewer birth-related horror stories than somebody my age. I’m not sure about the whole ‘courage’ thing, though. I’m a wuss. Tristan will vouch for this – even the prospect of jumping into a cold swimming pool is enough to bring about the fear in me.
Still, I guess that my enhanced people skills might make me better equipped to deal with things if anything untoward goes on during the birth.
Finally, we turn to the effects of advanced age on motherhood. Again, it’s a tale of two halves:
It is also well known that older women run more risk of having a Down syndrome baby. When a woman is 40 years of age the risk is 1 in 60, compared with 1 in 1,500 when she is 25 years of age. There are other much rarer chromosomal abnormalities, such as Patau’s syndrome and Edward’s syndrome, which also increase in incidence with maternal age. Maternal serum screening and other tests can give approximations of risk, and amnicentesis can provide firm diagnosis, which allows a woman either to terminate a pregnancy, or help prepare her for the special needs her baby will have. No woman has to undergo any tests if she would rather not have this information.
Despite the increased risk with increased age of mother, it is important to remember that the vast majority of babies are fine, and except for the factor of chromosomal abnormalities, research suggests that the babies of older mothers are no more at risk of birth defects than the offspring of younger mothers.
Phew! And I’m delighted to report that I’ve now had the combined results of my screening scan and blood tests, and we’re definitely low risk, with no further testing suggested. Hurrah!