How worried to be about birth defects with advanced maternal age?

[Anonymous]

Just be aware that the medical staff with call you an AMA -- for advanced maternal age. You will have more tests. They will monitor you much more closely at 35+. You will undergo chromosomal testing, the full workup, and probably go over the results at an appointment with a genetics counselor who interprets the findings. You have a X% chance of this genetic condition, an X% percent chance of that condition. Just know this going in.

[Anonymous]

Anonymous wrote:My genetic counselor told us we should proceed with full confidence through 36.

I'd be a little weary of listening to an expert who uses a hard cutoff like this.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I was 36 when I had a Down syndrome pregnancy. It was a devastating diagnosis to get, but after doing some research and speaking with a genetics counselor, we decided to continue the pregnancy. My husband and I were both 37 when the baby was born. Although our son is delayed and we have a lot of medical appointments and therapies, I don't regret our decision to have him. He is a happy little boy who has brought so much joy to our lives. Yes, I worry about his future, but we have legal and financial arrangements in place that will hopefully allow him to lead a comfortable life after we're gone without becoming a burden to his brother.

However, the issue isn't whether you want your child to have a disability (no one does) or whether you could handle a disability if one happened (you could), but different levels of risk tolerance between you and your husband. You are very unlikely to be in the same situation as me (less than 1%), but it's not impossible. If you decide to proceed with trying for another child, you and your husband need to have a discussion about worse-case scenarios and how you would handle them. If you can't agree, then the answer is no, unfortunately.

I have more concerns about what happens after I pass. A distant relative of my family had their down syndrome child in a group home and that's where he died. No one in the family ever visited him. Since I can't control how mean other people can be, I wouldn't wish that on my worst enemy much less my child.

Hi. Mom of the kid with Down syndrome here. Let's not start a debate on the ethics of having a child with Down syndrome; that's getting too far off topic. The point is that abnormalities like Down syndrome can happen to anyone at any age, but the risks increase as you get older. And despite what people on here are saying, there is nothing you can do to guarantee it won't happen to you. You can do the pre-conception genetics counseling (we did that), take the vitamins (did that, too), give up alcohol (yes), live a healthy lifestyle (yep), and do everything "right," and still end up with something wrong. Sometimes issues can be detected during pregnancy, and sometimes they can't. For anyone interested, there is a good essay on this topic called "Super Babies Don't Cry," by Heather Kirn Lanier: https://velamag.com/superbabies-dont-cry/

And to those who have said, "Just get an abortion if something goes wrong," I'll say this: It isn't an easy a decision for everyone. Most people don't find out there's a problem until the second trimester, past the point where they assume they are "safe" and have started to get attached. I was 17 weeks along when I found out. It's not an experience I would wish on anyone. Whether you are pro-choice or pro-life, a prenatal diagnosis can cause you to question all of your values. Ultimately few people regret their decision, whatever that decision may be, but it's a hell of decision to make. And you will be judged for it, no matter what you pick.

I'm not trying to scare anyone. I just don't want anyone to take the risks lightly. Your chances of a problem are low, but they are not zero. That doesn't mean you shouldn't try for another kid. Just make sure you have these difficult conversations with your significant other ahead of time. Where do you stand on terminating, and under what circumstances? Do you have the resources to care of a child with special needs?
Talking about these concerns won't prevent a problem nor the emotional upheaval of a diagnosis, but at least you will have a framework to go off of should the worst happen, so that you aren't making life-changing decisions in crisis mode. And if you disagree about how to handle a situation, better to know that before you conceive.

Good luck to all would-be mothers out there. May you all have healthy children.

[Anonymous]

Anonymous wrote:I had children at 32, 35 and 37. The child I had at 32 has a chromosomal disorder and the ones I had subsequently do not. It’s always a risk.
For what it’s worth, I just took all my children to a museum, out to lunch today and to an amusement park yesterday, everyone had a blast. I don’t actually see what having a brother with a chromosomal abnormality “does” to *them*.

Really? Perhaps your child is very easy going, has a very mild condition, or a combination of the two. I do not imagine most siblings of a person with a significant disability will claim that it has little/no effect on them. Sometimes the effects are actually really positive but a lot of times with really serious conditions they are not. I'm glad your family is not affected.

[Anonymous]

Hi OP, I had my kids at 36 and 39, so I generally would say go for it! But if your husband’s anxiety about the risks is very strong—even if there’s good data that might show that the risks are much lower than he’s assuming—that might be an indication to stop at two kids. I don’t know your husband of course, but I wondered if in expressing his anxiety he is trying to communicate that he would rather stick with two kids.

[Anonymous]

Anonymous wrote:Hi OP, I had my kids at 36 and 39, so I generally would say go for it! But if your husband’s anxiety about the risks is very strong—even if there’s good data that might show that the risks are much lower than he’s assuming—that might be an indication to stop at two kids. I don’t know your husband of course, but I wondered if in expressing his anxiety he is trying to communicate that he would rather stick with two kids.

Is it much more tiring to be pregnant at 39 than 36? Did you notice/feel a difference?

[Anonymous]

Anonymous wrote:Just be aware that the medical staff with call you an AMA -- for advanced maternal age. You will have more tests. They will monitor you much more closely at 35+. You will undergo chromosomal testing, the full workup, and probably go over the results at an appointment with a genetics counselor who interprets the findings. You have a X% chance of this genetic condition, an X% percent chance of that condition. Just know this going in.

I had my first at 37 and am pregnant with my second now at 40. PP sounds like it’s a hassle but it’s anything but.

I got a blood NIPT test at 12 weeks and they left a voicemail and sent an email with results. I also found out the gender then. Because I was AMA my insurance fully covered it automatically. My doctor has never said anything negative about my age. Only a matter of fact comment like “because of your age insurance will cover XYZ”. At 40 they said they “won’t let me go past my due date” at my first visit at 6 weeks but haven’t mentioned it again and I’m now 25 weeks. We had the option (like every pregnant person) to do genetic testing but opted to skip it.

[Anonymous]

I was 37 and the fetus tested positive for Down syndrome, the genetic disorder caused when abnormal cell division results in extra genetic material from chromosome 21. Although chances are very low, I was one of those due to advanced maternal age. It happens.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Hi OP, I had my kids at 36 and 39, so I generally would say go for it! But if your husband’s anxiety about the risks is very strong—even if there’s good data that might show that the risks are much lower than he’s assuming—that might be an indication to stop at two kids. I don’t know your husband of course, but I wondered if in expressing his anxiety he is trying to communicate that he would rather stick with two kids.

Is it much more tiring to be pregnant at 39 than 36? Did you notice/feel a difference?

Hard to say—I was definitely more tired the second time but I had a toddler so that was a huge factor!

[Anonymous]

Anonymous wrote:As someone who has a younger sibling with significant disabilities that were not accurately predicted in womb (my mom was 35), it is devastating for the family. My parents have sacrificed a lot; they never can go anywhere on their own, their life fully revolves around taking care of my sibling, and sibling will live with them lifelong. Once they pass, I know I will have sibling move in with me. If you’re concerned about the risk at all — and the risk does increase the older you are — I would not do it. If you ended up with a child that had significant needs, that will be very hard on your marriage, your life, and your other kids. Of course there are many people who ended up with healthy and happy kids post 35, but the question is not whether it’s possible, it’s whether you’re willing to risk it.

I’m sorry about your situation.

This is the risk with every pregnancy.

[Anonymous]

There's nothing magic about turning 35.

I'd go ahead and do all genetic testing/NIPT and make sure your anatomy scan is scheduled as early as possible.

[Anonymous]

Anonymous wrote:35 really isn't that old--in fact, in some circles in DC, it's young to have a baby! The odds are higher as you age but in absolute terms the risks are very low. And you can do a blood test basically as soon as you get a positive test that will find the most common chromosomal issues.

Learning Disabilities are much more common among children born to mothers over 35. In most cases these are mild and wouldn’t be obvious to anyone who wasn’t intimately familiar with the child’s academic performance.

[Anonymous]

Anonymous wrote:Get an amnio and end the pregnancy if there’s a problem.

Not everyone is this cavalier about ending the life of their fully formed fetus.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Hi OP, I had my kids at 36 and 39, so I generally would say go for it! But if your husband’s anxiety about the risks is very strong—even if there’s good data that might show that the risks are much lower than he’s assuming—that might be an indication to stop at two kids. I don’t know your husband of course, but I wondered if in expressing his anxiety he is trying to communicate that he would rather stick with two kids.

Is it much more tiring to be pregnant at 39 than 36? Did you notice/feel a difference?

Hard to say—I was definitely more tired the second time but I had a toddler so that was a huge factor!

I’m the PP who was pregnant at 37 and again now at 40. So far this pregnancy has been easier except that I sustained an injury unrelated to pregnancy so I’m already waddling like I’m 42 weeks along. 😂

[Anonymous]

OP it’s important to remember that nothing is ever guaranteed with kids. A friend had her first at 25, totally normal pregnancy, nothing to be concerned about. Went to hospital for labor and had a bad delivery and child ended up disabled with cerebral palsy. It has a hard few years for them parenting. There are thousands of things that can go wrong with a kid and very few of them are related to maternal age. It’s just a gamble.