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Old 02-03-2002, 04:59 PM - Thread Starter
 
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i'm not sure if this is the best category for my questions, but i'm hoping this is the best fit. i'm almost 40 and considering having a second child within the next 2 years. i'd like to have a home birth, and i'm wondering if anyone knows if the so-called risks of homebirth increase with the mother's age? i'm also in confusion about having an amnio. i can't find specific info showing the percentage of children born with down's to older moms, and i also can't find info explaining the specific causes of down's (i know it's caused by a chromosome anomaly, but what causes that anomaly? and how does it link to the mom's age? and are there preventive measures?) finally, i'd plan on child-led (assuming long-term) nursing, and i wonder what health problems that can cause for an older mom. if anyone has any info or can point me to reference sites/books that address these issues in laypersons' language, i'd be be soooo appreciative. thanks!
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Old 02-03-2002, 05:14 PM
 
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Well, I'm almost 38 (later this month) and recently decided to wait another whole year plus a few months before having my third child (or trying to!).

I think it's good to get a Pap smear and thorough exam before trying to conceive...plus a mammography, and making changes to your diet (if needed) and making sure you're getting enough folic acid, iron, and other vitamins. This will weed out a lot of problems before you even get started.

I would be cautious about looking at numbers of LIVE BIRTHS with down's syndrome and other genetic 'anomalies' becuase more women than you might think choose to terminate pregnancy when they learn their developing baby has such a condition. If you contact your doctor or a genetics/high risk pregnancy clinic, they can look at the odds for you. You could also opt to have genetic testing beforehand so you would know if there might be known risks with you and your partner.

Then there is amniocentesis. When I was pregnant with my now 17-month-old, the risk of introducing a problem with the amnio was about equal to the risk of there actually being a problem to detect with the amnio. That coupled with my foregone conclusion that I would not abort regardless of findings, I decided against the amnio. You also have to have an ultrasound to do the amnio, and I am just finding out that an ultrasound is not always a good thing (see thread on that).

Any pregnancy is a leap of faith. If I am lucky enough to become pregnant after my wait, I do not think I am going to get amnio or ultrasound, but will have other screenings done such as good measurements by my osteopath, listening to heartbeat with traditional equipment (not doppler), and counting movements. That's IF I end up being in low-risk category...such as normal weight gain, blood pressure, etc.

I hope this helps? It's not a whole lot of information, just MY recent thinking about my situation. My 17 month old is really healthy, a nice bright child, I didn't have any complications conceiving, carrying, or delivering him, or afterwards.

You have to do what your heart tells you to.

Sarah
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Old 02-03-2002, 06:47 PM
 
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In one of Dr. Sears' books (I think it was "the baby book") there is some discussion of this, because he and his wife Martha have one Down's child. I don't recall all of the details, but there was something about the genetic anomaly can come from either the sperm or egg, and older dads have a higher likelyhood than younger dads of contributing that extra chromosome..... I had always heard it blamed on "old eggs" and thought it was interesting to find out it could be either parent.

Also, I remember vaguely, years ago reading about the risk of Down's children increasing with the number of x-rays a mother has been exposed to. I am sorry to bring it up when I can't give you any more information.....but that's all I know.

I am a younger mom, but chose not to have amniocentisis done for any of my babies, for several reasons. I wouldn't chose to terminate the pregnancy, so the knowledge of any potential problem was a moot point. I was not convinced of the safety of the procedure, and I have a scar where the amnio needle poked me when the test was performed on my mother (to screen for "genetic anomalies)....too risky for results I didn't need.

Also, as the child of an older mom (40+ when I was born)....I'm all for it. I don't think my DH will go for anymore babies after I'm about thirty, though!

....living, learning and loving everyday with the Sweet Pea Bridgade
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Old 02-03-2002, 08:38 PM
 
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Although I don't have specific numbers for you an the Downs pregnancy rate, when I had my ds, my OB reminded me that even though the rates may be higher, it is still a much larger nmber of women who have healthy children. My ds was delivered at 43, and he was/is perfect! There is a risk of miscarriage with amnio, if you are sure you would not abort, I guess I would strongly consider not having one. I did an earlier technique called Chorionic Villi Sampling. The risk of miscarriage is a little higher than amnio, but you can have the results much earlier, at about 12-13 wks. My situation was differant, I have no real family living, and my dh has only elderly relatives. I felt strongly that if there was a major problem, I wouldn't continue the pregnancy, as there would really be no one to care for a special needs person when we got too old . This was certainly my and my dh feelings, but if I had been a little younger, and had family help, I probably wouldn't have had either cvs or amnio, just deal with whatever happened.
As far as BF, all the studies I have seen cite only health benefits for mom, age really isn't a factor. I nursed my ds until he was 4 and 1/2, and had so much milk I could have fed a third world!
Wish you luck and joy.
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Old 02-04-2002, 02:52 AM
 
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I had a VBAC (birth center) at age 39 and can say without qualification that I was MUCH healthier this time around. The care you get (and the care you take of yourself) makes sooo much difference.
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Old 02-04-2002, 03:58 AM
 
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Just a happy side note-I just read somewhere that if you have a child after the age of 40 you have about a 400% times greater chance of living to age 100! How about that!!
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Old 02-04-2002, 06:15 AM
 
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I don't know any data but I had my 2nd dd when I was 35 - almost 36. My first dd was born when I was one month over 20 ie a nearly 16 year gap. My midwife was really supportive of a homebirth until I got to about 7 months pregnant. Then started giving me scare stories but nothing specific to do with my age, other than saying coz of my age I should really go to hospital. Her main fear seemed to be shoulder dislocatia which I guess can happen to anyone. She also told me I was not having a big baby. So she contradicted herself there. she also gave me lots of stress about it being like a first pregnancy coz of the gap & different father so I couldn't base anything on my first experience. Anyways.... Saffron got born at home, by accident & her dad delivered her. I never made it to hopsital, she didn't get stuck, it was amazingly like my first labour all those years ago which was quick. She was also a very healthy baby. I looked up how to do apgars in spiritual midwifery with the exception of I have no idea what her heart rate was, I'd say she had apgars of 10.

All this said, I think it depends on how healthy you are personally. I am fit, I eat a good diet, I did lots of preconceptual stuff. I had acupuncture throughout my pregnancy. I didn't have any pregnancy related issues like anaemia, or high blood pressure or gestational diabetes.

I recently read somewhere that a lot of the genetic disorders they attributed to older women with ageing eggs, they are now finding come from the old men!! So it would probably pay to get your partner to do some preconceptual preparation with you. A good book to read is called "better babies" by francesca naish ( I think )

Best of luck
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Old 02-04-2002, 06:32 PM
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I had my fourth child one month before my 44th birthday (she is now 15 months old). I had an amnio for her and ds5 and I will tell you why. My second child was born (almost 15 years ago) with what they thought at the time was a rare genetic disorder. He was severely handicapped and terminally ill. He only lived for 3 1/2 months. We brought him home when he was a month old. I pumped my milk for him and fed him through a g tube that had been surgically implanted. He died at home. I was thirty years old at the time. I had no idea that anything was wrong during my pregnancy, he did not move as much as my older son, but there was fetal movement.

Nine years later when I unexpectently became pregnant again (baby 3) the genetics people told me my second son may not have had a genetic condition(1 in four chance in each pregnancy), it may just have been a random occurence, they just didn't know. That meant my chances for the same thing happening again were 0-25%. As I was 39 at the time I also had an increased chance for Downs. I opted to have amnio and the higher level ultrasounds because amnio alone would not tell me if this baby had what my 2nd son had.

My whole point is (yes I am getting to it) that even if you are positive that you would never abort no matter what, it is a very, very traumatic event to find out at birth that your baby is sick. I really believe that I would have rather been prepared before my baby was born to find out that something was wrong. At the very least it means that you would go to a hospital with NICU facilities for the birth and not have your baby seperated from you.

My third and fourth babies were born healthy, thank God and I am so grateful that I did not have to make that decision. In my case it did put my mind somewhat at ease to have amnio and other tests. The hardest part of the aminio is waiting 7-10 days for the results. You are usually required to have genetic counseling before having an amnio.

Everyone has to make their own decision and I realize my experience is not common.
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Old 02-04-2002, 07:03 PM
 
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I had my only child at 39, and because of my age, my results on the triple screen really skewed toward me probably having a baby with Downs. I was uncomfortable with amnio, and fearful of it bringing on miscarriage, but I did insist on a higher level ultrasound so we could look for anatomic markers of Downs. Turns out Delia does not have Downs, but it sure would have been nice to get educated before she was born if she did. through my work with LLL, I know that I would have needed extra support to enable the baby to breastfeed. And I wanted to be prepared for all the physical trials that can be the lot of kids with Downs. I wanted to be the best advocate for my kid...

That said, if you are physcially well and your pregnancy is uncomplicated and the prenatal blood tests, etc. give you no reason to fear for your child's life, there's little reason I can think of for you to automatically be high risk because of your age. Older primiparas can get a hard time from the docs, because I think research supports them in the feeling that we're wimps...

A footnote to this discussion: many times diagnostic ultrasound misses a lot. My sister had a son with a diaphragmatic hernia that was incompatible with life. She had had ultrasounds, and this GROSS abnormality was never detected. I went into the ultrasound room absolutely clear in my mind that this was not some baby's first picture party... A neonatologist actually did the ultrasound, and he was all business. (Of course, he also kept pushing me for an amnio...)

I'm 44, and I still want another...
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Old 02-16-2002, 10:58 AM
 
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From what I understand, older mums are more likely to have a down's baby as a result of non-disjunction. This means that a pair of chromosomes doean't seperate during sexual repro or that the chromatids don't seperate during mitosis. When you go for a scan they usually give you a risk factor. So they would say something to you like: we've taken your medical and social history into account as well as your previous pregnancy's and this is the chance we think you have for a down's baby e.g. 1 in 600 or 1 in 2000. the risk factor will be higher because of your age. It's kind of like laying out a deck of cards and telling you not to pick out the ace of spades. Only an amnio will difinitively tell you whether or not you have a down's baby. Think about what you want, how it would affect your lives according to the risk factor they give from the scan and then discuss it from there. You might check out midwiferytoday.com. You can do a search of their back issues and have any of interest sent to you e.g. homebirth and maternal age. Homebirths are as safe as hospital births for low risk women. Anything that can go wrong at home can also happen in hospital. In hospital you have the added risk of routine intervention which they (doctors) don't like sharing because they feel safer with a lot of technology. Technology is great when it's used properly and at the right time. If your midwife is delivering you then remember that she is a skilled practitioner who should be able to handle a situation e.g. if that means getting the appropriate help in any situation. The first chapter in the book The New Midwifery by Lesley Ann Page illustrates the situation of an older mum with more then three children wanting a homebirth.
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Old 02-16-2002, 01:17 PM
 
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http://www.ds-health.com/risk.htm

The link above goes to a chart that shows the rate of maternal age vs. fetus and babies with down's.

Hope this information is helpful.

LMK
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Old 02-17-2002, 08:16 PM
 
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Thanx Dotcommomma!

That link gives to the point info. very useful
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Old 02-17-2002, 09:25 PM
 
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I gave birth to my first child a few months before I turned 38. I had no amnio, just one ultrasound at 18 weeks and another at 41 to check fluid levels because I went post dates.
Before I conceived, I went to the midwife to do a preconception interview and asked her about my concern in having a homebirth at my age (then 37).
She said 'we assume all pregnancies to be healthy and normal until proven otherwiise."
In other words, there is not age which is appropriate or not, to have a homebirth. She really helped to educate me and I had an easy pregnancy and beautiful homebirth.
I am now 40, and IF we decide to have another in a year or so, I will absolutely be having my baby at home.
That is my first choice. I don't think I would do amnio even as an older person, because I don't want to choose the fear road. I guess I wouldn't be sure of what I would do until I get there, BUT, it is a choice to trust or not and I would rather not live with the anxiety.
At my stage in life, I would not be choosing to end a pregnancy even with so called problems, so I'm not sure that amnio would be all that useful. I would still intend a very non medicalized pregnancy.
All the way through birth.
Good luck to you...
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Old 04-17-2002, 05:01 PM - Thread Starter
 
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well, i'm no longer an old mama considering pregnancy -- i'm actually pregnant. we hadn't decided to *try,* but we had decided to welcome a pregnancy... well, when you've got italian blood, i guess that attitude is the same as trying. i wonder if there really are fewer fertility clinics in rome... i'm only a few weeks into this, and i'm trying not to get too excited, as i know at this stage my body could change it's mind, but i do feel exuberant! thanks again for all your input!
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Old 04-17-2002, 09:13 PM
 
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Hey congratulations!!!
Keep us posted how everything is going. Or start another thread for it if you prefer...
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Old 04-17-2002, 09:54 PM
 
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WordUp

Congratulations! I'm 43 and due in ... um ... sometime next week or whenever the baby decides to come.

I wanted to tell you about a study that was extremely helpful to us - it's called the FASTER study (First And Second Trimester Evaluation of Risk) and it's a blood draw and ultrasound between 10 1/2 and 13.9 weeks and another blood draw at 15 weeks. They're attempting to fine tune that blasted Triple Screen that's so inaccurate. Based on the blood draws and the ultrasound (looking at specific markers) you're given a "risk ratio" for your pregnancy - in my case my "age related risk" was 1:37 (or something scary like that) and the combined risk based on the blood etc was 1:370 well above the cut off for a recommendation for an amnio. So we didn't do the amnio and were very reassurred.

This study is ususally part of of a larger hospital, but here's the web link for more info:

http://www.ihc.com/xp/ihc/lds/forpat.../fasterfaq.xml]

And I had a baby at 40, and he's wonderful. Had to stop nursing when my milk dried up at 5 months pregnant, but otherwise would be still nursing him!

And my mom was over 40 when I was born. I think most days I'm fairly normal

Barbara
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Old 04-17-2002, 10:49 PM - Thread Starter
 
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thanks for the great testing info.
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