Sunday, February 03, 2008

Dr. Susan Bewley is now more aware of the issue of the age of the father and the health of the offspring

Women who delay babies until late 30s get health warning· Mothers advised to stick to 20-35 childbearing age· People have become blasé, warns consultant James Meikle, health correspondentFriday September 16, 2005The Guardian
Women who delay having children until their late thirties are "defying nature and risking heartbreak" as well as building up public health problems for the future, senior doctors say today. Those who want families and room to manoeuvre in their life and career choice should not wait that long before trying to have a baby.
Doctors and healthcare planners should urge women to achieve "biologically optimal childbearing" between the ages of 20 and 35, say the authors of an editorial in the British Medical Journal.

Susan Bewley, consultant obstetrician at Guy's and St Thomas' NHS Foundation Trust, London, and colleagues, are urging doctors and health agencies to do more to tackle the "epidemic" of middle-aged pregnancy. Pregnancies in women older than 35 have increased markedly in western countries and with that has come more age-related fertility problems for women, especially for the over 40s. Delay also affects partners, as semen counts drop gradually every year, and children of older men have an increased risk of schizophrenia and genetic disorders.
More than one in seven women in England and Wales now conceive over the age of 35, and more than one in 40 conceive over 40. Increasing numbers are turning to IVF, but seven in 10 women fail to achieve a pregnancy that ends in a live birth in their first cycle of treatment and 90% of the over-40s fail to do so.
Although most pregnancies in the over-35s still have successful outcomes, obstetricians and gynaecologists have been witnesses to tragedies too, say the three doctors, two of whom are women.
"The pain of infertility, miscarriage, smaller families than desired, or damage to pregnancy, mothers and children is very private, particularly when women blame themselves for choices without being fully aware of the consequences.
"It is ironic that as society becomes more risk-averse and pregnant women more anxious than in the past, a major preventable cause of this ill-health and depression is unacknowledged.
"Public health agencies target teenagers but ignore the epidemic of pregnancy in middle age.
"Women want to 'have it all' but biology is unchanged ... Their delays may reflect disincentives to earlier pregnancy or maybe an underlying resistance to childbearing as, despite the advantages brought about by feminism and equal opportunities legislation, women still bear full domestic burdens as well as work and financial responsibilities."
Reasons for difficulties lay not with women but "with a distorted and uniformed view from society, employers and health planners".
The other authors of the editorial are Melanie Davies, consultant obstetrician at Elizabeth Garrett Anderson and University College hospitals, London, who is president-elect of the Medical Women's Federation, and Peter Braude, head of the women's health department at Guy's, King's and St Thomas' medical school, London, and chairman of the scientific advisory committee of the Royal College of Obstetricians and Gynaecologists.
Dr Bewley, chair of the ethics committee of the college, said: "I think people have become slightly blasé." The biological window for the best age to have a baby "has not moved despite the fact celebrities are having their babies older and Cherie Blair has her baby older".
Patients "used to think they were old at 30, then 35, and now it is 40, but their bodies are exactly the same as 20 or 30 years ago. I think people know the health hazards but it sort of drifts past them".
Women doctors were as bad or even worse than others interested in a career, Dr Bewley said. "I look at my own consultants' body, and largely men have children when their wives are in their 20s and early 30s, and largely women have children in their 30s and 40s."

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