Already the parent of two teenage girls, Lancaster resident Daffney Price found herself pregnant at age 40.

It was no accident.

Price, a longtime single mom, married her husband, Mike, in October 2009. The couple decided they wanted a child, and their daughter, Emma, was born Dec. 1.

Although women in their 40s having babies isn't commonplace, it's less rare than it used to be. In fact, as birth rates nationally continue to drop, the rate for women in that age bracket alone is rising.

Medical professionals and others cite several reasons for this. Women 40 and older are often more financially stable than their younger counterparts. Also, they frequently wait later to marry and start families because they're devoting time to education and careers.

There are risks associated with later pregnancies, including a greater incidence of genetic abnormalities, but a healthy female in her 40s still has a very good chance of delivering a healthy baby.

According to a Centers for Disease Control report released Dec. 21, the birth rate for women ages 40 to 44 in 2009 increased 3 percent from 2008, while the overall birth rate dropped almost 3 percent.

Dr. Philip Bayliss is a perinatologist and medical director of the maternal-fetal medicine department of Lancaster General Health's Women & Babies Hospital. He said he's seeing more older women having babies, especially up to age 42.

Bayliss listed several contributing factors.

Recession is widely cited as a reason for the decline in the overall birth rate, but "some in the older age group may be a little more secure financially," Bayliss said, and can better afford children.

Also, women are marrying later, which means an increasing number are giving birth in their 40s, he said. And some are having children when they wed a second time.

The median age at first marriage increased to 28.2 for men and 26.1 for women in 2010, an increase from 26.8 and 25.1 in 2000, according to the U.S. Census Bureau. This climb continues a long-term trend that began in the mid-1950s.

In addition, Bayliss said, women have more educational and career options than ever before, which leads to a delay in starting families.

Finally, sometimes women in their 40s get pregnant unexpectedly, thinking their child-bearing years are over, he said. "It's a complete surprise."

Asked if there's a greater chance of complications in older women who become pregnant, Bayliss said: "Generally, the majority of women 15 to 45 who achieve a good pregnancy [without miscarrying] are going to have a good outcome."

There are some subtle increased risks for women 40 and older, he said, including possible difficulty in conceiving and a greater incidence of early miscarriages.

Fertility treatments do help, Bayliss said, and women in that age group tend to have more twins. Also, women can discuss their plans with an obstetrician/gynecologist and take good care of themselves before trying to conceive, he said.

A slightly greater chance of birth defects exists in pregnant women 40 and older, but that's not necessarily because of age, Bayliss said. Obesity, diabetes, high blood pressure or other medical conditions may be factors, he said.

When an older woman gets pregnant, physicians may monitor her condition more closely. During the last two months a baby is in utero, Bayliss performs a test that traces the child's heart rate, he said. This indirect check on placental function is designed to reduce the risk of stillbirths, he said.

Daffney Price's daughter, Emma, born six weeks early, was discharged from the hospital Dec. 21, just in time for Christmas.

She said her first two daughters also were born prematurely, so this wasn't a new experience.

With each pregnancy, Price required bed rest. Emma was in a neonatal intensive care unit for three weeks before coming home and is doing very well, she said.

Knowing the risks

Dr. Mike Meyer, chairman of the OB/GYN department at Ephrata Community Hospital, said he also is seeing more "advanced maternal age" patients.

There are two main patterns locally, Meyer said: women with multiple children who get pregnant into their 40s and women who start their families later.

A patient who's already in good health should be fine "once you get past the risk," Meyer said.

He said there's about a 1 in 100 chance that a woman at age 40 will have a child with Down syndrome and a 1 in 64 chance she'll have a baby with another genetic disorder. For women age 35, the comparable numbers are roughly 1 in 365 and 1 in 270, he said.

Tests, including amniocentesis and ultrasound, can be performed in the second trimester to check for abnormalities, Meyer said.

Conditions such as borderline diabetes, borderline hypertension and being overweight can complicate a birth.

Meg Carnegie gave birth to her second child - her first daughter - several months ago.
Carnegie was 42 when she and her new husband, Danny Wainwright, welcomed baby Quinn. The family also includes Carnegie's 11-year-old son and Wainwright's 13-year-old daughter.

A physician who works part time at Oyster Point Family Health Center, Carnegie said she elected not to have amniocentesis but did undergo a genetic screening test in the first trimester.

Quinn went full term. Carnegie said the main difference in her second pregnancy was the development of gestational diabetes, which is a greater risk in older mothers.

Confronting stereotypes

Elizabeth Gregory is an English professor at the University of Houston, where she also directs the women's studies program. In 2007, she published a book, "Ready: Why Women Are Embracing the New Later Motherhood," based on interviews with more than 100 moms who had their first child when they were at least 35.

Gregory, now 53, became a mother at age 39. In a telephone interview, she said education, work, self-development and finding the right partner are some of the reasons more women are experiencing motherhood later.

Gregory said she was prompted to write the book to counteract media portrayals of women in their late 30s and early 40s as desperate to conceive because their biological clocks are ticking.

Instead, Gregory said, she came across women "doing what makes sense for them" and not feeling the need to rush.

"What I found was people who wanted to do this," she said.

Women have to define readiness for themselves, Gregory said.

Of course, the risks for older mothers do have to be weighed against the benefits of waiting, she said.

Finding someone to settle down with first is a big priority for these women, Gregory said. Eighty-five percent of women 32 and older who give birth are married, she said, while 85 percent of teen mothers are unmarried.

In addition, women in their mid-30s and above are more likely to be financially secure and have an established relationship with their employer that allows them to negotiate a flexible work schedule once the baby is born, Gregory said.

But not every older mom has the same experience. Some are married for years and then retire from their jobs to start a family, Gregory said. Generally, though, women who delay their first birth tend to stay in full-time employment. Gregory went back to work five months after delivering her oldest daughter.

Down the road, she said, the increased number of older moms might also influence national policy when it comes to addressing issues such as day care.

By Paula Wolf, Sunday News staff writer