When it comes to changing diapers, breastfeeding and swaddling, 40 is the new 30.
A recent national report found birth rates falling in virtually every age group of women in their childbearing years — except for those between 40 and 50. The group aged 40 to 44 had its largest birth rate since 1967.
Benefiting from improvements in reproductive technology and the fact that most Americans are living longer, more women 40 and over are choosing to have children in later life, particularly after they've accomplished career goals.
That means that as the nation celebrates Mother's Day, over-40 moms are still scheduling visits with the pediatrician while some their age have become grandmothers. Yet several local over-40 moms said they'd have it no other way; the births come when they're more settled, selfless and focused on family.
"I had a very successful career, I did a lot of traveling and I really don't have a lot on my list of things that I haven't done," said Katherine Lally of Pikesville, 42, whose son Emmett will be 2 in July. She also has a 5-year-old daughter, Astrid.
"My take is that we bring our life experiences to mothering. By being an older mom I can bring everything I've learned from my studies, travel, work and life into it," Lally added. "That may be why the trend is towards delaying motherhood — the ability to wait until it's the right time for your family to begin."
The 2008 birth rate report, based on preliminary data from the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics, found that the birth rate for women in the U.S. aged 40–44 increased 4 percent from the previous year, to 9.9 births per 1,000 women. That was the highest birth rate since 1967, when it was 10.6. The rate for women 45-54 increased from 0.6 in 2007 to 0.7 in 2008.
The report said that in 2008 there were 106,090 births to women ages 40-44. In 1990, there were 48,607 births to that age group.
Brady Hamilton, a statistician at the National Center for Health Statistics and one of the authors of the report, said that during the sluggish economy younger women often delay pregnancy, something that older women cannot do.
Though the overall number of births to women 40 and over are still smaller than those of younger groups, the steady increase reflects marked improvements in life expectancy and improvements to prenatal care, experts say.
Data from the Cleveland Clinic shows that the risk of miscarriage is about 40 percent for women at 40, compared to 15 percent for women in their 20s.
At age 40, there is also a greater likelihood of giving birth prematurely or to a baby with low birth weight. The likelihood of Down Syndrome is ten times higher for a baby born to a 40-year-old woman than one who is 20. There is also a higher risk of ectopic pregnancy, in which an embryo implants outside the uterus, sometimes in a Fallopian tube. Hypertension and gestational diabetes are diagnosed more frequently in pregnant women over age 35.
Dr. May H. Blanchard, chief of the division of general obstetrics and gynecology at the University of Maryland Medical Center, said that with better technology to diagnose abnormalities earlier and monitor pregnant women more closely, some of the risks are tempered.
"I will say that for women who are of normal body weight and have no other complicating factors such as high blood pressure, diabetes or chronic illnesses, once we've done initial genetic screening and ruled out any chromosomal abnormalities, the risks shouldn't be that much more than someone five years younger," Blanchard said.
Being told of possible abnormalities can be stressful in itself, but Lally said that for older women it comes with the territory.
"A younger parent doesn't know going in that during pregnancy you're going to have some unexpected avenues and things happen, but when you are an older mom you have that presented to you as a possibility," said Lally, who said she had "an easy birth" with Emmett.
Lisa Karmel, 45, of Bel Air, knows what it's like to bear children at different stages of life. Married three times, she was 19 when she gave birth to her first child, Billy Lamana. She was 34 when her daughter Delaney Jennings was born.
She gave birth to her third child, Juliette, two months ago.
"My husband and I were married August, 2008, and we talked about adding to our blended family, and what a new baby would bring to our lives," said Karmel, who also has a stepdaughter, Naomi Karmel, 9. "We decided that we were ready and we wanted another child together. We conceived without any in-vitro assistance, and we see it as meant to be."
Karmel added that of her three pregnancies, she felt most comfortable with her last.
"As you age you learn to roll with the punches, and I found that I wasn't taking anything for granted," she added. "I feel fortunate that we were able to have a baby and have it go so well."
Rolling with the punches is vital, because older mothers admit that there are some challenges, namely battling perceptions that they are self-centered to have had a baby at such a late age. Those sentiments are consistent with a survey taken last year by Pew Research Center about attitudes toward women who give birth after 40.
In a nationally representative sample of 1,003 adults, included married and unmarried people, 33 percent said that they believe women giving birth after 40 was bad for society, while 47 percent said it didn't make much difference and 13 percent said it was good for society.
"Older Americans, 65 and older, are most likely to be disapproving: 43 percent of them said it was bad for society," said D'Vera Cohn, senior writer at the Pew Research Center and co-author of the survey. "Men are somewhat more likely to say that it doesn't make a difference."
Karmel said that for the most part, she's heard few comments about being an older mom with an infant.
But during a department store visit with Juliette, Karmel said that another patron approached the two, admired the infant, then turned to mom and said, "Is she yours?"
"And during my pregnancy I had a couple of people come to me and say, 'Better you and not me,' or 'You must be crazy,' " Karmel added. "Those comments stung a bit, but you have to have the maturity not to let things bother you."
Both Karmel and Lally say that support groups help in those areas, too.
A local branch of a national group for older mothers called Motherhood Later … Than Sooner was launched in January by Donna Bogash, 49, of Reisterstown. She said that her desire to have a child in her 40s was met with skepticism by a doctor who told her, "No reputable fertility specialist would touch you with a 10-foot pole."
"My mother had me at 39 and my youngest brother at 42, and that was back in the early 1960s. She's still around and active at 87," Bogash said. "Times, attitudes, lifestyles and health have changed a lot since then. My advice to a woman over 40 considering having a baby is, don't let the number get in your way. There are pluses and minuses to having children at any age."
Then there's Flowerpowermom.com, a website and blog launched six months ago to advocate for women over 40. Site creator Angel La Liberte, 49, of Santa Cruz, Calif., said she launched it because of experiences she endured as an over-40 mom. She gave birth to her first child at 41 and her second at 44.
The site, which has followers in the Baltimore area, lists famous women who have given birth over 40 (Nancy Grace, Susan Sarandon, Salma Hayek), as well as books, resources and a site newsletter. On Mother's Day, the site will feature, "Celebrating Motherhood After 40," a tribute photo album to older mothers across the country.
"They lend their support by telling their story, so other over-40 moms hear it and feel empowered," said La Liberte.
Karmel says she looks forward to what motherhood will bring in her older years.
"I find myself in a much more grounded position, and I am confident in who I am," said Karmel. "I am much more selfless and loving. There is a marked difference in who I am as a woman at 45 than at 19 and 34."
When it comes to changing diapers, breastfeeding and swaddling, 40 is the new 30.