An increasing number of women delay having children until after 35 years of age: Almost twice as many women between the ages of 35 and 44 become pregnant now than was the case in 1980. Women who have their first baby when older appear to have some psychological advantages. They are more resilient, report their partners are less controlling, and report lower symptoms of depression and anxiety during pregnancy than their younger counterparts (McMahon et al., 2011).

The greatest risk women and their partners face when they postpone having a child until the woman is in her mid-30s or older is that her fertility decreases with age. Women who have the financial resources to do so can have their eggs retrieved and fro­zen (a procedure called oocyte cryopreservation) when they are younger and more fertile, to increase their chances of becoming pregnant after their fertility declines with age (Stoop et al., 2011). The approximate cost is $15,000 plus a yearly storage fee of $400 (Lehmann-Haupt, 2009).

Healthy older women have no higher risk than younger women of having a child with birth defects not related to abnormal chromosomes. However, the rate of fetal

defects resulting from chromosomal abnormalities (such as Down syndrome) rises with maternal age. For example, Down syndrome rates for children of mothers ages 40 to 54 are about 14 times higher than those for women younger than age 30 (Martin et al., 2009). For women between the ages of 35 and 44, prenatal testing for chromosomal birth defects and elective abortion reduce the risk of bearing an infant with a severe birth defect to a level comparable to that for younger women (Yuan et al., 2000).

Pregnancy in women over age 35 poses additional increased risks to the mother and fetus. Slightly higher rates of maternal death, premature delivery, cesarean sec­tions, and low birth-weight babies occur (Hoffman et al., 2007). Most physicians find that pregnancy for a healthy woman over age 35 is safe and not difficult to manage medically because chronic illnesses such as diabetes and high blood pressure play a greater role than age itself in problems with labor, delivery, and infant health (Yuan et al., 2000).