Has not yet given birth: Why is it time to forget the word "old-bearing"
Olga Lukinskaya
WORD "OLD-BREEDING" many have heard - if not directly from health workers, then from the stories of friends or acquaintances, who were called so by the doctor or nurse. In the English-speaking world, the expression “geriatric pregnancy” can still be heard - and so is called a pregnancy that has arisen in a woman over thirty-five years old (see Megan Markle). We understand if age is so important - and even if it is important, why be careful with terms.
Everyone heard about the dangers and difficulties of “age-related pregnancy” - starting with the idea that after thirty-five it will be difficult to conceive. Theoretically, since new eggs do not appear, but with each menstrual cycle they are spent, at some point the stock can really be exhausted; On the other hand, most women still have menopause in about fifty years, and hormonal contraception makes it possible not to waste eggs at all.
Studies show that if fertility declines with age, it is insignificant - for example, in a study of 346 women from 20 to 44 years old who, during the observation, succeeded or failed to get pregnant, the average age did not differ between groups. It is believed that by the age of forty, one out of every ten women becomes pregnant during one menstrual cycle — that is, it is quite realistic to become pregnant during the year. In another study, fertility declined after 35 years of age - but primarily for men.
Often, there is another argument concerning age, the accumulation of genetic mutations that occurs over the years. It really increases the risk of lethal combinations in the embryo: the probability of miscarriage in the early period increases. True, the figure is not critical - by the age of thirty-five it is 20%, while the younger women also have a non-zero risk. The possibility of chromosomal abnormalities in the fetus is also gradually increasing, but again, not much - for example, by the age of 45, the probability of Down syndrome in a child exceeds 3%.
About the risks - real and fictional - we have to hear all my life, so that constant reminders of age do not contribute to peace of mind. A review of fifteen publications on the topic suggests that reminders of age-related hazards only increased anxiety in pregnant women. At the same time, the actual risk level is always individual and depends far not only on the number of years lived: systemic diseases play a serious role. There are many conditions that increase the overall level of risk to high — among them, severe heart failure, diabetes mellitus with insulin dependence, autoimmune diseases, and smoking more than ten cigarettes a day. If these conditions are added at a score of 10 points in the risk assessment, then age (over 35 or under 13) gives only 5 points - that is, the risk increases, but not critical.
Pregnancy can be defined as complicated or uncomplicated, associated with low, medium or high risk - but certainly not as “age-related” or “senile”.
However, when in other areas of medicine they talk about elderly patients with frequent comorbidities, people who are at least 65 years old are meant - in fact, geriatrics are involved in such patients. It turns out that the wording contradicts itself: a young woman, and her pregnancy is “old”. It is also unpleasant that the “old” in this context literally equates to the “bad”.
Given all the above, mark pregnancy as dangerous or severe only on the basis of age can not. In the United States, the PRAMS program has been going on for many years, under which a variety of data on pregnancy is collected for future analysis - including information on income levels, whether pregnancy was desired (and whether it was planned right now), contraception and family violence. . It is likely that, as a result of this analysis, new risk factors may emerge that were not previously taken into account. And it is already clear that pregnancy can be defined as complicated or uncomplicated, associated with low, medium or high risk - but certainly not as "age", "geriatric" or "senile."
At the same time, it is important that often pregnancy after thirty turns out to be much more conscious: the mother already has financial stability and an understanding of how she wants to raise her child. According to one British study, the largest number of unplanned pregnancies were between 20 and 34 years old. It is necessary to take into account not only physiological health, but also the psychological readiness to have children - and not the fact that the first aspect is more important than the second.
The abusive term "old-borns" is now replaced by the phrase "older reproductive age" - this is a good option for keeping medical records, but again it will not be very appropriate at the reception. It all depends on the individual characteristics of health and lifestyle, and a particular woman is 35, 42, or even 48 years old, and the pregnancy can be easier than a specific twenty-year-old. At the same time, this kind of “anxiety” for some reason does not concern men who became fathers at a really older age, like Alec Baldwin at sixty or Mick Jagger at seventy-two. Symmetrically abusive words like “the old-timer” simply do not exist: fathers are not criticized for “exposing the health of the child at risk” and not asking how they plan to run after the kid on the playground. Women, in addition to intimidation, have to face accusations and insults solely because of their age.
Photo: LeslieAnn - stock.adobe.com