Pregnancy for Older Women: Assessing the Medical Risks

Pregnancy for Older Women: Assessing the Medical Risks

Pregnancy for Older Women: Assessing the Medical Risks

Pregnancy for Older Women: Assessing the Medical Risks

Synopsis

Preface Medical Risks and Medical Beliefs Assessing the Medical Literature Important Issues for Older Women: Down's Syndrome, Infertility and More The Circumstances Surrounding Later-Life Pregnancy Past and Present Pregnancy for Older Women Appendixes: Studies of Advanced Maternal Age and Eight Pregnancy Outcomes, United States, 1917-January 1983; Percentage of Studies Falling into Each Rating Category According to Pregnancy Outcomes Studied and Findings Concerning the Effects of Advanced Maternal Age; Selected Medical Views Concerning Pregnancy at Advanced Maternal Age; Incidence of Down's Syndrome by Mother's Age: Four Samples; Selected Etiological Studies of Down's Syndrome References Index

Excerpt

This book is about choices-specifically, the choice of a woman to experience childbearing after the customary safe age of 30 or 35. As Barbara Ehrenreich and Deirdre English have shown us in their fine historical analysis, For Her Own Good, American women throughout the last 150 years have had many important decisions in their lives made for them by a variety of professionals who "knew best": home economists, pediatricians, and psychologists, to name a few. I hope that the material in this book, in clarifying our understanding of ways to evaluate age-related pregnancy risks, will help women to reclaim their right and obligation to informed decision making concerning this important life event.

In the last decade or so, as an outgrowth of the women's movement, increasing numbers of women have chosen to delay motherhood and have turned to still another group of professionals for advice, this time physicians. Traditional medical teaching has been pessimistic, laden with predictions of birth defects, complications during pregnancy, and lengthy labors and difficult deliveries. Yet, at the same time, stories in the media have documented problem-free childbirth experiences for women in their thirties and even early forties, who were well beyond the presumed safe boundary of age 35. I knew from my work as a psychologist and health educator that women were having a difficult time making important career and parenting decisions as a result of this conflicting evidence.

My research, then, was an attempt to somehow reconcile these discrepant views. First I would carefully examine the scientific sources of the pessimistic medical view to see if they were sound; then I would identify the special features of contemporary later-life pregnancy that might explain current-day successes. From the start, after only a superficial review of selected studies, I knew that there were serious methodological and statistical inadequacies that I believed threatened the conclusions of the studies. For instance, researchers who found increasing complications among older women tended to blame intrinsic biological factors related to aging without recognizing that other correlates of aging women could have explained the observed associations. I ended up spending much of my energy identifying these . . .

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