Massachusetts leads a trend of later-in-life motherhood
Shal Shahani got married in her mid-20s, while she and her husband were still in graduate school. They knew they wanted to have children, just not right away.
“It was a very conscious financial decision,’’ said Shahani, now a 37-year-old real estate agent in Newton. “We were just starting out.’’
In April, Shahani had twin girls, Rayna and Raiva, who joined a surging demographic. About 30 percent of babies in Massachusetts are now born to women 35 and older, the highest rate in the country and a striking sign of the societal shift toward having children later in life.
The new statistics, released last week by the US Census Bureau, show Massachusetts at the forefront of the national trend, followed by New Jersey, Rhode Island, the District of Columbia, and Connecticut in proportion of births to women between the ages of 35 and 50. The survey, taken from 2005 to 2009, included all births, not just first children.
Nationally, about 14 percent of all births in 2008 were to women 35 and older, up from 9 percent in 1990, according to a 2010 Pew Research Center study.
While women in general are waiting longer to have children, well-educated, professional women are particularly likely to defer parenthood, say specialists. Massachusetts has a greater percentage of college graduates than any state in the country, and the Boston area has a particularly strong concentration of women with high-powered careers.
Thus, it is no surprise that the trend to delay having children was particularly strong in Boston’s suburbs. In Norfolk county, for example, more than 38 percent of births were to women 35 and older.
“Women who are better educated tend to postpone having children,’’ said D’Vera Cohn, a senior writer at the Pew Research Center who has studied motherhood.
In the case of Shahani and her husband, the idea was to wait until they were professionally established. “If we had them any other time, we wouldn’t have been as ready,’’ said Shahani, a sentiment echoed by many mothers in their late 30s and early 40s in the Boston area.
While mothers like Shahani are prevalent in wealthy suburbs, they are less common in cities. In Suffolk County, which includes Boston, Chelsea, and Revere, the rate of over-35 births was 24 percent; in Worcester County, it was 25 percent.
Specialists cite several other factors behind the shift. Massachusetts residents marry much later than the rest of the country, with a median age at first marriage of about 30 years for men, 29 for women. And they have access to fertility treatments that have become increasingly effective.
Massachusetts is one of 15 states that require insurance policies to cover some level of fertility treatment, according to The National Infertility Association. Michael Greene, chief of obstetrics at Massachusetts General Hospital, said he has seen more successful in-vitro fertilizations in recent years, including many women in their 40s using donated eggs.
But Greene and other physicians caution that older women face a range of heightened risks during pregnancy, from miscarriage to premature birth to Down syndrome.
“It’s unfair,’’ Greene said, “but it’s biology.’’
Older women are also more likely to have preexisting health conditions that can complicate pregnancy. Yet because the risks are small and examples of successful late pregnancies so common, many women downplay the dangers.
“By and large society has made this leap without thinking about the medical ramifications,’’ said Carolyn M. Zelop, director of maternal-fetal medicine at Beth Israel Deaconess Medical Center. For instance, though the risk is relatively rare, women 35 and older are three times as likely to die during or shortly after pregnancy than women in their early 20s, Zelop said, citing government health statistics.
Such worrisome facts have done little to slow the trend. Nationally, in 1970, just one in 100 first births were to women 35 and older. In 2006, 1 in 12 were, according to a 2009 study by the Centers for Disease Control and Prevention. Over that span, the average age of first-time mothers rose from 21.4 years to 25 years.
In Massachusetts, the average has risen to about 28 years old, the nation’s highest. Birth rates among women 35 to 39 have risen 55 percent, and among women 40 to 44, they have surged 88 percent, according to state public health figures.
For doctors who have seen an influx of middle-aged women undergo often grueling fertility regimens to have a child, the statistics confirm the scope of the change and show how far societal expectations have shifted when it comes to starting a family.
“Over the last five years, it’s been the 40- to 50-year-olds that are rising the sharpest,’’ said Katherine Economy, a maternal-fetal medicine specialist at Brigham and Women’s Hospital. The trend of women having children later, she said, has reinforced itself by showing more women the potential of fertility treatments and late motherhood.
The change has primarily been a middle- and upper-class phenomenon. In 2008, for example, more than 60 percent of new mothers in their 30s and 40s had graduated from college, compared to about one-quarter of new mothers in their 20s.
Rebecca Sly, who designs educational curricula at software giant Oracle, got married in her early 30s, and she and her husband decided to wait on children until they bought a house and got settled.
“We didn’t feel quite ready,’’ said Sly, 39.
When they did, the couple struggled to get pregnant before turning to IVF treatments, and in 2007 they welcomed Lizzie into the world. Twenty months ago, Sly gave birth to twins, Alex and Emily.
“We don’t have the energy level we had,’’ she mused. “But we have more wisdom.’’
Matt Carroll of the Globe staff contributed to this report. Peter Schworm can be reached at firstname.lastname@example.org.