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Invited Commentary
December 2018

Balancing the Risks and Desires for Pregnancy in Older Mothers: Increasing Morbidity, Declining Fertility

Author Affiliations
  • 1Division of Family Planning, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora
JAMA Intern Med. 2018;178(12):1671-1672. doi:10.1001/jamainternmed.2018.4734

Over the past several decades, women have entered the workforce at continually greater rates as societal changes have allowed women more access to, and expectation of, full participation in education and paid work. As American women have taken advantage of these opportunities, childbearing has been increasingly delayed. In 1990, the mean age at first birth was 24.2 years, and by 2014, it had risen to 26.3 years.1 Furthermore, first births to women aged 35 to 39 years increased 64% between 1990 and 2012, while first births to women 40 to 44 years increased 230% in the same time period. Because the mean desired number of children for US women is 2.62 and fertility declines rapidly in the late 30s and early 40s, women having a child when they are older than 35 years are likely to plan to have their next child soon thereafter.

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