Family Planning for Older Couples

Do you have any advice for older couples who are thinking about having children? My husband and I are both in our early forties and are newly married. It's a second marriage for both of us, but neither one of us have children. We'd like to start a family of our own and we're giving serious thought to getting pregnant.

We want to begin by commending you on your open-mindedness. There are many couples at your stage of life who wouldn’t even consider the possibility of having kids. Scripture says that children are a blessing (Psalm 127:3-5), and we feel certain that the Lord is pleased with your willingness to accept this wonderful gift from His hand. But we also understand that you may have some special concerns about becoming pregnant after age forty. Our first piece of advice, then, is to look to God for wisdom, guidance and support as you work your way through this important decision.

As you and your husband discuss your options, several positives of having children at this point in life may come to mind. Couples at your life stage have had opportunity to mature and gain life experience. This will be an advantage to you as you take on the challenges and responsibilities of being a parent, and your kids will also profit from your accrued wisdom. Also, many “older” couples have achieved a greater level of stability – including financial security – than they enjoyed when they were younger. These can all make parenting a bit easier for you and can provide benefits for your children.

There are, however, several issues you should be thinking about. None of these things should necessarily dissuade you from trying to get pregnant. But you should be aware of them and take some time to talk about them in advance.

First, a woman’s fertility decreases rapidly after age thirty-five. This means that while you may get pregnant without any problems, it’s possible that it will take longer to happen. And if you find that you can’t get pregnant, you should know what other options are open to you – for example, adoption or assisted reproductive technology. When thinking about the latter you will want to consider how assisted reproduction aligns with your faith and faith tradition, and you’ll need to discuss the moral, ethical and practical implications of each of the technologies (e.g., in vitro fertilization) you are considering. You and your husband should be on the same page where all of these questions are concerned. You should also discuss them at length with an OB/GYN before attempting to get pregnant.

Second, if you have any underlying medical conditions that might complicate a pregnancy – for example, high blood pressure, heart disease, kidney disease, or diabetes – you will need to discuss them with your doctor to see how they might affect your health and that of your baby.

Third, as a couple gets older the risk of birth defects, particularly Down syndrome, increases. Talk with your health-care provider about age-associated risks, as well as any family history of certain birth defects. Find out what the chances are that your baby will be similarly affected. It’s also a good idea to begin taking prenatal vitamins with folic acid now while you are contemplating pregnancy. These supplements can reduce the risk of neural tube defects and possibly other types of birth defects.

Fourth, if you do become pregnant, you’ll have to decide whether you want to undergo prenatal screening to determine your child’s risk of having a birth defect. And if you choose to go ahead with the screening, you’ll have to make up your minds how you will manage the results if your child receives an adverse diagnosis. Are you willing to carry your baby to term regardless of whether he is healthy? (We recognize this is a sensitive topic, but we would urge you not to get pregnant if you are not willing to carry to term.). Some couples choose to forgo prenatal screening because they know they will carry their baby to term regardless of the results. Others, who are just as committed to carrying their baby through to birth, opt for screening with the understanding that advance knowledge about certain defects can help them to provide better care for their child prior to birth, as well as allow them to prepare more effectively for birth and childcare.

As you talk with your doctor about the risk of congenital anomalies, he or she may mention the likelihood for various birth defects based on your age and other factors. For example, you might learn that, given your risk factors, you have one chance in forty of giving birth to a child with Down syndrome. While we wouldn’t dismiss that risk or minimize the emotional impact of such a report, it’s worth remembering that your chance of having a baby without Down syndrome is thirty-nine to one. Bear this in mind as you and your husband talk about pursuing a pregnancy.

While we are on the subject, one very important question to consider is how you would react to a diagnosis of Down syndrome. Although we’ve discussed Down syndrome itself as a risk, children with this disorder are not “risks” – they are precious lives that bear the image of God. While the initial diagnosis of Down syndrome is fraught with many difficulties – and often pain – most parents of children with this condition find their lives are filled with many unexpected joys and blessings.

In addition to all these considerations, you and your husband may wish to discuss the lifestyle changes you’re likely to experience with the birth of a newborn. Is your house big enough to accommodate a new addition, or will you have to move or remodel? How might your work situation (or your husband’s) be affected? Discussing these issues can help identify those areas of your marriage that need special attention in order to minimize the risk of disruptions to your relationship. You might find it helpful to talk with a Christian counselor or with other couples who have had children later in life to get their perspective on some of the changes that are on the horizon.

One last thought. While it’s good to think about the things we’ve mentioned, you shouldn’t let yourself get overwhelmed. It’s easy to focus on potential problems and complicating factors and forget the central issue – namely, your desire to bring a new life into the world. Some of the considerations we’ve talked about are weighty, but it’s important to remember that later-in-life pregnancies can also be a source of amazing joy and satisfaction.

If you need more advice, call us. Focus on the Family’s Counseling Department can provide you with referrals to trained counselors practicing in your area. Our Counseling staff would also be more than happy to discuss your situation with you personally over the phone.



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