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In recent years, the rate of first-time births for women in
their late 30s and 40s has soared. Thanks to advances in
technology and obstetrical care, the health risks to these
older mothers and their babies have been reduced and postponing
motherhood has become a viable option for millions of
women.

Diana Dell, M.D., an assistant clinical professor in
obstetrics and gynecology and psychiatry at Duke University
Medical Center says that the decision about having children at
a later age is increasingly reflected in our culture.

"We see this today in popular shows, such as 'Friends,' in
which characters get into their early 30s and begin to explore
this question in a serious way," she says. "There are probably
career women, career couples, who are writing for these shows
who are looking at these issues in their own lives."

Dell is co-author with Susan Erem of "Do I Want to Be a
Mom?: A Woman's Guide to the Decision of a Lifetime"
(Contemporary Books/McGraw-Hill, 2003). Their book looks at
decisions about motherhood from medical, emotional, sexual,
social and financial perspectives, including the pros and cons
of midlife motherhood.

According to Dell, there are a number of important questions
a woman may want to ask herself before deciding whether to have
a child at a later age. Among these are:

• Will there be other moms my age?
• Where will I be in my career?
• How well will I know myself?
• Will my parents be around to help?
• How will it go with my mother?
• Will I find the right partner?
• Will I have energy for kids?

Dell says a woman should also realize that, the older she
gets, the more difficult it may be to conceive.

"Once a woman reaches age 30, there is a significant decline
in her fertility, a really significant decline by the time she
reaches 40," she says. "There are certainly higher rates of
obstetrical complications and more chromosomal abnormalities
possible in the infant, because of aging of the eggs. And Mom
herself at an older age probably has lower energy. Babies
require an incredible amount of energy."

On the other hand, Dell adds, older motherhood definitely
has its advantages. "Mom is wiser. She is more patient. She's
less reactive in many ways because she has learned over time
that things that seem insurmountable will pass over time. She's
got a better support system. And she may have gotten to a place
in her career where she can make choices in terms of the kind
of help she can have to help care for a child. So there are
pluses and minuses to waiting."