The optimal age for childbearing

Introduction: In Australia there is a growing trend for women to give birth later in life. In 2013 the average age of all women who gave birth was 30.1 years, compared with 29.5 years in 2003. The average age of women having their first baby also increased from 27.8 to 28.6 over this ten-year period. More significantly, the proportion of mothers aged 35 and over increased from 19 to 22 percent during this time [1]. The social and demographic changes seen in our mothers has led many to ask, "What is the optimum age for childbearing?" The answer to this question is complex, as it is impacted by many social variables as well as medical outcomes. Families, couples, individuals, and their prospective health care providers are likely to have different personal ideologies about family life and the importance of good health. Examining this question from a biosocial view, there is evidence that women who delay childbearing are more likely to have completed a higher level of education, have stable employment and have more wealth. They are less likely to be smokers, more likely to have a healthy diet and are more likely to book early for and attend antenatal care. These factors are all likely to lead to better long-term health outcomes for both the women and their babies. [2, 3] The tradeoff to these social and educational benefits is that with increasing age there are increases in the risk of miscarriage and stillbirth, along with an increase in prevalence of medical conditions which potentially affect pregnancy, such as high blood pressure, diabetes, and kidney disease [3]. There is no single right answer to the question, "What is the optimal age for conception?"; rather, a need to recognize that individuals need to be able to balance their physical, emotional, social, and financial wellbeing. We have limited this review to focus on the medical impact of maternal age in relation to pregnancy.