This Mother Had A Baby At 50 Without Intervention. Here's What She Learned.
When Lisa Weber, a 44-year-old saleswoman, married her second husband, Lee, in 2004, she already had three sons from her first marriage. Lee, meanwhile, had no children of his own and was keen to carry on his family name, so the newlyweds set about trying to add a fourth to their brood. But after two painful miscarriages, they halted their efforts.
“Having another child would be nice—the icing on the cupcake,” Weber remembers thinking. “But it wasn’t like if we didn’t have a child, we wouldn’t be happy.” So, with the dream of having another child dashed, the couple continued on with their lives, content to raise their three active boys together.
By her late 40s, Weber was experiencing symptoms of perimenopause, including the occasional missed period. Assuming she was no longer fertile, she went off birth control. It was at a wine-tasting charity event, when she was 49, that she suspected something truly unexpected had happened. “I love wine, and none of the wine tasted good at all,” Weber says. She also felt exhausted and left the fundraiser at 9 p.m. “I got home and thought, Oh my god… I don’t like alcohol, and I’m unbelievably tired. I bet I’m pregnant!”
At the time, she felt (in her own words) “a little embarrassed” about the possibility of being pregnant given her age, so it was with the stealth of a jewel thief that she went to the drugstore to acquire a pregnancy test. “I didn’t say anything to my husband because I didn’t want to get his hopes up,” she says. She didn’t need to worry: When the timer went off, the results were clearly positive. “My husband’s first words were, ‘I’ll never be able to retire,’ ” Weber says.
All joking aside, Weber—and Lee—were thrilled that they were going to have a child. When she delivered son Blake in 2010 at Mercy Medical Center in Baltimore, Maryland, at the age of 50, she was told by hospital personnel that she was the oldest woman to give birth there who had conceived naturally. Weber went into menopause soon after. (Breastfeeding and hot flashes—what a combo!)
Today, at 64 years old, she’s getting ready to send Blake, now 14, to high school. “It’s been such a blessing,” she says. “He absolutely helps keep me young.”
The Pregnancy Age Bump
Though Weber’s experience of getting pregnant naturally at 49 is rare, it is emblematic of a cultural shift in the whens, hows, and whos of pregnancy. Indeed, while there used to be a time when the astonishing feat of a 50 something woman giving birth might get splashed across the cover of a supermarket tabloid alongside photos of “Bat Boy” and a slice of toast that resembles Elvis Presley, advances in fertility technology such as egg freezing and in-vitro fertilization (IVF) have now made pregnancy at 40, 45, and even 50-plus more possible. And not just for rarefied celebrities like Hilary Swank, Janet Jackson, and Halle Berry.
In the U.S., we’re delaying pregnancy even longer (the average age for a first-time mom has increased from 25.6 years old in 2011 to 27.3 years old in 2021), and the number of women giving birth in middle age, specifically, is on the rise. For women ages 40 to 44, the birth rate increased 4 percent between 2021 and 2022 (and has been continually inching up since 1985), while the birth rate for women ages 45 and over increased by 12 percent, according to the most recent data from the Centers for Disease Control and Prevention.
There are a number of socioeconomic, emotional, and physical drivers for this trend, according to Nicole Tchalim, MD, a reproductive psychiatrist at Columbia University’s Women’s and Reproductive Mental Health (WARM) program. “For some individuals, the answer might be that they didn’t feel they were at a financially stable place,” Dr. Tchalim says. “Perhaps [they] were wanting to have a more significant family relationship or partner relationship to feel comfortable bringing a child into the world. Or perhaps they were going through fertility treatments, and this is when they were able to get pregnant.”
For women who already have children and want more, it could boil down to new circumstances at home, as in Weber’s case. It’s a phenomenon that Mary D’Alton, MD, department chair and professor of obstetrics and gynecology at NewYork-Presbyterian/Columbia University Irving Medical Center, sees in her practice. “Usually, if someone wants to get pregnant in their 50s and their children are teenagers, there’s been a life change,” she says.
Examining The Fertility Question
While births among middle-aged women are on the rise, the statistics paint only a partial picture of pregnancy at 40 (and beyond). For many individuals, the journey toward a plus-sign on that little test stick is long, uphill, and sometimes even verging on Sisyphean. That’s because our fertility drops precipitously in middle age—through no fault of our own. We’re out here living our lives, watering our snake plants, attending book club, and all the while, our eggs are quietly, and without our permission, declining and degrading.
“We’re born with all the eggs we’ll ever have,” says Alicia Ogle, RN, an advanced practice nurse prescriber at the Mayo Clinic Health System. “To throw some numbers out there, at birth, a woman has 2 million eggs. At puberty, it’s 300,000, then it decreases to around 25,000 at age 37 to 38. At menopause, they’re nearly depleted.” And just because a woman has, say, 100 eggs left doesn’t mean they’re all viable eggs, as the quality of eggs declines over time. The result is rather bleak odds for conceiving after the age of 40 without the help of medical intervention.
“This is how I counsel my patients: You have about a 5 percent chance of getting pregnant spontaneously at age 40—it’s quite low,” says Dr. D’Alton. “It’s about 3 percent at age 43, and it’s very low at age 45. Less than 1 percent. Then, I would say close to zero after that.”
For women ages 40–44, the birth rate increased 4 percent between 2021 and 2022 (and has been continually inching up since 1985), while the birth rate for women ages 45 and over increased 12 percent. Source: CDC
How long a woman in midlife should try conceiving naturally before seeking fertility treatment is a question for her and her doctor. Dr. D’Alton, for instance, usually advises her patients try for three to six months. “It takes an average couple about four months to get pregnant,” she says. Ogle takes a more conservative approach. “For a woman in her 40s, I would recommend not waiting, and coming in for a consultation before they start trying.”
What does a fertility consultation look like? Once again, it will vary from provider to provider, but Ogle will typically begin with a battery of questions to understand her patient’s menstrual cycle. Next, she’ll do a physical exam utilizing an ultrasound machine to look at things like the fallopian tubes, ovaries, and uterus to check for potential complications such as fibroids. Then she’ll discuss the possibility of conducting an ovarian reserve test to determine how many eggs the patient has left. This can be done with either a blood test or another ultrasound exam to visually count the number of follicles (i.e., the small fluid-filled sacs that hold one mature egg) on the ovaries. (Ogle will also perform a semen analysis for the patient’s partner, if the patient has one. Infertility cuts both ways!)
From there, Ogle will have a baseline understanding of her patient’s fertility and can advise next steps—whether it be trying naturally for a few months or seeking assisted reproductive technology (ART) right away.
While we often think of IVF—in which a retrieved egg is fertilized in the lab with collected sperm and then placed inside the patient’s uterus—as the gold standard, there are other intermediary options that might be available to a couple, such as intrauterine insemination (IUI), in which sperm is placed directly into a woman’s uterus during ovulation. That procedure, paired with follicle-boosting medication, may be enough to achieve pregnancy. Though, as you may have guessed, success rates once again drop after age 40.
Navigating A Bumpy Road
When Brooke Glass, a 41-year-old copywriter, got married in 2017, she and her husband, Jason, wasted no time scheduling a fertility consultation with a well-regarded provider in the greater Boston area. (She had known since childhood that she wanted to be a mother someday, and around the age of 37, she began to have that sinking feeling that time might be running out—not based on anything her physician told her but simply due to the societal expectations placed on women.)
The appointment, unfortunately, was a disaster.
“The doctor said, ‘I’m not going to lie: At your age, it’s difficult. I wish I were a wizard and could erase a couple of years of your life, but I’m not, so we’ll work with what we’ve got,’ ” she recalls him saying. “I sat in our car sobbing for an hour. After a moment to reflect on our way home, I was like, ‘Which years of my life did he want to remove?’ Because I thought they were all important, even the bad ones—maybe especially the bad ones. Does that imply that the goal of having children is more important than anything else I’ve done—everything that led me to this place where I’m even in a position to have kids and be myself?”
The experience left Glass rattled, even though her test results indicated that IVF could be a very plausible option. But she knew she couldn’t go back to that physician, so she and Jason tried on their own for a few months to no avail. Eventually, she found another doctor.
“The [second] doctor we met with was the loveliest, warmest man,” Glass says. “He was just so sweet and so confident about my chances and so supportive and had a really ‘we are going to get this done’ attitude.”
That attitude would be necessary as they faced multiple disappointments in a row: One round of IUI and two rounds of IVF proved unsuccessful.
“It was more crushing than I’d expected,” she says. “I went into it thinking, This can’t work. So I didn’t think I had that much hope to dash, but I still remember where I was sitting when I got the news each time.”
IUI had never been part of her physician’s plan, but when Glass began ovulating earlier than expected, they tried to salvage the round of treatment by switching from IVF to IUI. (While insurance covered her treatments—except the “outrageous” copays—not everyone is so lucky; without insurance coverage, a person can expect to spend an average of $12,000 to upwards of $25,000 for a single round of IVF.) The test results indicated that the procedure had resulted in something, but it didn’t last long enough to develop into something more.
The first IVF procedure was a wash—her doctor wasn’t able to do a transfer because none of the embryos ended up being viable after testing. The same thing happened with the second round.
By the third round of IVF, she and Jason decided it would be their last. The emotional and physical effects were taking a toll on Glass. She had already begun to console herself with the things they could do without a baby in tow: Go to Europe! Buy a beach house! Their hopes were hardly buoyed when the doctor delivered the news that only one viable embryo had been retrievable for implantation.
“They usually want to implant multiple, but at this point, I was 43, and it clearly wasn’t quite as fruitful as they were hoping it would be. And then that one fighter…” she says, trailing off, tears building in her eyes. Because that one fighter, that one embryo, latched on and never let go.
Despite the excitement of the successful transfer, the pregnancy itself wasn’t any easier. Early on, Glass experienced breakthrough bleeding while at work and was sure she had lost the baby. Not long after, she fell, and while the baby, who was just shy of the age of viability, was fine, Glass started experiencing contractions. That was followed by preeclampsia (high blood pressure, which, left untreated, can lead to major complications for the mother and/or child), something that is more common among pregnant women in their 40s and 50s.
“Women who get pregnant later are more likely to have medical or surgical complications,” says Dr. D’Alton (who was not Glass’s physician). In addition to preeclampsia, complications can include miscarriage, gestational diabetes, and postpartum hemorrhage. Older women are also more likely to deliver via C-section rather than vaginally, and they have a higher risk for chromosomal abnormalities. For instance, the chance of conceiving a child with Down syndrome is 1 in 350 at age 35, and it increases to 1 in 30 by age 45. Studies have also found that likelihood of autism increases with maternal age.
Despite all of the hiccups along the way (and a raging pandemic), Glass delivered a healthy baby boy named Asher in 2020. “My first thought was, Thank god he has a chin. Because in one of those 3D ultrasounds, it really looked like he had lip all the way to here,” she says, pointing to the bottom of her face. “I was like, ‘I will love him no matter what, but oh, that’s so much for a baby to deal with.’ They brought him over and I was like, ‘Oh my god, that is a gorgeous face with all the parts where they’re supposed to be!’ ”
Looking At The (Older) Brain On Baby
For midlife mothers, the emotional rigors of getting pregnant can be just as profound, if not more so, than the physical. And for many, it’s the compounding grief of multiple losses and all those almosts that can ultimately cause them to question—or even end—their fertility efforts.
“Supporting individuals who are going through fertility difficulties in those 40s and 50s is becoming a growing area in our field,” Dr. Tchalim says. “People tend to underestimate just how much of an increased risk there is for some level of depressive or anxiety symptoms. You’ll often see that the treatment itself, due to some of the hormonal changes, can have quite a bit of a psychological impact.”
Even after a successful delivery, middle-aged moms are faced with unique challenges, including the possibility of stigma and criticism for having a baby “so late in life.” (Check out any Instagram birth announcement from any celebrity in her late 40s/early 50s and there will be at least one troll commenting on how she won’t be alive long enough to see her son or daughter get married or have children of their own.)
“There’s a lot of judgment made about women getting pregnant in their late 40s and 50s,” Dr. D’Alton says. “Nasty comments are made in the office where they’re working or in their neighborhood. That can be very isolating for patients.”
While Dr. Tchalim says that most of her patients’ friends and family members are supportive, she does sometimes hear about hurtful comments. “Some of the things that have been unfortunate for them to hear is other family members saying things like, ‘You should have started earlier’ or ‘You were too career-focused,’ ” she says.
For her part, Baltimore-based mom Weber has been mistaken for son Blake’s grandmother on multiple occasions. In middle school, Blake sometimes got picked on by classmates for having “old” parents. In those moments, Weber remains upbeat, even defiant. “When that happened to him in sixth grade, I said, ‘But I could probably outrun most of their moms!’ It’s the truth.”
When Dr. Tchalim’s patients are faced with any kind of negative feedback surrounding motherhood, she advises them to focus on their “why.”
“The people around you don’t understand why you decided to wait for that child, and they’re never going to fully understand, but you do,” she says. “Feel comfort in that and know that you made the best decision for yourself and your family.”
Indeed, while it’s easy to wallow in the negatives of becoming a mom later in life, there are plenty of positives to celebrate too.
“I’m sure there are people that have everything they need at 25 [to raise a child]—I was not that person at all,” Glass says. “I didn’t have the temperament, and I didn’t have the wisdom, insofar as I have wisdom now at 47.”
Weber, meanwhile, feels that with youngest son Blake, she’s able to give more of herself than she could as a younger mom to her other three sons. “I did not have the time for my other boys, as much as I would have loved to have enjoyed them,” she says. “I was a single mom for a part of their life, so I was really double-timing it. Now, I have more appreciation, I have more knowledge. Whoever wants to have kids when they’re older, more power to ’em.”
NO EGGS, NO PROBLEM?
The first “test tube baby” was born in England in 1978, and since tracking officially began in 1985, more than 1.2 million babies have been born in the U.S. with the aid of assisted reproductive technologies (ART), according to the American Society for Reproductive Medicine. While IVF has helped millions of people have babies who may not have been able to otherwise, it isn’t a panacea.
If a woman no longer has viable eggs—whether due to menopause or to undergoing a medical treatment like chemotherapy—no amount of ovarian stimulation is going to reverse that, and she may have to use a donor egg in order to conceive. But that could all change in the future: A team of researchers at Oregon Health & Science University, led by Shoukhrat Mitalipov, PhD, director of the OHSU Center for Embryonic Cell and Gene Therapy, are working on a new technique called in vitro gametogenesis (IVG), in which a skin cell is repurposed into an egg. (Sounds like something from a sci-fi movie, right?!) The process works by stripping the nucleus out of a donor egg and replacing it with the nucleus of a skin cell from the mother.
A similar technique was used in 1996 when researchers famously cloned a sheep named Dolly. But this process is slightly different, as the nucleus’s chromosomes are reduced by half, so rather than a direct clone of the mother, what’s produced is an embryonic egg ready for fertilization by sperm. (FYI, this process can also be done with a male skin cell, meaning a trans or gay couple could have a child that’s genetically related to both parents.)
Dr. Mitalipov’s team has already produced offspring in mice using this technique, and they recently published their findings in the journal Science Advances. “There is a lot of work to be done perfecting the technology and translating it to human eggs and embryos,” says Dr. Mitalipov, who estimates another decade of research and testing is needed. And, of course, IVG will also have to go through all the regulatory hoops. “Anything that relates to reproduction has lots of ethical issues, so that usually delays it,” Dr. Mitalipov says. But for would-be mothers and fathers of the future, IVG could really deliver.
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