What health implication does a woman having a child past age 35 bring?

Studies show that women are delaying motherhood more and more, and yet, only a few know about the health risks that come with it.

The questions were inevitable: family and friends started wondering when Miriam* was going to have a baby as soon as she hit 30.

She is a pilot and at the time, she would be away for work for five to six weeks at a time. She was also working towards becoming a captain, which, as soon as she attained the position, required a few years of proving herself, solidifying the position.

In 2009, Miriam was involved in a plane accident and during the six-month recovery period, she had time to think and realised she was missing out on motherhood. She was 33-years-old then. Apart from her demanding job, she and her partner worked in separate towns. She changed jobs so she could 'settle down' and moved to Nairobi to join her partner. She doesn't fly actively anymore.

They started trying for a baby, and after a year with no positive results, decided to see a fertility specialist. Miriam first went through a hysterosalpingogram (or HSG), a test that detects blockages in the fallopian tubes and abnormalities in the uterus, both of which can prevent pregnancy.

There were no physical problems detected. The doctor prescribed drugs that would regulate ovulation. Because her job required frequent travel and being away from home for weeks at a time, she wasn't able to take the drugs.

In October 2015, when she was 39-years-old, she found out that she was pregnant. Unfortunately in December that year, she suffered a miscarriage. "After that I wasn't in the right frame of mind to start trying again," says Miriam. In fact, she stopped thinking about it altogether.

Regular exercise helped get her out of the funk. "I started doing a lot of exercise, lots of boot camp and the good thing about exercise is, apart from helping you in keeping fit, it helps clear your mind. Before that, all I thought about was trying to have a baby. With exercise I got peace of mind. My thinking changed from desperately wanting a baby to 'If I get pregnant, well and good. If I don't, so be it.'"

She went back to the doctor's in May last year for the next course of action. After a blood test revealed again that there was nothing physically wrong with her, the doctor suggested assisted reproductive technology.

Before deciding what to do next, Miriam took a vacation and while away, she missed her periods. A test for pregnancy turned out positive. She had, she says, the usual nerves every expectant woman suffers, but that increased following routine questions by a radiologist who asked how old she was if that would be her first childbirth and whether she had done genetic testing (she hadn't). She had just hit 40.

"Naturally, I was worried when he brought up chromosomal abnormalities and how the risk goes up in older women," Miriam says. The screenings revealed a healthy foetus. The pregnancy went smoothly, "even smoother than those of my younger friends. I didn't have any adverse reactions to food, I didn't experience any nausea. I only had heartburns when I was nine months," she says.

She describes herself as a "laid back mother and more chilled out than I would have been if I had had the baby earlier." And because she is much better off now financially and mentally, "my partner and I worry less and enjoy the baby more, even though the sleepless nights are killing us," laughs Miriam, who requested that we don't use her real name to protect her privacy and that of her partner. Her last statement isn't surprising given the growing body of research that shows that older mothers are better, less worried mothers.

OLDER MOTHERS ARE BETTER, LESS WORRIED MOTHERS In the most recent study, researchers from Aarhus University School of Business and Social Sciences found that older mothers are less likely to punish and scold their children while raising them, and that the children have fewer behavioural, social and emotional difficulties.

This is as a result of psychological maturity attained with age. "We know that people become more mentally flexible with age, are more tolerant of other people and thrive better emotionally themselves. That's why psychological maturity may explain why older mothers do not scold and physically discipline their children as much," Professor Dion Sommer, one of the researchers of the study, said.

Sociology professor Grace Wamue-Ngare of the Department of Gender and Development Studies at Kenyatta University says that women are increasingly having their first baby later in life because of factors such as education and career advancements, improved contraception and high living costs.

But while women are attaining psychological well-being with age on one hand, biology is playing against them on the other. When Janet Jackson announced her pregnancy last year at age 50, comments on social media feeds varied from congratulatory messages to questions whether pregnancy at 50 is healthy.

Medical experts have warned about the risk factors associated with advanced maternal age, that is, when a woman is 35 or older whether the childbirth is the first or not. While the factors that determine when a woman should get pregnant range from one individual to the other, or as one doctor I interviewed succinctly put it, "none of our business," where the health of the mother and the baby are concerned, age does matter.