The shift towards older motherhood is irreversible and it is pointless to warn women to have their children by the age of 35 or risk their babies suffering a range of medical problems, according to Britain's top maternity doctor.
Dr David Richmond's relaxed view of the growing number of women delaying motherhood until their late 30s or early 40s contrasts sharply with the acute concern expressed in recent years by senior doctors, including the government's chief medical officer.
"I think it [the trend] is irreversible because of increasing equality in the social, professional, financial [and] corporate environment we live in. If you put a man in that situation, they would do exactly the same. I completely respect that position.
"Older women becoming mothers is a trend that's here to stay, I believe," Richmond said.
The average age of motherhood across all age ranges has been creeping up, and now stands at 29.8 years in England and Wales. The average age of fatherhood has also been rising.
"All I can do is say, 'Hang on, we're the ones at the receiving end and these are the problems that we then face,' and that's a challenge," Richmond added. Many women hold off starting a family until their mid-30s or later because they want to feel secure professionally and financially before taking maternity leave, said the doctor, who is the president of the Royal College of Obstetricians and Gynaecologists.
The most recent Office for National Statistics data shows that the number of live births in England and Wales to women aged 40 or over has risen more than fourfold from 6,519 in 1982 to 29,994 in 2012 – out of the 700,000 babies born that year. Similarly, the number of babies born to women over the age of 50 has more than doubled in four years from 69 in 2008 to 154 in 2012.
Later maternity can reduce a woman's chances of conception and involve a greater risk of miscarriage, a more complicated labour, and medical intervention at the birth.
However, most women who leave it late know the risks they are running, the doctor believes.
"I would have thought that that message [about the potential risks] is out there. I think those who are delaying their pregnancies are by and large well aware of what's happening. Those who delay, both men and women, are probably well aware of what's happening. I think it's a conscious decision," Richmond said.
Asked about obstetricians previously telling women in strong terms that they should have their family before their fertility started to decline in their mid-30s, he said: "Education might help arrest the trend, [but] informing them of the facts, that can only help a little. I think society's changed. I don't think [health] professionals can influence that societal change."
Richmond's pragmatic, understanding attitude contrasts with the stance of the college he heads. Its statement on maternal age in recent times has emphasised that "there is an urgent need for better public information on the issues surrounding later maternity" and that "later maternal age is an emerging public health issue". It also stressed that while women should be supported in their life choices, "both women and society need to be aware of the possible problems that older mothers may encounter".
Research last December from the respected Karolinska Institute in Sweden found that the risks of older motherhood compared with those face by younger mothers – stillbirth, a greater chance of premature birth and low birth weight – began in women as young as 30-34, and not just those over 35, as had previously been thought.
Richmond was also unconcerned by the extra costs often involved in the treatment of older mothers. The continuing trend of older motherhood "is going to be a financial burden and a healthcare burden. But the number of women over 40 having babies is a fraction of the whole, so it's probably an inconsequential financial burden," he said.
