Modern Maternity

Jennie Villa wanted to have it all. A great education and career. Financial security. A loving husband. And kids. For Villa, the dream came true, albeit a little later than she would have liked. At age 37, she met that man of her dreams. Three years later they got married. This past August, at age 41, Villa, of Cleveland, gave birth to fraternal twins: a son, Quinn, and daughter Kendall. Her life, she says, is "pretty perfect." And when it comes to her kids, she is over the moon. "I think they're a miracle," says Villa, who got pregnant the old-fashioned way, without the use of assisted reproductive technologies.

Any woman who has had a child after age 40 can understand Villa's hyperbole. That's because, statistically speaking, the chances of having a successful pregnancy at what doctors call an "advanced maternal age" are fairly dismal. By about age 40, a woman's chance of getting pregnant naturally is only about 5 percent in any given month (down from about 20 percent at age 30). The use of assisted reproductive technologies ups the odds—but not as much as it could if a woman were younger. By age 45, a woman's chance of getting pregnant with her own eggs is virtually zero.

Still, some women are defying those odds. According to the National Center for Health Statistics, the number of mothers giving birth at age 40 or older has doubled in the last several decades, partly due to medical assists like in vitro fertilization or the use of donor eggs.

The reasons women become first-time moms or add to the brood later in life are as varied as the women themselves. There are career goals to meet. And bank accounts to grow. Some women waited for marriage. Some never married at all. There are second marriages. And even surprise births.

For those who wait, getting pregnant is a roll of the dice even with the help of science. "Not every egg over age 40 is created the same," says Dr. Karen Ashby, assistant professor of reproductive biology at University Hospitals Case Medical Center. "Some healthy women will get pregnant without a problem, other women simply won't."

It's clear that even as medical interventions are helping more older women get pregnant, science can't keep up with the increase in the number of women who delay childbearing and then find themselves battling the clock. For every high-profile midlife mom like actress Marcia Cross or Nicole Kidman, there are lots of women who can't get pregnant. The total number of women age 40 to 44 who don't have kids at all is about 20 percent—double what it was 30 years ago, according to a census report released in August.