Giving Birth at 40, Late Motherhood in Cuba

While fertility rates in Cuba decrease in most age groups, the downward trend does not occur among women who are between 35 and 39 and between 40 and 44 years old. (14ymedio)

14ymedio bigger14ymedio, Luz Escobar, Havana, 16 June 2018 — Marcel runs through the park while his mother follows him everywhere and, between races, sits on a bench to rest. She is 47 with a small son who hasn’t started school yet. She is one of the many Cubans who preferred to give birth in her 40s despite the risks, social prejudice and “the fatigue that comes with age,” she tells 14ymedio.

They are women who do not have the energy of a twenty-year-old and are already combing gray hair, but have in their favor greater maturity, family stability and professional development. Many of these late mothers have been wanting to get pregnant for decades, others waited for better conditions to bring a child into the world, and for some of them, the arrival of a baby was a surprise.

When they show up pregnant at the OB-GYN clinics they are called “elderly” and talked to about risks and problems. Because along with social prejudices that see motherhood as something exclusive to young women, they must also face a public health system that has a hard time adapting to a global phenomenon: the postponement of pregnancies.

When they show up pregnant at the OB-GYN clinics they are called “elderly” and talked to about risks and problems. (14ymedio)

Grisell Rodríguez Gómez, a psychologist and researcher at the Center for Demographic Studies of the University of Havana, has studied this trend on the island. “The fertility of women over 30 years of age began to rise” explains the specialist, who says there is currently “a greater presence of mothers in these ages,” in Cuba. The Cuban health system considers any woman who is expecting a baby after the age of 35 as a “high risk” patient, although it is not contraindicated to conceive a child at this stage of life. “My doctor at the Family Clinic cried to high heaven and predicted a rather dark picture for me,” says Marcel’s mother. 

“I was the first pregnant woman in her 40s she had cared for and she was very nervous, because doctors are very demanding when it comes to a baby that is coming… There is still a very narrow mentality about motherhood at this age and they see us as a phenomenon, an abnormality, sick mothers,” she emphasized.

Little by little, society has had to get used to the presence of these mature women who push a baby stroller and are not grandmothers. The economic crisis of the 90s has been one of the triggers causing the postponement of motherhood, because many women preferred to wait for better times, according to several specialists consulted by this newspaper.

The Cuban health system has had to get used to the presence of these mature women who push a baby stroller and are not grandmothers. (14ymedio)

While the fertility rates in Cuba decrease in each age group, the downward trend does not occur among women between 35 and 39 and between 40 to 44 years old, who have steadily shown an increase in motherhood in recent decades, as proven by data collected by the National Statistics Office.

At 39, Ariadna López is preparing to enter her fourth decade of life with a newborn baby in her arms. She is now seven months along and one day she woke up with the suspicion that her second son was coming ten years after she had her first. A new relationship had started and her husband was happy with the announcement.

“The family doctor was scared at first,” recalls Lopez. “When I gave her the news, she raised his eyebrows in concern,” especially because now the Public Health authorities in the municipality of Habana del Este where she resides, “are in a tizzy because they have an old pregnant woman, which is a headache.” Lopez immediately began a strict plan of prenatal vitamins and folic acid. If it had been a planned pregnancy it would have been better to start with this regimen even before conceiving the baby to ensure the correct development and functioning of the brain of the fetus. 

The feminist activist Marta María Ramírez recently announced her pregnancy on social networks. At 42, each consultation has been a battle to stop them from treating her “with fear because of the risks involved in pregnancy” at her age. She is tired of hearing phrases like “let’s have a look at your problem” and she prefers not to know the biological sex of the baby until the delivery, something difficult for the medical staff to understand and accept.

According to a study conducted by several specialists and published in the Cuban Journal of Obstetrics and Gynecology, “a woman in good health” and “with adequate prenatal care” is very likely “to have a happy delivery and a healthy child” although they clarify that the health system of the Island must prepare itself to deal with the tendency to become pregnant later in life.

Society has had to get used little by little to the presence of these mature women who carry a baby stroller and are not grandmothers. (14ymedio)

“Many of these pregnancies are not spontaneous but occur in mothers who have had fertility treatment for many years,” explains Kenia Ferrán, a Cuban obstetrician who worked for years in the public health system until in 2017 she emigrated to Ecuador. of these pregnancies begin from the beginning because there is a high rate of spontaneous abortions among women over 40.”

If they manage to overcome the first trimester of pregnancy,”they still face the high possibility of suffering from gestational diabetes and hypertension, problems that affect not only the health of the pregnant woman but also the baby,” Ferrán said. “Genetic risks are also high, such as the presence of chromosomal alterations such as Down syndrome.” 

However, Ferran says that in her professional life she has treated “many women who decided to become mothers after 40 and in most cases everything has gone very well. The most important thing is the follow-up and above all, ethically, to respect the decision that the woman has made. We are here to accompany her on that trip, not to criticize her.”

Some of the women she cared for in her clinic “waited to have a place to have a child, because the housing difficulties force many of them to postpone the moment.” The economic situation and “dreams of emigrating” also influence the decision, along with “the desire to take more advantage of professional opportunities in the 20s and 30s,” she says.

Beatriz Medina, 41, has two children from a first marriage and this week she visited the Ramón González Coro Gynecology-Obstetric Hospital in Havana to ask for advice about a new pregnancy. “Among the problems they told me is the chance that the child will beborn underweight or that I deliver early,” she says, and immediately says that she is not afraid.

Medina, however, does not feel so confident about what will come next. “I estimate that at 60 I will still be taking care of a young man and the generational abyss will be tremendous.” The mother is concerned “that she she won’t live to see him develop his professional life, be an adult, have his own children,” although she believes that she will have “more maturity to educate him and more resources to support him.”

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