Exploring the older mother from different perspectives: the voices of women (an exploratory study of women’s views and experiences of delayed childbearing) Alison Cooke1, Tracey A Mills2, Tina Lavender2 1 Central Manchester University Hospitals NHS Foundation Trust, 2 The University of Manchester Introduction Results The trend for maternal age at first birth has steadily risen over the past two decades (1). Women are given a high risk classification for pregnancy due to their age. Obstetric and neonatal risks of delayed childbearing are numerous (3-6) but studies are methodologically limited. There is little qualitative research on this topic, and no UK-based research (7). Although health professionals focus on obstetric risks for this childbearing group, women do not appear to. Finding the right relationship, ‘being ready’ and ‘life experience’ are given as the main influences for timing of starting a family. Physical effects on the body and what society thinks are perceived to be the main disadvantages. Women report a lack of available relevant information and do not perceive age alone to be a risk factor. UK The voices of women “I think we should adopt … just to kill this loneliness” “delaying … that implies that there’s a choice” (2) “I always thought I would have time” “I always thought I could have children” Aims and Objectives “you don’t want to be seen as the grandma at the gate” Aims: to gain an understanding of women’s views and experiences of delayed childbearing and use the findings to inform clinical practice. Objectives: to explore what factors influence women’s decisions to delay childbearing, their experiences and perceptions of associated risk. Conclusions Health professionals need to understand the complexities surrounding women’s reasons for delaying childbearing. Sensitive information and support should be provided allowing for individual medical and obstetric history and varying perceptions of risk. Women may benefit from pre-conception education. Design A phenomenological qualitative study, using a Heideggerian approach to develop understanding and give meaning through exploration of the ‘lived experience’ of women who delay childbearing. Method References Sample: a purposive sample of 30 women at various stages of their life plan 35 & over, not pregnant, no children 35 & over, pregnant with their first child 35 & over, not pregnant, no children, infertility patients Data Collection: semi-structured in depth interviews and short questionnaire for background/demographic detail. Data Analysis: thematic analysis with a hermeneutic (interpretive) approach, using thematic networks (8) for organisation of emerging themes. 1. Office of National Statistics (2007) Birth Statistics: Review of the National Statistician on births and patterns of family building in England and Wales [Website] www.statistics.gov.uk/downloads/theme_population/FM1_36/FM1-no36.pdf [Accessed: 4 March 2009] 2. Karlin, A (2009) Rite of Spring: Russia Fertility Trends [Website] www.sublimeoblivion.com/2009/04/26/rite-of-spring/ [Accessed: 31 August 2009] translated from www.demoscope.ru Permission provided 15/10/09 3. Gilbert, W Nesbitt, T & Danielsen, B (1999) Childbearing Beyond Age 40: Pregnancy Outcome in 24,032 Cases Obstetrics & Gynecology, 93, 9-14. 4. Jacobsson, B Ladfors, L & Milsom, I (2004) Advanced maternal age and adverse perinatal outcome Obstetrics & Gynecology 104, 727-733. 5. Nybo Anderson, A Wohlfahrt, J Christens, P Olsen, J & Melbye, M (2000) Maternal age and fetal loss: population based register linkage study. British Medical Journal, 320, 1708-1712. 6. Temmerman, M Verstraelen, H Martens, G & Bekaert, A (2004) Delayed childbearing and maternal mortality. European Journal of Obstetrics & Gynecology and Reproductive Biology, 114, 19-22. 7. Cooke, A Mills, TA & Lavender, T (2010) ‘Informed and uninformed decision making’ – women’s reasoning, experiences and perceptions with regard to advanced maternal age and delayed childbearing: a meta-synthesis [currently in press] 8. Attride-Stirling, J (2001) Thematic networks: an analytic tool for qualitative research. Qualitative Research, 1, 385-405. Correspondence: Alison.Cooke@manchester.ac.uk