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PETALING JAYA: Putting her career first and wanting to be more financially sound, Lenny Kulleh decided that her hopes of becoming a mother would have to wait.
But when she got pregnant at 36, the operations manager from Sarawak felt concerned.
She was already over 35, or in the advanced maternal age, which comes with higher risks of complications during pregnancy.
“Immediately, I quit smoking – a habit I have had since I was 18,” said Kulleh, who also consulted a doctor about her health.
It was a smooth pregnancy and in March, she and her husband welcomed their bundle of joy – their son Caleb.
Lenny Kulleh, 36, (right), holding Caleb in her arms. With her is her friend Bernardine Grace Chong (left).
Celebrating Mother's Day for the first time today, Kulleh said she hopes her story will offer reassurance for women out there who were afraid of giving birth past the age of 35.
“If you want a child, don’t give up, get a good doctor and seek their advice,” she said.
Later motherhood
Kulleh is part of the increasing trend of women in Malaysia who are becoming mothers later in life.
Data from the Statistics Department showed that a higher percentage of babies were delivered by women aged 35 and above.
From 20.2% in 2017, the number increased to 23% in 2022, according to the department’s Vital Statistics Malaysia report.
This means that nearly one in every four babies in Malaysia is delivered by a woman of advanced maternal age.
Click on the "play" button below to see how this trend took shape in 2022:
Most or 77% of live births in the country are by women aged below 35.
However, the national average age of women who delivered their first child has increased from 27.3 years in 2011 to 27.9 in 2022.
Consultant obstetrician and gynaecologist and fertility specialist Dr Hoo Mei Lin said such trends were neither good nor bad – they were simply a reflection of modern times.
“Marriages are also happening later in life, with couples delaying childbearing to pursue their careers and education.
“Others want more time finding the right partner, enjoying their time as a couple and fulfilling personal goals,” said Dr Hoo, who is the past president of the Obstetrical and Gynaecological Society of Malaysia.
Consultant obstetrics and gynaecologist Dr Milton Lum added that such a pattern was occurring together with increasing urbanisation.
“Contributing factors include economic reasons like the rising cost of living, cost of raising a child and changing attitudes towards pregnancy,” said Dr Lum, a former president of the Federation of Private Medical Practitioners Associations and the Malaysian Medical Association.
The average age of women to have a baby for the first time also differs by state, with Putrajaya having the highest mean age.
The average age of a first-time mother in the federal territory is 29 – above the national average of 27.9.
Sarawak recorded the youngest average age at 26.8 years.
According to the data, ethnic Chinese and Indian women in Malaysia gave birth for the first time at a later age compared with others.
The average age of a Chinese woman to deliver her first child is 30.6, exceeding the national average of 27.9 years in 2022.
Similarly, the average age for Indian women to give birth for the first time is at 30.1 years.
Malaysia is No 2 in Asean
In South-East Asia, Malaysia is the second-ranked country with the highest percentage of babies born to women in the advanced maternal age, as of 2021.
Singapore topped the list with 27% of newborn children delivered by mothers aged 35 and above that year, followed by Malaysia’s 23.2%, based on figures from Our World In Data.
Consultant obstetrician and gynaecologist Datuk Dr NKS Tharmaseelan said it was a worldwide trend for more women to have babies later in life, especially in developed or developing countries.
“It is an expected outcome of development, but we should not be lamenting this.
“It just boils down to how we manage this situation to our best abilities,” said Dr Tharmaseelan, who is also a former Malaysian Medical Association president.
Current trends to continue
Experts believe that Malaysian women will continue to have babies later, but medical advances are also expected to provide support for such a situation.
The good thing about more women having babies later is that they are more mentally and financially prepared, said Subang Jaya Medical Centre consultant obstetrician and gynaecologist Dr Lou Wei Yeng.
“But most of them will have to bear the risk of advanced maternal age.
“This means there is a bigger risk of the mother having hypertension, gestational diabetes and a Caesarean delivery (the surgical delivery of a baby).
“For the baby, there is a higher risk of low birth weight, birth defects and perinatal death (death of a baby a few weeks before or after birth),” she said.
However, Dr Lou stressed that this does not mean that all pregnancies during the advanced maternal age will have bad outcomes.
“Most mothers still go through the pregnancy smoothly.
“Early and regular perinatal care increases the chance of having a healthy baby,” she said, adding that screening tests were also available widely to identify genetic disorders.
With Malaysia’s fertility rate dropping to 1.6 children per woman aged between 15 and 49, Dr Lou said such numbers will continue to drop.
“Unless the economy gets better, parenting will ultimately be more stressful.
“Nevertheless, the number of children might be reduced, but quality is always more important than quantity,” she added.
To counter the declining fertility rate, Obstetrical and Gynaecological Society of Malaysia honorary secretary Dr Loh Huey Wen said women should be made more aware about their fertility window through education.
Dr Loh said the availability of affordable and high-quality childcare facilities as well as flexible, part-time careers for women would also encourage couples to consider having more children.
An increase in the advanced maternal age
The advanced maternal age has been inching higher over the years and will keep going up.
“Just a few decades ago, it was 30, compared with over 35 today," said Dr Tharmaseelan.
“It will increase slowly by a year or two over time,” he said, adding that advances in medicine will help break the glass ceiling with better healthcare and screening techniques.
“Eating nutritiously, maintaining a regular exercise routine, not smoking, and managing existing health problems will also ensure a healthy pregnancy,” he said.
Dr Tharmaseelan said many have the mistaken impression that pregnancies at an advanced age were too risky and plagued with a host of problems for mother and child.
“With proper support and medical care, people over 35 can have healthy pregnancies and babies.
“Don’t miss the opportunity if there is a need and it is important to you,” he advised.
In future, Dr Hoo said it would be possible for women to have babies at an even later age.
“With advancing age, the chances of a successful pregnancy go down mainly due to a decline in the quality and number of eggs.
“At 40 years, we estimate only about 20% of eggs are healthy.
“This explains the reduction in getting pregnant, increase in miscarriage rates, chromosomal abnormalities like Down Syndrome in women who are pregnant after 40,” she said.
However, it may still be possible to have babies at a later age if a woman freezes her eggs earlier – ideally by age 32, Dr Hoo said.
“We cannot reverse time, so we need to continue educating women and their partners that if they see children in their future, there is a ticking clock.
“Older women can have safe, uneventful pregnancies – all that is required is planning,” she added.
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