It is not that far back in time when women awaited with extreme anguish the arrival of their period. The women of the developing world which do not have complete access to the family planning and voluntary abortion, still pay a "high price" for the so-called clandestine abortions, with serious complications as infertility and often death.
Progress such as family planning, access to the voluntary abortions, schooling and the financial independence of women, allowed a dissociation between sexuality and reproduction, which postponed the age when a child was desired.
The desire for being mother always exists, but the first pregnancy occurs more and more tardily, naturally decreasing the number of children per woman.
However, it is not exceptional to see a 50-year old woman give birth, this being most often seen among women with multiple pregnancies.
This phenomenon of "late maternity" develops while exposing a certain ignorance of the physiology of the woman, physiology which changed little since the beginning of times.
Indeed, conception is a natural and random phenomenon with little control over it. Ability to conceive steeply decreases with age. This decrease is in connection with the fall in quantity and quality of the ovules of the woman and the spermatozoa of the man. The rate of conception per sexual relation is 25% at 25 years, 12% at 35 years and 6% at age 40. One finds the same limitation levels after heavy treatments by In vitro fertilization (IVF).
Not only women wish to have their first baby later, but they also accept solutions to their possible problems more lately; thus in the French statistics, 50% of the women treated by IVF have more than 35 years and in Douala, 50% of these women have 38 years, 15% even have 40 to 44 years.
Another fact is that of complications for the pregnancies of 40 years old women, namely high blood pressure, miscarriages, delivery problems, and foetal malformations ... The age of 37 years seems to be an age limit before which it is necessary to have had taken a decision.
In conclusion, it is not that one should see a dark picture nor to discourage the "40-something" from taking benefit of the latest technical and social advances; the structures of medical care evolve with time. However each woman should have all the available information on conception before making an informed choice, because after all, this is indeed a choice.
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