When can a woman comfortably venture into parenthood?

The Medical View: Beyond the question of age and readiness of the body to bear children, there are issues of psychological and financial preparedness for a woman to be a parent. Of course, the babies may come at any stage, but what effect does this have on your general wellbeing, your babies’, and the quality of life you will live after this?

According to the World Health Organisation (WHO), at least one woman dies from complications related to pregnancy or childbirth every minute, which translates to 529, 000 a year.

For every woman who dies in childbirth, the organisation reports, around 20 more suffer injury, infection or disease, which is about 10 million women each year.

It is further reported that some age groups are more at risk of suffering child birth related deaths and complications than others, as explained below;

Less than 21 years: The riskiest phase
According to Dr Mike Kagawa, a gynaecologist and obstetrician at Mulago hospital, Kampala, neither the mind nor the bones are ready for childbirth below 21 years of age.

“The bones are a real danger,” the doctor emphasises, “When the bones are not ready, this means that the pelvis may not allow the baby to pass through.”

He adds that if a baby fails to pass through the pelvis for a natural birth to take place, then there are chances of a woman having obstructed labour, which is associated with complications like a ruptured uterus, leakage of urine (fistula), and an increased risk of losing the baby. The leakage of urine results from the woman having pushed a baby without the baby coming out.

“She might require to be delivered by Caesarian Section, which means that the chances of delivering again by operation are increased by over 80 per cent just by doing it once, compared to someone who has delivered naturally,” Kagawa says.

The death threat
Women with obstructed labour are more likely to die because it is one of the leading causes of maternal death. These women are also at a higher risk of having infections after giving birth (sepsis), which is also another common cause of maternal death.

The chances of suffering bleeding during child birth, yet another cause of death, are also increased. “Generally, small bones are not a good thing in child bearing, so, we want them to have grown and matured before they start bearing children.”

When someone delivers very early, they sort of suddenly mature, he adds. “We cannot say that when one gives birth at seventeen, they come back at twenty five much better,” says Kagawa, explaining, “The bones will not grow anymore; the way she was at seventeen is the way she will be, the bones remain the same. Yet, if she had not delivered, the bones would have grown much more and would have been ready for child birth.”

21-35: the best years
According to Kagawa, this is the safest time for all body systems, because at the time, the systems have settled for reproduction.

After 35 years
According to the gynaeclogist, a woman is born with all their eggs and each month they lose some in menstruation. This means that the “store” eventually gets depleted. Fertility decreases with age and after 35 years, it is even harder to conceive and if one does, there are several associated complications.

Associated risks after 35
These complications include malpositions (wrong baby birthing position), multiple pregnancies, congenital abnormalities (present at birth), high blood pressure and diabetes although this has a familial predisposition.

Being above 35 years has its own risks and yet aside from one’s age and the risk factors, multiple pregnancies alone is a complicated pregnancy. “It is associated with high blood pressure,” he explains, adding that a mother expecting more than one child is considered a high risk mother, regardless of their age, yet there are known age-risks as already mention.

Women carrying more than one baby are more likely to deliver small babies who will need special care. The same babies may be preterm requiring critical care. Delivering the second twin is also usually complicated.