How Old Is Too Old for a Second Child in China?

A young Chinese baby.

The Chinese Gender Predictor or Calendar is a traditional way of predicting a baby's gender upon birth. (Image: Jie Xu via Dreamstime)

On December 28, 2016, at Hospital Number Two at Jilin University, a woman gave birth by C-section to a large baby boy weighing 9.5 pounds. This story is remarkable because she gave birth to her child at age 64, making her the oldest new mother in Mainland China.

The hospital revealed that the new mother had been post-menopausal for the last 10 years, and the baby was conceived through in vitro fertilization (IVF). The successful pregnancy and birth were attributed to the mother’s strong will and the high quality of medical care that she received while pregnant. However, other women this old may not fare as well as there are many issues that can arise that might affect the mother’s health.

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Women over age 40 are more than twice as likely to suffer a stillbirth, while the risk of miscarriage is greater than the chance of a live birth.
Women over age 40 are more than twice as likely to suffer a stillbirth, while the risk of miscarriage is greater than the chance of a live birth. (Image: Mrmongkol via Dreamstime)

Change to the ‘one-child policy’ and new opportunities for older couples

Since the introduction of the “one-child policy” by the Chinese Communist Party (CCP) some 35 years ago, it is estimated that more than 400 million babies have been lost to mandatory miscarriages and abortions.

The CCP abandoned its one-child policy in October 2015, and many couples hope to have a second child. However, many of these women are in their 40s and 50s, which puts both the child and mother at increased risk during pregnancy and childbirth.

There are other factors involved as well. A poll conducted by Sina, one of China’s most prominent news websites, revealed that just 29 percent of Chinese parents choose to have a second child. In another survey also conducted by Sina, some 71 percent of respondents listed economic pressure as the main reason for their decision.

What are the risks of having a second child when older?

Women over age 40 are more than twice as likely to suffer a stillbirth, while the risk of miscarriage is greater than the chance of a live birth. According to China’s National  Health and Family Planning Commission, the national maternal mortality rate is 18.3 deaths out of 100,000 for the first half of 2016. This represents a 30.6 percent increase compared to the same period in 2015.

There are additional risks to the mother. For example, women over 30 are more than twice as likely to suffer from life-threatening high blood pressure (pre-eclampsia) during pregnancy than those under 30 (5 percent compared with 2 percent).

Increasing maternal age also increases the chance of dying during pregnancy or childbirth. Mothers in their 40s and 50s are also between three and six times more likely to die in the six weeks following the baby’s birth than their younger counterparts from complications associated with the pregnancy, such as bleeding and clots.

The decision to have a second child when the mother is over 40 is a very personal one that an increasing number of couples are making today in China.
The decision to have a second child when the mother is over 40 is a very personal one that an increasing number of couples are making today in China. (Image: Kenishirotie via Dreamstime)

A personal decision that requires well-laid guidelines

The decision to have a second child when the mother is over 40 is a very personal one that an increasing number of couples are making today in China. And although pregnancy is possible in a post-menopausal woman with hormone support, the incidence of complications remains very high.

This new situation raises the need for developing well-laid guidelines for performing IVF in older age group women in China. Furthermore, counseling the couple regarding the pros and cons of pregnancy after age 40 will help them weigh the risks against the benefits.

Translated by Jean Chen and edited by Kathy McWilliams

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