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The consensus of opinion as regards the optimum age for effective and safe reproductive capacity in civilized society is between twenty-one and thirty-five years. There are many attendant hazards that may affect obstetric performance when pregnancy is entertained at a very early age (the so-called teenage pregnancy) or at an older age (the so-called old mother).
Teenage pregnancies are fraught with dangers and should be discouraged. Apart from the inherent psychological and emotional instability attending these young mothers, there are other harrowing hazards.
Most teenagers, are unlikely to take full advantage of ante-natal care. So they run increased risk of pregnancy induced hypertension. Some may not carry their pregnancies to term. Lacking knowledge about the dos and donts associated with pregnancy, the pregnancy may end up in premature labour resulting in the birth of small unhealthy babies.
Frequently, operative intervention has to be called for in order to effect a safe delivery. More commonly this is a Caesarean Section, if there is disproportion between the pelvis and the baby's head.
It is note worthy that most teenage mothers belong to the low social class although this is not invariable.
High and reproach at home by parents may lead the pregnant unmarried teenager to show serious aversion for her conception and would resort to ways and means of ridding herself of the pregnancy. She may attempt various self medications orally and vaginally causing damage by poisoning and local burns of her vagina in an attempt to procure abortion. She may attempt self harm or even suicide.
If she continues with the pregnancy and is successfully delivered of a baby she requires support from her parents. Without parental support, she may be frustrated and may resort to baby battering. Dumping the baby in the dust bin, toilet or by the road side is a possibility.
The overall sequelae is that maternal and perinatal mortality and morbidity are dominant features.
The prevention of these undesirable sequelae may be achieved by adequate child care, sex education and contraceptive advise to promiscuous teenagers.
Now let us consider the case of older mother i.e. a mother who continues to bear children after age forty.
It should be noticed that as a woman grows olde, any pre-existing diseases, diabetes, hypertension and others also tend to grow worse.
These conditions are liable to affect adversely the course and outcome of any coexisting pregnancy.
A more serious consideration is the risk though not so frequent of giving birth to a baby with some abnormality. Such risk especially that relating to Down's Syndrome, Characterized by certain chromosomes and body abnormalities and mental retardation is particularly associated with having a baby at an older age.
The risk of having a baby with Down's Syndrome in relation to martnal age is:
Paternal age appears not to be significant in this respect.
It is universally acknowledged that as age advances, the tissues of the body tend to lose their elasticity and undergo dimunition in resiliency. This implies that when delivery is to be accomplished, the tissues and muscles of the birth canal of the older woman who has never had any vaginal delivery previously may not stretch enough to allow easy outlet for the baby. thus the baby may suffer all the repercussions of protracted labour while the mother heself may become exhausted and demoralized.
The situation will then call for intervention in the form of operation to help the mother to deliver the baby.
Considerations such as these would lead one to believe that teenage marriage with consequent tenage pregnancies ought to be avoided. Continuing child bearing beyond the age of forty is hazardous although the obstetrician would give serious consideration and encouragement to a sub-fertile woman who having tried for a family for many years finally became pregnant at an older age. Attempts should be made to make good use of the optimum reproductive life namely ages between twenty-one and thirty-five.
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