A Narrative of the Musculoskeletal Implications of Late Parenthood

The average age women become mothers in Australia (and around the western world) is increasing, and currently stands at 30.3 years old ¹. Forty years ago, the average age of new mothers was 25 years old ¹. What has driven this change and what does it mean for our physical health?

There are many theories and suggestions as to why people are having children later in life – most of them linked to the empowering results of the social changes of the last few decades:

• More women are continuing further studies after high school, which delays earnings.
• Many women are prioritising establishing a career before starting a family.
• Living costs and the costs of buying a first home continue to increase, faster than wage rises.

There are many sources which describe the possible increased risks to the baby associated with conceiving and delivering at an older age. However, the focus of this post is the challenges posed to the body of a woman because of delaying child-bearing into their thirties or forties. Pregnancy causes a dramatic change in hormone and fluid levels and is therefore associated with a higher risk of developing conditions like joint pain and tendinopathy. These hormonal and cellular changes tend to settle slowly back to normal in the months and years after the birth of the youngest child.

This physically vulnerable stage of life coincides, of course, with the intensive physical demands of caring for a young family. Babies and toddlers are bigger and heavier, on average, than they were several decades ago. And, an increasing proportion of mothers are juggling caring for young children with managing a successful career. Finding time to look after our own physical health and fitness can be very difficult.

To further complicate the picture, women are starting menopause earlier ¹. Again, there are hypotheses as to why this trend is occurring ^{2, 3}:

• Obesity
• Genetics
• Smoking
• Decrease average number of births (per woman)
• Increased synthetic hormone use in foods.
• Alcohol consumption

As with pregnancy, menopause is marked by a radical change in hormone levels, and is associated with greater risks of joint pain, tendinopathies and obesity – very similar to the risks identified during and after pregnancy.

This means that two of the biggest hormonal changes in a woman’s life are tending to occur closer together than ever before - sometimes only a decade apart. This puts a great strain on the cellular health of joints, tendons and muscles.

Ask almost any orthopaedic surgeon or physiotherapist, and they will report an increasing influx of women who match this profile – it can be a ‘perfect storm’ of hormonal change, physical demands and busy life. The end result? More obesity, less fitness, and more pain in many parts of the body – especially in our tendons ⁴.

So, what can we do? We are certainly not suggesting a reactionary response – that women should choose a family over their career, or that women must have children as young as possible. In fact, there are other, different risks associated with having children when you are younger, and there are advantages to being an older mother with more years of education and greater financial resources to support and raise a child.

Let us recommend a proactive approach instead. If you are considering having a child in your thirties or forties, please also consider the impact on your body. Start working as early as possible on gaining the physical strength and fitness that will help you care for a young child with the minimum of risk of developing these painful problems. For advice on how to go about doing this, see the Wellbeing section of this website or talk with your physiotherapist.