MIDDLE-CLASS women who become pregnant in their late thirties and early forties are as big a public health problem as teenage mothers, a leading obstetrician has warned.

Dr Susan Bewley, consultant obstetrician at Guy’s and St Thomas’ hospital in London, wants ministers to formally categorise the epidemic of what she describes as “middle-age pregnancy” as a health hazard and come up with specific policies to deal with it, as happens with teenage mothers.

Bewley’s research shows that more than 20% of births are now to women over the age of 35 and that the trend is putting a huge strain on National Health Service resources.

Not only do many experience difficulty conceiving and require expensive IVF treatment, but they suffer a much higher rate of miscarriage and complications during pregnancy, putting their own long-term health and the health of their babies at risk.

“Middle-age pregnancy is a public health problem because women en masse are moving out of the optimal age of childbearing and that brings preventable disease and stress with it,” said Bewley last week.

“Middle-age pregnancy has complications in the same way as teenage pregnancy. We have policies to address teenage pregnancy but not middle-age pregnancy.”

Bewley advises women to complete their families between the ages of 20 and 35 to lessen the risk of complications. Not only do the risks of premature births or birth defects increase markedly after 35, but risks to the mother’s health such as high blood pressure and diabetes also jump.

“Doctors and public health authorities have to give clear and consistent messages about the optimal time for reproduction,” says Bewley in a paper to be published later this year in the Fetal and Maternal Medicine Review. “Knowing the constraints, rational women would choose to have completed their families by 35,” she adds.

Bewley’s comparison of older mothers to teenage mums and her call for government intervention is likely to prove highly controversial. While few would object to the risks of late pregnancy being pointed out, most do not see themselves as a public health problem.

Claire Fox, director of the Institute of Ideas, a think tank, said: “Even if there are health risks in older motherhood, and I think they are being overstated, this is not a matter of public policy.

“It is no business of doctors to tell people when to have their children. This is turning the medical profession into social engineers.”

But Bewley is unapologetic. Her paper looks at the broad costs to society of the trend towards late motherhood.

It says: “A rapidly ageing obstetric population inevitably requires more maternity services and resources, and this has not factored prominently in NHS debates about maternity funding.”

Nevertheless, the comparison with teenage mothers will still sting. The two groups could not be more different. One is made up largely of deprived and feckless girls while the other is dominated by highly educated and successful career women.

The problems caused by single teenage mothers are also very different and largely social in nature. The problems for middle-age women in contrast are mostly — but not entirely — medically related.

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