Doulas On Call
Doulas on Call is a heartfelt and real podcast hosted by two seasoned doulas, sharing stories, wisdom, and unfiltered insights from life on call. From birth room moments to behind-the-scenes support, we explore what it really means to serve growing families with compassion and experience.
Doulas On Call
A Historic Shift in Birth Trends: What We're Seeing in the Birth Room
The birth trend in America is shifting dramatically. For the first time in history, women over 40 are having more babies than teenagers – a complete shift that raises fascinating questions about modern motherhood.
Drawing from our extensive experience as birth doulas, we dive into this groundbreaking CDC study showing births to women over 40 have surged 193% since 1990 while teen births plummeted 73%. The statistics align perfectly with what we're seeing in our practice, where approximately 75% of our clients now fall into the "advanced maternal age (geriatric pregnancy)" category.
What's driving this shift? We discuss multiple factors: better access to sex education, birth control, career advancement opportunities allowing women to establish themselves professionally before motherhood, evolving dating patterns (with many finding partners later through work or online dating), and remarkable advancements in fertility treatments making pregnancy possible for many who might previously have been unable to conceive in their later reproductive years.
But delayed motherhood brings unique challenges. Healthcare providers typically approach pregnancies in women over 35 differently, recommending additional monitoring, earlier inductions, specialized genetic screening, and generally higher levels of medical management. Through personal stories and observations, we examine how older mothers – particularly those who've undergone fertility treatments – often approach birth with different expectations than younger mothers. Having already navigated the complex medical world of reproductive technology, they typically have a different relationship with the healthcare system than women who conceived easily in their twenties.
Have you experienced pregnancy after 35? We'd love to hear your story! Text or email us about what you wish your birth team had known about supporting you. Whether you're part of this growing demographic of older mothers or among the declining number of younger parents, your perspective matters to us and our community of listeners navigating similar journeys.
The studies referenced in this episode:
Thanks for listening! Always feel free to message us for more information or, if you have information you feel we should see, please send that. We LOVE to hear and learn from you!
I'm Misty and I'm Tammy and we're the Doulas on Call. Remember, mamas, we're not doctors, midwives or magical birth wizards. I wish Just two passionate birth workers with microphones sharing personal experiences, trusted information, the best snacks for labor and a whole lot of heart. What you hear on this podcast is meant to educate, encourage and connect, but it's not medical advice, please consult your trusted healthcare provider when making decisions about your health, your birth or anything clinical.
Speaker 2:Basically, don't sue us. We're just here to talk birth, spill some tea and share the love.
Speaker 1:Ring ring. Duel is on call. Hello guys, thanks for coming back to another episode. Hi Misty, yeah, I can't believe people are still listening to us, tammy.
Speaker 2:It's like, ooh, it's working. Kind of like when I first met my husband. I'm like, oh, wow, he's actually listening to me.
Speaker 1:Wow, he knew he remembered what my last name was. Amazing, oh gosh, yeah. So today I really want to get into a topic that I'm pretty passionate about, which is there's a recent study that the CDC put out in March 2025 about how US women over the age of 40 are having more babies than teens.
Speaker 2:That's so crazy For the first time. For the first time they're outnumbering.
Speaker 1:Yeah, wow. So in that study they talked about how births to women over 40 hit 4.1% in 2023. Doesn't sound like a whole lot, but just edging out of the teens, which is 4.0%, it's 193% jump for older moms since 1990, while teen births dropped 73%.
Speaker 2:The total flip, total flip. Yeah, that's huge, I mean. I think that also begs the question too about our general like this is generalization, our clientele? I mean, how, what percentage would you guess of your clients, missy, that are over over 40, or let's say, over 35, even?
Speaker 1:The advanced maternal age Geriatric Air quote geriatrics. Yeah, yeah, so I call Geriatric Air quote geriatrics yeah yeah, I call them my gerries Gosh over 35, I would say I mean it's fair to say 50% plus.
Speaker 2:Yeah, I would agree. I can, I think, safely say at least 75% of my clients are over 35.
Speaker 1:Yeah, In that age bracket, and I think that could be for several reasons. Sure, yeah, tell me why. So number one, obviously I think, going back to this study here, that we're seeing an increase in women over the age of 40. Yep, I mean number one, number one, number two, I think it could just be. You know, it makes me think of the recent consultation I had where she said we specifically wanted an older doula.
Speaker 2:Oh yeah, correct, I've had that happen as well, because she's over 39.
Speaker 1:Right, so, and it was important to her to have an older doula because she is older. Yes, yes, so I think that plays a part. I think, why is our age?
Speaker 2:Yeah, we are older doulas Right, compared to the younger. Hey, we're not that old but but we are older, I think, and that's life experience you know, chalk it up to life experience and having our kids are grown like I'm an officially empty nester and that makes a difference.
Speaker 2:I also think financial, you know having being established as a couple and, yes, being you know, having the finances to hire a doula and and a experienced doula, you get what you pay for. I mean, I just I looked this up recently. What are the rates for doulas in Denver Metro? We are a booming town, man, a lot of people moved here during COVID, stayed here. We call it a sticky state. They came here and it sticks on you.
Speaker 2:You can't leave, you got to stay. So I feel like a lot of my clients definitely are in the older they have established careers. They've waited. A lot of the moms have definitely undergrad, graduate degrees. Yeah, there's definitely a stereotype, if you will, I think.
Speaker 1:Yeah, and it was interesting as I was reading more on it and looking at it, because it's not just a decision right Of like waiting until you're older. For some people it's our infertility problem Correct, so they're older because they had fertility issues and struggles.
Speaker 2:So it's not just the decision to just say I'm in a way yeah, I agree, right.
Speaker 1:So it's not just saying like oh, or at least I'm not thinking oh, this is because women are choosing to wait until they're 40 and teens are choosing to not. I think, I think personally I think a lot of it can come from our fertility. And why is that down?
Speaker 2:Well, and I think that the other, you know the other factors, for you know there are insane IVF advancements, amazing career opportunities that they didn't you know women didn't have before. Yeah, you didn't have them before and then delayed partnerships. The dating game, right? Do you ever take a poll? I always ask my clients how they met.
Speaker 2:It's a really good distraction during, you know, transition or later stages of the birth. I typically I'm giving away some of my secrets. I know you are a client of mine, but I think it's a great distraction too. It also increases oxytocin when they're talking about it. But I ask them, I take a poll. You know, secretly, I'm taking this data of how did you meet, how did most of your clients meet?
Speaker 1:How did a lot of my clients meet? A lot of my clients met at work. Okay, organically.
Speaker 2:Yeah.
Speaker 1:Organically. That's incredible. A lot of them will tell me oh, we worked for the same company. Okay, that's how they met. Some of them have pretty funny stories.
Speaker 2:I love it, one recently.
Speaker 1:He's like she was my boss, which I loved Like she was my boss, like going back to like what you were saying, like go girl, these career advancements. I was like that's pretty cool, I think a majority of mine have met online online dating.
Speaker 2:That's the other one, and especially because of COVID, so you know that that's probably the biggest way. So, yeah, that's the other one, and especially because of COVID, so you know that's probably the biggest way. So, yeah, there's definitely reasons why this is happening. And just on the flip side, why do you think less teens?
Speaker 1:So I have my thoughts on this. Yeah, please, I think having teenagers, having raised teenagers I mean, my oldest is now 25. Right, I feel like a lot of them are choosing to wait Interesting For various reasons, but I really think mental health is a piece of it, oh gosh yeah that maybe they have low self-esteem, low body image. It could be questioning themselves like who do they like?
Speaker 2:Who do they?
Speaker 1:prefer, or it could be more of a choice of you know. It's something that they choose to do for themselves. It's a trending thing, it is trending to wait.
Speaker 2:So our kids are 21 and 18, and they're fairly open with me. Also, the kids I nannied, you know. Looking at their I mean they were born in the 90s 90s babies I also think education is better, I think you know like for you and I sex education and or growing and changing is better.
Speaker 1:Well, I had. So what I will say? I was a teen mom, so I got pregnant at the age of 17, had my son right at turning 18. For me you know the sex ed talk I think was more, don't do it, you shouldn't be doing it, you need to wait till you're married. It was like this kind of think was more, don't do it, you shouldn't be doing it, you need to wait till you're married. It was like this kind of like I don't know fear tactic right on me. I grew up in a very like baptist family, went to a christian school so it was more, but jesus yes, so it was like that fear-based thing, okay.
Speaker 1:So for me, that was my sex education, right. That was like don't do it. And so what do kids do? What do teenagers do? The opposite, right, because that's just what they want to do, whereas I feel like there's more around it now.
Speaker 2:Well and also having safe sex. So the education piece of you choose to do it, it you know where you be safe, or you know and the availability. Correct the availability gosh of having a place totally or like we just never.
Speaker 2:I felt like I was never alone, so there was until I went to college and then it was like that became a choice of oh, are you, you know? Then it was more, but it was definitely more fear-based, you're not wrong. So I feel like you know, with my kids I've been very open, almost probably too open, where they're like putting their fingers in their ears like mom, okay, we're good, thank you same my kids would probably say okay, my mom can be kind of annoying with stuff like that yeah, I'm just very open.
Speaker 2:I was very open, I also came from just a little bit of background. Yeah, more background on me.
Speaker 1:Yeah, and not only was I 17 when I got pregnant. Right, my mother was 17 when she got pregnant. Okay, Her mother was 17 when she got pregnant, so for me it was also. I kind of want to put a stop to that trend in my family.
Speaker 2:So you made a choice To break the cycle, and you made a choice to break the cycle.
Speaker 1:Yeah, okay, so we have successfully done that. High five and we're a 25-year-old, almost 26-year-old, our new oldest just graduated college Same as yours.
Speaker 2:Same, so look good as fist bump.
Speaker 1:Yes, girl, you can't see it but we're doing a fist bump.
Speaker 2:Yes, well, I think that's true, I think so I comes the doula element of this.
Speaker 1:Yeah, right, this is also something I am interested in because of this study. You know talking study. You know talking about how you know well, and for me is like what comes along with this decision or choice to wait until you're 40.
Speaker 1:Right, and this is like that doula piece, totally any woman giving birth, but like I think, women helping them through this, because there are going to be I don't want to use the word complications, but there are there are going to be things that kind of come up in your, in your pregnancy and your journey and like how are you going to manage that?
Speaker 2:And how do we navigate it? Because now you're older. So I think this is a big one, because a lot of my clients that are older and they don't want to be managed whether they care not to be managed or not be managed it's their first time baby they really don't know. For a younger mom yes, okay, and there are different red flags. What are those? Right, yeah, yeah. So I think one of the biggest ones are increased monitoring. Yes, so my women over 40, you know they want to do more ultrasounds or they want to talk they want you to take a baby aspirin right.
Speaker 1:Preventing preeclampsia preventing all of these Prevent preeclampsia because you're High blood pressure. Higher risk of preeclampsia, Correct, Once you're AMA geriatric, Right Right Higher chance of gestational diabetes, Exactly so you know. And then not only to you but but for baby, right there's. There's those more risks there to baby. So there's a lot more monitoring in pregnancy in general, just in general, yeah, Just in general birth.
Speaker 2:Right. Do you think that I would also say that in, like IUGR, interuterine growth restrictions, all of these things come up with baby, do you think? I would say I think it's because they're monitoring more. They see it, whereas if they weren't monitoring, you know probably is happening, but they're just not aware of it Because, yeah, they're not getting the additional monitoring. Would you agree? Yeah, yeah, I think so. What else? What else are providers doing to help moms who are over 40? Like what would you say the extra is?
Speaker 1:to help moms who are over 40? Like what would you say the extra is? So I see a lot more you know referring over to maternal fetal health or MFM. You know having that, that additional support through them. You know just more monitoring things, like you said, monitoring more of their blood sugars, monitoring more of their blood pressure. Yeah, I see a lot more recommendation on inducing you know, and inducing sooner.
Speaker 1:Right, so you know ACOG, american College of Gynecology, right? You know their actual recommendation is induction past 42 weeks, but we've seen an incline. I'm laughing. I know she's laughing because-.
Speaker 2:I haven't seen a mom go to 42 weeks in a very long time, I know right, but that's ACOG recommendations, right, yeah, it's ironic actually.
Speaker 1:But what we're seeing is, you know, an increase like it's. 41 weeks is right, they're saying, but for women over the age of 40 or at least that I've seen they're recommending even like 39.
Speaker 2:That's right yeah, yeah, and even before then I let's back up, because I feel like pre, pre, even being pregnant, there's an intense, you know, genetic screening there's a ton of pre-counseling, genetic counseling, genetic screening, so they're doing all of this work ahead of time, in addition to when they actually get pregnant, whatever route they get pregnant, whether it's IVF or otherwise. Yeah there, there's just, there's just a lot of extra right, yeah, so very interesting.
Speaker 2:I think I would say I would love. I'm not in agreement with the induction piece, you know, and we can do our own episode on the ARRIVE study To do that. Also, I think that evidence-based birth did a more updated on induction and whether it's good or bad or why. But, that being said, I have had many clients. I always tell my clients this if they're and they're over 40 or you know, geriatric if you will, and the doctor recommends induction, have you found this to be true? My clients who agree to it and are a wholeheartedly invested in it, not upset, do not mind being managed, have beautiful inductions.
Speaker 2:Yes, and I think that goes for any person. If they're the one that instigated and or for whatever reason, whether it's physiological, clinical or not clinical, just emotional, like get this baby out of me, like I'm okay with an induction, they tend to have good induction.
Speaker 1:Right when they're there mentally. They're mentally kind of surrendering and accepting that and choosing to do that Absolutely, Because birth is a big part of it is mental, so much so much, absolutely.
Speaker 2:Yeah, okay. So question for you. I'm just curious.
Speaker 1:Sorry, go ahead. And this is not like a serious question or anything. What is your oldest client Like? Do you know how old To?
Speaker 2:date. I think the oldest client that I've supported was 41. 42., 42., 42. Did she conceive?
Speaker 1:on her own no so.
Speaker 2:Ivf.
Speaker 1:IVF. Yeah, okay, yeah, mine was 48, wow 48. A single mom by choice. Okay, decided she wanted children. She had froze her eggs earlier on. I think she was in her 30s or something when she froze her eggs wow on, I think she was in her thirties or something when she froze her eggs, Wow. And then she, just she went through the like the donor process and don't act Okay, but that was yeah.
Speaker 1:That was my oldest client that I've supported, 48 years old that is me in five years and I cannot imagine doing that. She is a warrior. I can't either.
Speaker 2:I'm like girlfriend did she you go. So this begs the question where why doulas? Why are doulas necessary or why are doulas helpful in the statistics? Help us. This statistic helps us absolutely. Actually increases our business. Yeah, why do you?
Speaker 1:think that is that it. It increases our business. Yeah, yeah, yeah, well, I feel like, especially if you let's say that women who have infertility, they are just more used to the process, right, right, most of them I should say not all of them, but most of my clients who are over the age of 40, they have gone through infertility, right. So, whether that's IVF, whether that's IUI, whatever it is Right. Anything other than the normal intercourse, I get pregnant, et cetera, et cetera.
Speaker 2:And are natural Right, right, okay, so they're used to so much.
Speaker 1:They're used to so much and so it took that process to get there, and so I think they're seeking out doula support because of that. They know that it's going to be a journey getting to this birth.
Speaker 2:Next chapter. Yeah, they're on the next chapter and they want the assurance and the guidance which, to be honest, we do. That's what we do, yeah.
Speaker 1:This just brought up a question. I don't even think I had this listed to even ask you. Sure, but with that being said, do you feel like the majority of your clients who are over the age of 40, how many of them do you think birth outside of a hospital?
Speaker 2:Oh gosh, none to date. Yeah, yeah, Genuine. Genuinely, though, the clients that I've had that have gone through IVF IUI, that have gone through IVF IUI, they definitely do not mind being managed. In fact, they like the reassurance. I think sometimes it, you know, and please, we welcome any feedback.
Speaker 2:Text us on our podcast, like, if we're talking about this and you are a mom over 40, I would love, we would love love to hear from you on any of this. But yes, they definitely. I know going into it that they are not as adamant about the birth process. They are not as leery of intervention. They have been poked and prodded and prodded literally, not figuratively so much that they are. It's very unlike my client who's 24, you know got pregnant on the first try and wants to have a home birth right, right, truly, yeah, yeah, no, they're.
Speaker 1:I feel like they're stereotypically, whether it's they're open to it, sure, whether it's gut feeling for them. Maybe it's like you know, I kind of look at my moms who go through ivf or over the age of 40, especially, you know, for the mom that was a single mom, 48, very different it was. That was her only child, yes, like that was it for her. Yeah, so so to them they feel again, using air quotes here, safer birthing in that Absolutely, and I don't use air quotes to say that they're wrong.
Speaker 1:No, absolutely not but that, I'm just using that as a and they tend to be more anxious To put words in their mouth.
Speaker 2:Yeah, and they tend to be and that's validated Like much more anxious in the sense. I mean, how could you not be? You've gone through so much to have this child, everything is invested in this. You get one shot, yes, so to speak. Yeah, so I don't. You know that's. There's no judgment on that whatsoever, and I also think that's why we are hired you you know, especially for single moms. So I've had one single mom. I'm hoping that at some point she'll be a guest on our show. I just think her, her story, is fascinating. You know, sperm donor has an established career, never really wanted a partner, found a partner and decided to. She wanted to be a mom and my support for her looked very different.
Speaker 2:You know it looked very different because not that I don't do unlimited, I think you could speak to that for your 48 year old mom but it was definitely more of an emotional, because we do offer emotional support as well as physical, but it was definitely more emotional and lots of doubts going in you know.
Speaker 1:Yeah, I mean we're involved, like you said, we're very involved with our clients, like if if any of you have ever worked with tammy or myself, like you know that we are invested, we are invested I tell my clients that all the time you know there's there's no too much no information? No, there's there's no too much contact right. I enjoy that. I enjoy that part of my job.
Speaker 2:I think even more so for moms over 42 and couples where the partner's over 40,. We are an invaluable resource because of our objective point of view in guidance and navigating the care from their care team. What things are necessary, what things are not necessary, what choices do you have? Can I say no to that? What does that look like? I always use the analogy of choose your own adventure and magic tree house books. If you say yes to this, does it go to this? That's just normal birth in general, but especially at that point because there's just so much more to navigate.
Speaker 1:There's a lot more to navigate if you're over the age of 40 and choosing or not choosing, but this is your, your, your life path. There's a lot to it, so there's a lot more to navigate. So, kind of like what you said it provides you with a job.
Speaker 2:It does provide us with a job. We want your stories. Honestly, if you are listening right now, you're a parent over 40 or you're a younger parent, so let's flip it. You're in your 20s, You're younger and this is. You know, that is rare. It is rare that I get couples, Although I have a group of clients right now that friend of a friend suggested there's probably five of them now where I'm their doula for their little life group. You know, and and I think it's interesting to me they are in their twenties and they're yeah. So if you're, if you're over 40 or you're younger, what is one thing you wish your birth team knew? What is one thing you wish that they knew? That's a good question, yeah.
Speaker 2:You can share it social with hashtag doulas on call. You can email us. I'm actually on our podcast. Does it have right?
Speaker 1:It says text us or email us Email us your questions so you can send a text directly. It comes to us, so you can ask all the questions. You can give us your feedback, whether it's good or bad. How you can give us your feedback, whether it's good or bad. Right, how old were?
Speaker 2:you or I would love a poll. I mean, maybe we take a. We could do this on our, on our Insta. I would love a poll of how old you were when you had your baby and did you hire a doula. Let's do it. Is it pertinent to you know? Do you think older parents hire doulas or you know what's the? I'm curious what the percentage would be Real quick because you brought that you.
Speaker 1:You brought it up when you said on the flip side, it just made me think so. Prior to doing doula work full time, I was always involved in the in the birth world. It's always been something I've been fascinated with. One of it was um volunteering a lot of my time for teen moms, right. So that was something I felt strongly about was giving back to that. So you know, I've worked with girls as young as 16. I'm having babies, but I would say my youngest paying client was 22. Oh, me too. Didn't we work with her together? I think so. I think we did. I think it was me. Yes, was it when you were training? I was one of her trainings.
Speaker 2:Yes.
Speaker 1:Okay, so we did, we worked with her together, and then I had an independent.
Speaker 2:Well, actually I think she was 23. But very close.
Speaker 1:So it was Okay. Okay, she had her first daughter at 17. Amazing. And then she was five and she was in nursing school. Yep, I know Exactly, yeah, yep. So wow, yeah, interesting.
Speaker 2:Yeah, she was 22 years old and she reached out for doula support, but I think it's interesting too, cause she was in nursing school, yeah, yeah, so we do always ask. I always ask how you found me and how you heard about me. Um, and, it is nice to be referred by midwives and providers. We are definitely referred a lot in the Denver Metro area, I think, would you agree.
Speaker 1:Oh, absolutely, I've done births for OBGYNs.
Speaker 2:Right, I've been there. Oh, yes, exactly which I have too, which is so fun.
Speaker 1:I worked with a student midwife before, but never. I remember when I got the call and she was an ob-gyn. Yeah, it's a little daunting. Wow, I know.
Speaker 2:So you're like okay, but sometimes we're our own worst, right. So absolutely we're our own worst. And within our group we have women in our group, her and we're all we're like we're fighting to be the doula's doula. Oh, yes, yeah.
Speaker 1:Any time anybody gets pregnant, it's like who's going to be the doula?
Speaker 2:That's awesome yeah.
Speaker 1:But no thanks, tammy, for chatting about this because again, this is something that I think because of my experience as a teen mom, I was very blown away by the stats on that. I was blown away to see that and to hear that. So interesting, and we'll make sure that we include the study in there so you guys can read it for yourself as well. It is really cool, so we'll have links to that and reach out to us.
Speaker 2:Hit like and subscribe while you're on here. If you're enjoying it, please share it with your friends. We humbly ask. I would be super fun. Tag us on social If you listen to it and you or something that spoke to you. Definitely don't be afraid to reach out. We really appreciate you. We're we're having fun. Yes, we, we appreciate you. We love coming in and chatting, and getting to hear from you is even better, so thanks, thanks for listening. Yeah, we'll catch you soon. Bye.
