The chapter opens by noting the growing presence of older parents and the ambiguity between mother and grandmother, then distinguishes intentional delays from delays by circumstance. Advantages include greater self-knowledge, patience, financial stability, and improved ability to integrate career and parenting. Disadvantages include higher medical and genetic risks, lower energy, overlapping retirement and empty nest, potential ageism, and intensified fertility challenges with age.

The medical section explains that while risks rise with age, healthy habits and good prenatal care can support favorable outcomes, and prenatal genetic screening can inform preparation or difficult termination decisions. The author cautions that motherhood over 35 is not for everyone; some may prefer earlier parenting to avoid later fertility constraints and career conflicts.

A vignette follows: after failed high-tech treatments, Jen (40) and Will (43) decide to adopt but worry they are too old and too tired. The counselor validates their grief and loss of control and reframes their exhaustion as the cumulative burden of infertility, decision-making, and adoption processes. The couple is told energy typically returns once the child arrives and the struggle ends, a reassurance later borne out by families who return energized.

Strategies to minimize age-related challenges include exercising before and during the path to parenthood, optimizing health and medications with clinicians, staying active and learning current parenting practices, and connecting with younger and same-age parents. Planning for retirement, advance directives, and college funding is urged to reduce future burdens on the child. The chapter encourages nurturing grandparent relationships when possible and grieving when illness or death prevents them.

Common reasons for delaying include incompatible partners, healing from difficult childhoods, education and career launch, debt, housing, divorce recovery, caregiving, medical recovery, hoping for a partner before single parenthood, and prolonged infertility or adoption timelines. The text emphasizes that agencies and clinics generally seek understanding rather than judgment. It closes with a family script: when Carolyn’s mother-in-law laments their age, Carolyn and Steve explain they cannot rewind time and must choose between childlessness or later-in-life parenting, asserting the compassion needed for their circumstances.