Last Chance Moms

In recent years, Friday pau hanas for my group of 40-something friends have somehow morphed into Friday playdates for our toddlers. Discussions about careers and dream vacations have given way to talk about birthday parties, the best baby gear and childcare. Even the playful competitive one-upmanship among the dads no longer involves football or golf scores, but rather baby milestones.

Photo by Mark Arbeit

Michelle Doo Van Rafelghem, 43, with her son, Luke.

My friends are part of a growing number of women who have delayed motherhood until they are well educated, well established and well traveled. Dubbed “last-chance moms” by the media, this label describes the increase in first-time mothers over the age of 35 in the United States. According to the National Center for Health Statistics, the number of first-time birth rates for women ages 35 to 39 more than doubled in the 1980s, while birth rates among women ages 20 to 29 declined.

Hawaii mirrors this national trend. According to the 2006 edition of Health Trends in Hawaii, which uses source data from Hawaii’s state Department of Health, the greatest increase in birth rates since 1980 to 2003 was among mothers 40 and older, followed by mothers ages 35 to 39. For women in these two older age groups, the birth rate increased by more than 100 percent (approximately 36,000 to 75,000 births a year). During this same time period, the birth rates for women ages 20 to 29 have either dropped or remained stable.

Much that is written about this group of moms characterizes them as women who have postponed family until they have accomplished personal goals. But “last-chance moms” are notable in that they also give motherhood a lot of thought. Few older mothers get pregnant by chance, nor does one casually adopt, or accidentally undergo fertility treatment. Here, we profile four Island women who embody the reasons more and more women are becoming older mothers.

A Struggle to Conceive

“I got married at 27 and started trying to get pregnant at 33,” says Jessica Perez-Mesa, a pharmaceutical representative. When Perez-Mesa finally got pregnant at 36, she miscarried. She says she was sad, but also relieved because “we knew everything worked and that I was at least able to get pregnant.”

She and her husband, Carlos, an attorney, kept trying, unsuccessfully. When a close friend got pregnant after trying for one month, Perez-Mesa remembers, “I was really, really upset. I kept thinking something was wrong with me. I started infertility treatments when I was 37.”

Although the couple was assessed to be an “easy case,” heartache and disappointment ensued. Over the next couple of years, they did numerous testing, 20 intrauterine insemination procedures, surgery to correct endometriosis and three invitro fertilization attempts. “It was the worst time in my life,” recalls Jessica, “We were supposed to be ‘easy,’ but nothing was working. We even started doing acupuncture and herbs. It got to be crazy.”

Photo by Mark Arbeit

Jessica Perez-Mesa struggled for nearly a decade to have children.

“Even more horrible,” adds Perez-Mesa, “was people assuming we didn’t want kids and making hurtful remarks.” She dreaded meeting new people because they would inevitably ask her why they were childless (“I would in my mind think, ‘because I’m sterile,’” says Perez-Mesa). She was often told to hurry up because “time was ticking,” or that she was selfish because she didn’t want to adopt.

In 2004, they decided to do one last procedure, then consider other options, including remaining childless. But it worked, and after 13 years of marriage, the couple, then in their 40s, welcomed Carlos Jr. Soon after her son was born, life unexpectedly blessed them a second time and Jessica, at 42, gave birth in March to a baby girl, Ava.

Jessica feels fortunate to have her family and has learned the importance of being balanced. “I used to want to climb up the corporate ladder. But given what we went through, I realize that a high-powered job isn’t everything.” She also makes her marriage top priority. “We feel that our marriage, and not the kids, should be the center. It makes for a happier mom and dad and we think that’s better for the children.”



 Building a High-Powered Career

“Ever since I was little, I fantasized about being a doctor. Throughout my 20s and 30s, it was all about achieving this dream,” recalls Dr. Cheryl Lynn Rudy. Now in her 40s with a thriving obstetrics and gynecology practice, Rudy’s priorities have shifted from her career to her husband, Michael, 45, and daughters Makena, 5, and Emma, 2. “I love my work,” she muses, “but now I fantasize about being able to spend more time with my family.”

During the week, Rudy is on call 24 hours for her patients. Every third weekend, she covers for herself and the other two doctors in her practice. Every morning at 5, Rudy gets herself and her daughters ready. She takes Makena to preschool and then heads to her office located at either Kapiolani Women’s Medical Center or in Waipahu. Her day is packed with patients, babies, surgeries and paperwork. She’s home by 7 p.m. to bathe, read to and put her girls to bed. If she’s called away for a delivery, Michael or the nanny steps in. “Michael is equally busy with his law practice,” she explains, “and when he has a court hearing or is traveling abroad for work, it gets hectic.”

Rudy candidly views herself as a “weekend mom” and at times regrets her demanding schedule. She plans to adjust her call schedule so that she has more free weekends and evenings. “Before I had kids, being pulled away from a dinner party for a delivery was, at most, an inconvenience. Now, doing a delivery early in the morning and in the evening could mean not seeing my daughters at all that day.”

Still, postponing starting her family has afforded Rudy resources, such as a live-in nanny, and trips to the Mainland to visit relatives.

“I’ve accomplished my dream of becoming a doctor,” she states. “But now, I realize that this only helps me strive for my most important accomplishment yet: Raising my kids.”

Pursuing Education

Connie Gazmen, 45, lives on the North Shore with her husband, Scott Brewer, 47, and their daughter Sierra, 3. Gazmen, who is a full-time instructor at the University of Hawaii at Manoa School of Nursing and part-time nurse at Queens’ oncology department, made a conscientious decision to delay marriage and motherhood. “Pursuing education was my primary goal. I wanted to finish my master’s in nursing before anything else.”

photo courtesy of Kristin Lipman

“I come from an immigrant family, where education is very important,” says Gazmen, who grew up on Maui. “My parents never had the opportunities I did. They were supportive and proud of me. They sacrificed to pay for my bachelor’s and I wanted to honor that.”

Attending the University of San Francisco, she says, “opened my eyes. After college, there were all these things I wanted to pursue. I couldn’t see myself getting married and having a family.”

She dated Scott, a mortgage broker, for seven years, and married him when she was 36. After focusing on her career and marriage (“We went on trips to Bali, Costa Rica and Tahiti”), Gazmen started trying to get pregnant at 38. After two miscarriages and surgery to remove fibroids, Gazmen was 42 when their daughter was born.

Gazmen believes that being an older mom has helped her be a better parent. “I’ve done what I wanted to do. I don’t mind now if I don’t get to see a movie or go to a concert. We may not have the spontaneity we used to. For example, I used to just go to San Francisco for five days. I can’t do that anymore. But that’s OK,” smiles Gazmen, “I have Scott and Sierra.”




Finding Mr. Right

Michelle Doo Van Rafelghem, 43, did not plan to delay motherhood. In fact, she thought ideally she’d marry at 26 and start having children at 30. “What I didn’t count on,” she laughs, “was how long it was going to take me to find the right person to do this family thing with.”

After a series of not-so-promising relationships during her 30s, she remembers thinking she was never going to get married, let alone have children. She took to pursuing personal goals like traveling and competing in triathalons. A University of Southern California business school graduate, Van Rafelghem built her career and bought a home in Kahala.

At 39, Michelle finally found and married Mr. Right, real estate agent Francis Van Rafelghem. Their son, Luke, was born soon after, in 2006.

Van Rafelghem admits that she was concerned about the challenges of conceiving and the risks of being pregnant post-40. And as older parents, the couple does worry, she says, about “being in Luke’s life for as long as possible.” They know they may not get to see grandchildren. “And when he’s in college, we’ll be in our 60s. So if he wants to go past four years of school, we may not be able to offer him financial help because we’ll be retiring.”

Still, she says, “I have had no regrets about starting late because it took me this long to find the right person. I wouldn’t want a family sooner if it meant having it with someone I didn’t think was right for me.”

Reina Graves is a “last-chance mom” who lives in Hawaii Kai with her husband, Darren, and daughters Gavriella, 3, and Sabrina, 1.

 Hoping for a later-in-life baby?

– Be realistic and patient. “Fertility decreases considerably from the age of 35,” explains Dr. Christopher Huang, a Honolulu-based board-certified reproductive endocrinologist. “For example, a very healthy woman post-40 has a less than 5 percent chance of conceiving each month. A lot of my patients don’t know this and are shocked to learn this. Many couples come in expecting results in days, maybe weeks. It’s more realistic to expect results in terms of months.”

– Be supported. Resolve, a national nonprofit that provides help to people having a hard time conceiving or carrying a pregnancy to term, has a local chapter. The group usually meets at Kapiolani Medical Center on the fourth Tuesday of the month, at 6:30 p.m.; visit for more information.