EBB 178 – Pregnancy After 35 with OB/GYN and Maternal-Fetal Medicine Specialist, Dr. Shannon M. Clark

Learn more about Dr. Shannon M. Clark and “Babies After 35” here (https://www.babiesafter35.com/). Follow Dr. Clark on Facebook (https://www.facebook.com/babiesafter35/), TikTok (tiktokbabydoc), and Instagram (tps://www.instagram.com/babiesafter35). 

 Learn more about the National Institutes of Health (NIH) here (https://www.nih.gov/). 

 Learn more about maternal-fetal medicine (MFM) here (https://www.smfm.org/). 

Rebecca Dekker: Hi, everyone. On today’s podcast we’re going to talk with Dr. Shannon Clark about having babies after the age of 35.

Welcome to the Evidence Based Birth®® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. Evidence Based Birth®®As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details.

Hi everyone. Today I’m so excited to welcome Dr. Shannon Clark to the Evidence Based Birth® Podcast. Dr. Clark is a double board-certified obstetrician and gynecologist and maternal-fetal medicine specialist focusing on the care of women with maternal or fetal complications in pregnancy.

Dr. Clark has taken a special interest in pregnancy after the age of 35, which many considered to be at “high-risk pregnancy,” and she’s been inspired not only by the experiences of friends and patients, but by her own personal experience of trying to start a family at the age of 40. Dr. Clark runs the Instagram page, Babies After 35. So welcome Dr. Clark to the Evidence Based Birth® Podcast.

Dr. Shannon M. Clark: Thank you for having me.

Rebecca Dekker: We’re so excited that you’re here. I’ve loved following your stories and all the information you share on Instagram, and I would love to hear from you why you went into medicine in the first place and what you love about obstetrics.

Dr. Shannon M. Clark: Well the truth is I went to college to actually be a lawyer. That was my goal. Then somewhere in my sophomore year maybe I was taking a government class and I hated it. The guy I was dating at the time was pre-med and he knew I was pretty good in science. He was like, “Hey, why don’t you go pre-med.” I was like, “Okay,” and I ended up doing really well. Unfortunately he did not get into medical school and I did, but you know, that’s neither here nor there. It worked out that way.

I went on to medical school, and went to medical school to be a forensic pathologist. Spent a lot of extra time in the medical examiner’s office in Kentucky, the state medical examiner’s office in Kentucky where I grew up.

But then the last rotation of my third year was obstetrics, the OB/GYN rotation third year of medical school, and I completely changed my mind. And here I am this many years later doing obstetrics still.

Rebecca Dekker: What changed your mind?

Dr. Shannon M. Clark: I still love forensics. Anything forensics I’m still hooked, and I’m actually pretty knowledgeable on the topic. But I don’t know, there was something about seeing that first baby being born that I was hooked, and the experience I had as a medical student wasn’t the greatest. I just like the idea of taking care of pregnant persons and delivery babies and having two patients in one.

Then really quickly on in my residency, I decided to do high-risk obstetrics. I decided that in my first year of residency because I like the different complications that pregnant patients can have and trying to figure it out when you have the two patients in one. Then I went ahead and pursued a fellowship in maternal-fetal medicine.

Rebecca Dekker: And where did you do your medical school and residency?

Dr. Shannon M. Clark: So medical school at the University of Louisville in Louisville, Kentucky. Residency up in Pittsburgh at Allegheny General, and then fellowship down in Texas at the University of Texas Medical Branch in Galveston, and that’s where I stayed on after my three-year fellowship. Now I’m a professor in maternal-fetal medicine here.

Rebecca Dekker: So tell our listeners a little bit about what maternal-fetal medicine or MFM is. So you had to go on and do extra residency after your OB/GYN residency?

Dr. Shannon M. Clark: Yeah, it’s not considered residency. Most residencies are anywhere between three to say five years. Then if you decide to sub-specialize or do something more specific within your residency field, which mine would have been OB/GYN, then you can go ahead and do a fellowship.

The maternal-fetal medicine specialist fellowship meant that I did three additional years of fellowship training, or post-graduate years after the residency in order to do high-risk obstetrics. That just means all of my patients are pregnant and they either have maternal complications, fetal complications or a combination of both, something about their pregnancy that makes them higher risk, needing additional surveillance or testing or a specific type of delivery, timing of delivery. It can be anything, and some patients have more complications than others. We get to see everything. There’s a lot of pathology.

Rebecca Dekker: And with the fellowship, you did MFM. It’s my understanding you do a research project as well or you get some research experience. Can you talk a little bit about that?

Dr. Shannon M. Clark: Yeah, I think all fellowships are different. Back when I was doing fellowship ’04 to ’07, we have a very healthy research infrastructure here at UTMB for maternal-fetal medicine research. So I did basic science on the fetal origins of adult disease in a preeclampsia model. That’s what my thesis ended up being on.

When you do your oral boards to get double board certified as a maternal-fetal medicine and OB, one of the things you have to do is defend or submit your thesis and that’s what my thesis was on. But I’ve done additional research since then with the NIH and ICHD, all kinds of different things. It’s part of academics, and once you’re in academic medicine, you’re doing the clinical part, which means taking care of patients, educating, which means educating medical students, residents, and fellows, and then also the research part, which can be basic science, clinical research or a combination of the two.

Rebecca Dekker: And what sparked your passion about helping people have babies after the age of 35? Because we’d love to hear your personal story. I know you have an interesting story.

Dr. Shannon M. Clark: Yeah. Obviously as you can tell, I trained a lot. So I did not meet my husband, it was 2011. I had just turned 38. He had just turned 38 as well. Our birthdays are a month apart and neither of us had ever been married. Neither of us had kids. We decided pretty quickly that we were going to do it together.

We were married a year and a half later. I was 39 and a half at the time, we were trying naturally of course. Very early on had a miscarriage. Then I was diagnosed with melanoma. I had to have that taken care of, so that put me at 40 and a half. Then I started to panic. Went straight for IVF because my testing was not favorable. Go ahead.

Rebecca Dekker: Okay. You’re testing, so you got some initial tests to see if you had any fertility issues?

Dr. Shannon M. Clark: Yeah, yeah. Well that’s all you can do. I’d already had one miscarriage, is do the ovarian reserve and I was already 40 and a half and my levels were not that great.

I ended up doing five cycles of IVF. Out of 16 embryos from those five cycles that were tested, genetically only one was genetically normal, and the transfer of the embryo did not take. That was purely based on my age and having decreased egg quality and quantity.

After that, we had to reset. Decided to try donor egg. We did get five embryos from an egg donor. The first transfer of two did not take, which was actually really devastating because I had put so much hope in that.

Rebecca Dekker: So after all of that heartbreak of not getting pregnant with your own eggs-

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: You then were like, “Well, surely this will work.”

Dr. Shannon M. Clark: Yup.

Rebecca Dekker: And then it didn’t.

Dr. Shannon M. Clark: And then that failed, yeah. That was crushing. It was worse. Yeah.

Rebecca Dekker: Can you go back to your first, you said five cycles of IVF. What was that experience like, for listeners who haven’t gone through that?

Dr. Shannon M. Clark: I mean, I think, I never thought that I was going to need five cycles, and I never thought I would do five cycles. That one genetically normal embryo that we got was on the third cycle, and looking back, I think because of my age, because I was going through this from 40 to 42, I probably should have stopped after three, because I think the writing was on the wall then.

But there was a part of me that just … I think it was my personality. I was an overachiever from day one, you know, as you could tell by career. I just thought I was going to get another embryo or two and it just didn’t happen. So looking back, I probably should have stopped after three, but I didn’t and that’s okay. But it’s not easy.

It was two years we were newlyweds. We went straight from being newlyweds to going straight through IVF for a few years, and it was tough. It was very tough years. Plus during that time I was also a full-time associate professor then, so it was really tough. I still had a full-time job and trying to do all those appointments and the stress of the hormonal treatments and the injections and trying to take care of patients.

Then also knowing I was infertile and delivering babies every day. That was especially tough. But I did make it through and ultimately on a second embryo transfer with donor eggs we did get pregnant with twins. We’re very thankful for that, but that was a long two and a half, three years for sure.

Rebecca Dekker: What did it feel like then when you found out you were pregnant with twins?

Dr. Shannon M. Clark: I was immediately scared, because I was 42 when I got pregnant with them, and being a high-risk obstetrician, I knew what the complications were going to be, A, with twins, and, B, because of my age. I remember right after we found out we were pregnant, my husband was up for renewing his insurance or changing his insurance policy and I said to him, “Why don’t you add me on too?” And he was like, “Why? You have insurance.” I said, “Just to be careful.”

Thank goodness we did, because I ended up on two months of hospital bed rest and then delivery at 31 weeks with the twins in the NICU for six weeks. So I think I knew what was going to happen just based on my experience as a high-risk obstetrician, and I was right. I don’t know if it was better knowing as much as I did or if it was worse. Some days I think it was better that I knew and was prepared somewhat, and sometimes I wish I didn’t know as much.

Rebecca Dekker: So he could have had a little bit more of a blissful-

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: Beginning of your pregnancy, at least.

Dr. Shannon M. Clark: Possibly, yeah. Yeah, I was worried the whole time that something was going to happen and I pretty much predicted it. But it is what it is. I was hospitalized on the same labor and delivery unit where I work, which is a blessing, because I was taken care of by my colleagues and the nursing staff that I knew very well. So I did receive excellent care, and then my babies were taken care of in the NICU by my colleagues that I had worked closely with all those years delivering babies and preemie babies. So I’m very thankful that I did deliver where I work.

Rebecca Dekker: And what complications did you experience then that led to a preterm birth?

Dr. Shannon M. Clark: Yes. At around 20, let’s see, 22, almost 22 weeks, I had a shortened cervix. I had hardly any cervix left. I was feeling a lot of pressure the weekend before. I felt my daughter who was Twin A, I felt her kicking in my vagina. I’d never been pregnant before, but I knew that probably wasn’t right.

So Monday morning when I went to work, I had them do a scan and sure enough, I had pretty much no cervix left. It was closed, but it was funneling the membranes and short cervix, and her little legs were kicking me right there.

I was immediately put in the hospital on bed rest, was in preterm labor off and on multiple times. I was on magnesium for preterm labor at around 28 weeks for almost two weeks and went into pulmonary edema. It was a rough couple of months in the hospital.

I was ultimately discharged home at 30 weeks because I had done well, and then made it a week and one day and then I abrupted and had an emergent delivery with hemorrhage at 31 weeks and one day. So I got the whole high-risk pregnancy experience, needless to say.

Rebecca Dekker: Can you explain what a placental abruption is for people listening-

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: Who don’t understand what that is?

Dr. Shannon M. Clark: Yeah. So the placenta is attached to the uterine wall, and there are multiple things that could cause a placental abruption, but that just means there’s a bleed behind the placenta. Sometimes it could just be a little tear that causes a bleed between the placenta and the uterine wall that really has no clinical consequence or it really doesn’t cause any complications. Then sometimes it could be an abruption, which is an acute bleed. That is a large bleed that causes you to contract and requires an emergent delivery.

There’s a whole gamut, or different ways it can present. It doesn’t always mean it’s going to be catastrophic or require emergent delivery. Sometimes there’s a small abruption and it stops and everything’s okay. Everybody’s a little bit different. But in my case it wasn’t, and it required delivery.

Rebecca Dekker: And how did you know that your placenta was abrupting?

Dr. Shannon M. Clark: I knew because I started contracting and then my uterus would not relax. I knew then that that’s … I’ve examined, I’ve delivered hundreds of abruption patients before and I knew that’s what it was when we were driving to the hospital.

Rebecca Dekker: Did you see any blood?

Dr. Shannon M. Clark: No, I never had any vaginal bleeding. No actually, clinically speaking some of the worst and most catastrophic abruptions do not have vaginal bleeding.

Rebecca Dekker: Okay. And so the warning sign that you knew to look out for was-

Dr. Shannon M. Clark: There’s the contraction, it’s called tetany uterine, where the contractions are very tetanic and they just are very close together or on top of each other, or you just have one sustained contraction where the uterus does not relax and your uterus just stays really hard. That’s what my uterus had done.

Rebecca Dekker: So essentially your uterus is trying to clamp down to stop the bleeding.

Dr. Shannon M. Clark: Yeah, essentially, Yeah. It’s also irritated by the blood, so the response is to cause the muscle to contract since the uterus is a muscle. So all that blood there just makes the uterus contract and it’s not allowed to relax.

Rebecca Dekker: Okay. So did you rush to the hospital then? What did you do?

Dr. Shannon M. Clark: Yeah, straight to the hospital. They knew I was coming and straight to get the IV and then straight to the OR.

Rebecca Dekker: And then how did the birth itself go during the cesarean?

Dr. Shannon M. Clark: I don’t know, because I had to be put to sleep. I did hemorrhage and require a blood transfusion during and after the cesarean section. I remember probably maybe six or seven hours after I’d already woken up, when the anesthesia wore off was when I remember waking up. The very first memories I have were probably about six or seven hours after I delivered.

Rebecca Dekker: And how are your babies doing now?

Dr. Shannon M. Clark: They’re great. They’re great. They got excellent care in the NICU. Thirty-one weeks is pretty good. The main issues you would have with a 31 weeker would be lung maturity issues. My daughter did great. She was a lot smaller. She was about two pounds smaller than my son.

He was huge for 31 weeks. He was five pounds actually. He had a little bit of lung issues, required oxygen a little bit longer. Today it’s not necessarily asthma, but if he ever gets an upper respiratory infection he has more of a lung component. But other than that they’re doing great. They’re four and a half. They’ll be five in September.

Rebecca Dekker: I would also love to hear going through the IVF donor egg process.

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: How did that work, for people who are listening who might go through that situation? Did you pick out a donor? How does that whole process work?

Dr. Shannon M. Clark: Yes. There’s a lot more available now than even when I did it, whatever, five and a half years ago. But they have egg donor agencies, and each of those agencies has a registry of egg donor candidates who have been through the process to get vetted or be approved to be egg donors. Every agency’s a little bit different on their criteria, but the criteria are very strict as far as who is a candidate for being an egg donor.

They submit their profiles, and you can go through the whole registry by doing a dropdown menu. You can pick height, weight, eye color, hair color, education level, ethnicity. There’s a whole lot of things you can pick from to see what candidates are there.

Then you pick, what we did is we ended up picking three because not everybody’s going to be available when you’re available. You have to sync up the schedules. Then out of those three, what we did is we found the one that was able to fit our timeline as far as when we could do it. Then you just go from there.

The egg donor agency facilitates everything. The fertility center where everything’s going to be done is also involved. You could pick egg donors from different states, but I didn’t want to do that. I didn’t want to involve two different fertility centers, being out of Texas where I am. I did pick someone local, and everything worked out.

From the time I picked the egg donor, it was probably about three months, less than three months before she had the egg retrieval. We did do a dedicated egg donor cycle, which means that all of the eggs that she was able to produce from stimulating her ovaries were ours. I don’t remember, looking back, how many eggs we were able to get, but we did get five embryos that were then frozen.

Then my uterus was prepared to accept the embryo. The decision was made to put in two. The whole thing about single embryo transfer is much more, what’s the right word? It’s recommended now for fertility centers for single embryo transfer than it was when I did this, what five and a half years ago, because of the complications with twins. I’m very well aware of that. Because of those reasons, most fertility centers will not transfer two embryos in anyone unless they’re over age 40 or have had multiple failed embryo transfers, then they might consider putting in two. But generally speaking, the fertility centers now just do single embryo transfer.

Rebecca Dekker: Okay. So the first time you went through that process, you did not get pregnant with the first two embryos. Then you were able to use some of the frozen embryos to try again.

Dr. Shannon M. Clark: Yeah. After the first two failed I had three left, and then transferred two more and that one took and we still actually have one that is still frozen.

Rebecca Dekker: Thank you for sharing all that information. I’m sure many people aren’t really aware of how that process works, but essentially, it’s very similar to IVF. It’s just that you’re not stimulating your ovaries to produce eggs.

Dr. Shannon M. Clark: Right.

Rebecca Dekker: You’re just getting your uterus ready to accept the fertilized eggs.

Dr. Shannon M. Clark: Someone asked me this the other day. It’s more similar to the process for using a gestational carrier. If you have a gestational carrier, that means the person that is carrying the pregnancy, the egg nor the sperm obviously doesn’t belong to the gestational carrier. Technically I was a gestational carrier because my DNA, they were not my eggs and the egg and sperm joined to form an embryo that I had no part of, but it was put in my uterus. The only difference was is I wasn’t just a carrier. I was the one that delivered and then the babies were mine. So I guess technically speaking, that would be similar as far as how the process works.

Rebecca Dekker: So at Babies After 35, you talk a lot about pregnancy at 35 and beyond. I was wondering if you could talk about what are some of the common challenges and questions people have when they get pregnant at 35 or older?

Dr. Shannon M. Clark: So once they’re pregnant, I think because of the, I don’t know if it’s the stigma. I think the first thing that people think is, yes, when you’re 35, just based on your age alone you’re going to be considered a high-risk pregnancy. Right or wrong, that’s medically speaking we do, because the first thing is the potential for having genetic abnormalities in the baby. That does start to increase at age 35 although everybody’s different.

So once the genetic screening has been okay and the ultrasound’s okay and you have no other medical complications, you’re otherwise healthy, your pregnancy should be expected to progress as anyone else’s. The only difference is that people pregnant after 35, and especially after age 40, are at increased risk for certain pregnancy complications based on age alone, no matter how healthy they are.

I was a very healthy person too. Now I had twins, but I’ve seen many healthy 35 and 40-year-olds that are doing just fine other than their age and they do have an increased risk for certain pregnancy complications like gestational diabetes, preeclampsia, placental abruption, placenta previa, cesarean delivery. Those types of things we still have to watch out for even if you’re otherwise healthy.

So some people get offended that they’re considered high risk still. I would say that’s not necessarily a bad thing, because it just means a little bit more surveillance and more attention being paid to the pregnancy based on your age alone so that we can look out for those things a little more closely. So I would not take too much offense to it, although I do understand why people think that being called a geriatric pregnancy or elderly primigravida or multigravida would be a little bit offensive because the terminology we use for billing purposes is not very flattering. So that I do understand.

Rebecca Dekker: Yeah. You mentioned genetic challenges. Do you have a lot of clients who have fertility challenges with trying to get pregnant at 35 and older?

Dr. Shannon M. Clark: I don’t.

Rebecca Dekker: You don’t.

Dr. Shannon M. Clark: Because the patient population I have, have delivered or I had patients that have used fertility assistance or assisted reproductive technology, yes. But where I work, that’s not as common. I see more of the complications in pregnancy in general and then also those associated with being older, after age 35 and especially after age 40.

Rebecca Dekker: Okay. But you do see a lot of your clients who are 35 and older have used assisted reproductive technology then?

Dr. Shannon M. Clark: Not as many as some places. My patient largely is Medicaid, so a lot of them don’t have the funds to do fertility treatments.

But that being said, about one percent of my patients do have private payer and some of them have had pregnancies via assisted reproductive technology. It’s just a matter of the type of patient population that I care for.

Rebecca Dekker: I think that raises a good point though, that fertility options are not equitable in the United States, people who would like to have children at 35 and older but can’t.

Dr. Shannon M. Clark: There is a barrier there, based on finances and what resources that people are able to have. By and large, doing fertility treatments, especially IVF, it’s not cheap.

Rebecca Dekker: Did your insurance cover it or did you pay out of pocket?

Dr. Shannon M. Clark: No, no. Everything was out of pocket.

Rebecca Dekker: Do you mind sharing how much one cycle of IVF would cost?

Dr. Shannon M. Clark: The average cost of one cycle of IVF is about 15,000, 12 to 15,000. But it’s going to vary mostly by the cost of the meds, and every individual is different as to how much medications they need. The older you are when you’re going through IVF, the likelihood that you’re going to need more medications and the medications are not cheap. That will drive the cost of one IVF cycle up based on the amount of meds that are needed.

Rebecca Dekker: I can see how emotionally that could make it more stressful too, knowing that each time you’re paying this amount of money and if it doesn’t work, how much more devastating it is.

Dr. Shannon M. Clark: Yeah, I think there’s a lot. It’s financially straining. Emotionally it’s a strain on a marriage. There’s a lot of stressors related to IVF or infertility in general. Then once you start adding on the financial aspect, of course.

I will say that I was very … I did not come from money. My parents, neither graduated high school. I did very well and I’ve done well for myself and I was fortunate to have the finances to do that. But I do understand, those that don’t have that I understand that and I do feel that we could do better as far as insurance coverage to make it more equitable for people who need it to be able to obtain those services.

Rebecca Dekker: So you talked about a lot of the challenges of your clients who are 35 and older have to do with … Some of the things they experience are increased surveillance or increased fetal testing, higher risk of gestational diabetes and some other complications. I was curious if you could talk about, are there any myths, any myths you think that needs to be busted about being pregnant after the age of 35?

Dr. Shannon M. Clark: I get a lot of messages on social media all the time. I’m 35 or I’m 36. I’ve been trying for three months. Does that mean I can’t get pregnant? No. It might take a little bit longer to get pregnant. I think people feel that if you hit age 35 that it’s not going to happen. That’s simply not true, because each individual is different.

Even though we know, we have general stats about how fertility declines with age, that doesn’t mean it’s an absolute for everyone. Everyone is different, and I think that’s why it’s very important. One thing that needs to change is with women’s health and the well-woman exam is to start talking about fertility earlier on and letting people know what happens with fertility as we age so that people could be more aware and not be surprised once they hit that age that there might be some roadblocks or some difficulties. That should be part of every well-woman exam and I think there’s a push to try to start doing that, and I agree with that, especially having gone through it myself. So it’s just not an absolute.

There are some general guidelines if you’re between age 35 and 37 and you’re trying for six months with normal menstrual cycles and you’re actively trying to conceive and you haven’t, then seek some help. If you’re 37 to 40, maybe three months.

Then at age 40, knowing what I know now, I would see a fertility specialist right off the bat. That doesn’t mean they’re going to sign you up for anything like IVF, but they could at least do some baseline labs, an ultrasound and see where you stand and give you some recommendations. Because it is definitely much more difficult to conceive after age 40 spontaneously. The more you know the better, especially if you’re on a time timeline with when you want to start your family. It’s better to get that information sooner than later.

Rebecca Dekker: So do you feel today, since it’s normal to delay pregnancy into your 30s is becoming much more normal, especially for people who want to have a career or get advanced education. They put it off into their 30s. Do you think most people realize that it’s more difficult to get pregnant if they wait?

Dr. Shannon M. Clark: No, I don’t. Because I think it’s more popular, and especially with celebrities doing it and not necessarily revealing how they got pregnant. And look, it’s not their responsibility to. There’s an assumption that it’s normal and it’s going to happen or they use their … My mom had a baby at 40 or my grandmother or my sister, but fertility is not inherited. It doesn’t mean it’s going to apply to you.

So we have to get that education earlier on, and we need to not assume that just because this person got pregnant after age 40 or 35 that there’s not going to be any difficulties for you. We have to still be educated and know what the potential complications might be.

So I do think that social media and the media in general do lend to some of the myths regarding the ease of getting pregnant later in life. I think that should be taken with a grain of salt, and people should understand that a lot of these people may not be revealing the lengths that they went to become pregnant, especially after age 40 or the cost, so making sure that we are educating and providing that accurate information.

But it’s a fine balance, because that’s what I do. I educate a lot about that, but I don’t want to be negative. I want to be realistic, and sometimes being realistic makes it seem like I’m being negative. But the stats are the stats, and the complications are the complications and we have to be willing to understand that because the more we know the more empowered we are to make those decisions, especially when it comes to our family planning goals.

Rebecca Dekker: I often think there’s two things people don’t think about when they’re delaying parenthood. One is the fertility and the difficulty in getting pregnant the longer you wait, and the other is a grandparent deficit.

I was thinking a lot about how my grandmother was around 40 when she gave birth to my dad, and she had twins. They were her last children. It was actually a surprise twin birth. This was before ultrasounds. They didn’t know she was having twins. She had her babies at the age of 40.

Then I was born when my dad was 42. So by the time I was born, my grandparents were already in their 80s. If my grandmother was alive today, she’d be almost 120. So there was a gap in my life in that I never really got to know my grandparents on that side of the family because of the delay in pregnancy if you know what I mean.

Dr. Shannon M. Clark: Yeah. No, I get that too. I can use myself. I know I had grandparents that passed away when I was really young, so it can happen. I think we just have to make the best decision that we have for ourselves at the time. Unfortunately, we compare it to what men are faced with and they don’t have the time crunches per se, although there is such thing as advanced maternal paternal age but it’s a much later than we start to experience it. It’s biology, and it is what it is.

Don’t get me wrong, I’ve thought about that as well. Having my babies nine days shy of my 43rd birthday, I think about it more now that they’re older and the older I get. But I wouldn’t change anything. I love being a mom and I love being an older mom. In some ways, not always, but I do.

Rebecca Dekker: Can you talk about some of the benefits of being an older mom, because I think that there’s a reason people delay? So what are some of the benefits you’ve found in parenthood starting in your 40s?

Dr. Shannon M. Clark: Probably the more maturity. I’ve done a lot in my life. I was able to travel and get a lot of things, see the world, and now could pass that on to them when they’re old enough to do so, and the patient’s level, the financial stability. I will say, I’m 47. I’m not 27. My physical body is not necessarily like it would be 20 years ago. But overall I feel being financially stable and mature and having a lot of life’s experiences under my belt that I can share with them, it is very positive.

But again, I know nothing different. I’m a first-time mom at almost 43, so I really have nothing to compare it to. For me, it’s how it was supposed to work out I suppose. I didn’t meet anybody when I was younger that I ever wanted to have a family with or settle down with. It just happened when I was 38. So I don’t know. I don’t know if I believe in destiny or things happen the way they’re supposed to happen, but that’s how it happened for me.

Rebecca Dekker: Yeah.

Dr. Shannon M. Clark: And that’s how it worked out, yeah.

Rebecca Dekker: And you have an amazing family.

Dr. Shannon M. Clark: Oh, thank you.

Rebecca Dekker: Is there anything else that you could share with our listeners that might be helpful for them? As you were talking it made me think of freezing your eggs and that’s becoming more common. Even some corporations are starting to include that as a benefit for their workers. Do you have any thoughts on that?

Dr. Shannon M. Clark: Yeah, I am a huge advocate for freezing eggs. I think for anybody that’s thinking about it, if you’re thinking about it you should probably look into it. There are some ideal times. The younger you are the more eggs you’re going to get, but also the younger you freeze your eggs the less likely you’re going to use them. I think the best time is probably between 28 to 32. If you’re at that age and you’re already anticipating delaying childbearing to after 35, or there’s no future family-building plans on the horizon for you, then considering freezing your eggs is a viable option.

It’s never going to hurt to go talk to a fertility specialist about it. They are the experts, they do this every day and they can ask you a lot of questions that you may not have even thought about to help you make your decision. There’s nothing wrong with just getting that opinion to see what they think to help you make your decision.

I know the cost is off-putting and I get that. But I have several friends that are in their early 30s and they’re… they’re not having families anytime soon. And I say, “Listen, I know the cost is not appealing. However, you don’t want to be in my position because that cost really isn’t appealing, trust me. It’s a lot different.” Not that everybody’s going to have to go through the lengths that I went through, but if you end up being like I was, it’s a lot of money and it’s a lot of time. It’s a lot of stress and anguish and ups and downs. If I could save just one person from going through what I went through by telling them to freeze their eggs, freeze the eggs.

Rebecca Dekker: Is there anything else you’d like to share with our listeners?

Dr. Shannon M. Clark: Be proactive about your fertility. The last thing I would say is this, back to the proactive. Be proactive. Ask questions. Get educated. Empower yourself with knowledge about what happens as you age with your fertility. The more you know, the better.

The other thing is this, I hear people all the time say two things. Number one, I don’t want to have kids so it doesn’t really matter. When I was 28, 29, 30, 34, 35, I thought I didn’t want to have kids either. I really didn’t, and I was fine with the thought of not being a parent until I met my person, and that completely changed and I was not expecting that.

So be willing to change your mind, because there is a possibility that even if you’re 30 and you say, I do not want kids, there’s always a possibility that you would change your mind. So just be open to that and be willing. I know that there is a possibility that you might change your mind. So that’s probably one big piece of advice I would give.

Rebecca Dekker: It reminds me of that saying, never say never. What you think at 30 you might not think in five years.

Dr. Shannon M. Clark: I know, and I hear that all the time. The other thing that I hear is, well if I’m old and I don’t have eggs left, I’ll just do IVF. They consider IVF a valid Plan B if they can’t get pregnant or they didn’t freeze their eggs. Well, IVF didn’t work for me. So IVF doesn’t work for everybody. That has to be considered as well. So relying on IVF as a Plan B is not necessarily the best approach to take either.

I know that sounds very negative, but it’s realistic and it does happen to some people who just think, well if it happens, it happens. If it doesn’t, then I’ll just use IVF and then IVF doesn’t work for them. So we have to be realistic about that as well.

Rebecca Dekker: And I think you’re right, you were talking about celebrities earlier, and we get this vibe or this feeling that, oh IVF isn’t that hard. It always works. It’s the magic cure. But as you experienced, it wasn’t.

Dr. Shannon M. Clark: No, it’s not. It wasn’t the magic cure for me. And I was healthy. I have no medical conditions, no medications I was on, nothing, and it did not work for me. I needed another person’s eggs.

Rebecca Dekker: On your Instagram page @babiesafter35, what are some of the topics you cover? What can people expect if they follow you there?

Dr. Shannon M. Clark: Well actually right now it’s been overtaken mostly by COVID education. I have been very proactive about educating on the COVID vaccine, COVID infection and pregnancy, trying to conceive and breastfeeding because there was a need for that. Those that follow me know that’s taken over a lot of my time. It’s needed though so I don’t regret that because I am one of the people I think people go to, one of the docs that people go to, to get that information.

But other than COVID, I do talk a lot about trying to conceive, fertility, pregnancy and parenthood after age 35. I run the life cycle, if you will, of conceiving after age 35. But oddly enough, my largest demographic is age 25 to 34. I think that is because people are wanting to get educated and wanting to get that information earlier on. So they do come to my account to get that information, which actually makes me feel really good because that means I’m doing something right if younger individuals are wanting to get that information.

Rebecca Dekker: So people are getting educated before they turn 35 about their options. Yeah, and also your point about COVID and pregnancy, that throws another wrench into the situation for people. Because some people are thinking, well, I’ll just wait to get pregnant until this pandemic is over, but they aged during that period. So what are your thoughts on that?

Dr. Shannon M. Clark: When the pandemic first hit, the reality of not being able to see a physician in person as much or having a complicated pregnancy and not having a support person in the hospital was more real. It’s not so much that way now because we have better provisions in place and ways to protect patients, we have the vaccine available.

Now it’s not the same in doctor’s offices or hospitals as it was, say, six months ago. Six months ago what I would tell people at the beginning of the pandemic, I would say if you were to get pregnant and it was a complicated pregnancy, would you be okay not being able to be seen in person for all of your visits? Would you be okay having to go to the hospital with a complication and not having a support person there? That was a very real thing that they had to consider when they were-

Rebecca Dekker: In 2020.

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: Yeah.

Dr. Shannon M. Clark: When you were thinking about conceiving. Not so much now, thank goodness. Things have changed. So now I say, go for it. Because that’s not as much-

Rebecca Dekker: No reason to delay-

Dr. Shannon M. Clark: Yeah.

Rebecca Dekker: Right. Okay.

Dr. Shannon M. Clark: No reason to delay.

Rebecca Dekker: Yeah. I did see that they’re saying that the birth rate went down during the pandemic.

Dr. Shannon M. Clark: Yeah. We were expecting a “baby boom,” if you will. That didn’t happen, which tells us as obstetricians that people were really taking it very seriously and were worried about conceiving during a pandemic and the potential consequences.

I said to go for it, but I think people need to also understand as well, and you can get this education on my Instagram, about the complications of having COVID in pregnancy. We are getting more data on that, and the long-term consequences even of being infected with COVID earlier in pregnancy. There are some potential consequences of that and we’re getting more data. So you still have to protect yourself. Vaccinated or not, there’s still provisions that need to be taken into consideration to keep your risk of getting the infection very low. Because vaccine or not, pandemic getting better or not, you still do not want to get COVID and pregnant.

Rebecca Dekker: Yeah. And as an MFM, are you helping care for people who are getting COVID during pregnancy?

Dr. Shannon M. Clark: Yeah. Yeah. We’ve done a very good job here though. We were one of the, actually I think the only center when the pandemic first hit, other than those in New York that were testing everyone when they came in. So in the very beginning we were testing and screening everybody for it. We’ve had that in place for a long time, which has been very beneficial for the providers and the nursing staff and everybody taking care of these patients.

Rebecca Dekker: Awesome. So I would encourage everybody to follow Dr. Clark on social media. You’re on Instagram, but you’re also on TikTok as well.

Dr. Shannon M. Clark: Yes, yeah.

Rebecca Dekker: What’s your TikTok handle?

Dr. Shannon M. Clark: So TikTok is tiktokbabydoc.

Rebecca Dekker: Awesome. Well thank you so much, Dr. Clark-

Dr. Shannon M. Clark: Thank you.

Rebecca Dekker: For sharing your story with us and all this information. We really appreciate it.

Dr. Shannon M. Clark: Thank you for having me.

Rebecca Dekker: Today’s podcast was brought to you by the Evidence Based Birth® professional membership. The free articles and podcasts we provide to the public are supported by our professional membership program at Evidence Based Birth®. Our members are professionals in the childbirth field who are committed to being change agents in their community. Professional members at EBB get access to continuing education courses with up to 23 contact hours, live monthly training sessions, an exclusive library of printer-friendly PDFs to share with your clients, and a supportive community for asking questions and sharing challenges, struggles, and success stories. We offer monthly and annual plans as well as scholarships for students and for people of color. To learn more, visit evbirth.com/membership.