Over the past 20 years women have moved out of the proverbial kitchen en masse and starting climbing the rungs of the career ladder. For an increasing number of women, this has meant putting off having children. But is leaving kids until later in life a safe option? And if so, do 'vintage mums' have what it takes to raise a child? 'More women are working and putting their career ahead of a family,' says Ann Quon, anchorwoman on ATV's main news, who counts herself in that category. The 43-year-old former editor of the Sunday Morning Post is also senior counsel (public affairs) for Ogilvy & Mather public relations firm. She was so busy with her career that she had little time to think of raising a family, let alone get down to the nitty-gritty of pungent diapers and 3 am breast-feeding sessions. 'My career was developing when I was in my 20s. I didn't think much about children until I was in my mid-30s and then my biological clock started ticking and I realised if I was going to have a family I had better get on and do it.' Three months ago, Quon gave birth to her second baby, Harry, a sister for five-year-old Sasha. Despite being in her 40s, Quon was confident she would not have any difficulty with the pregnancy. 'I was not too worried as I was in good health - I've always felt that if you're in good nick you shouldn't have too much trouble. And my mother had us when she was in her 40s, so there was no history of problems in my family or in my husband's,' she says. Nevertheless, Quon still had to consider the very real fear of giving birth to a baby with Down's syndrome - a chromosome disorder causing mongoloid appearance and mental retardation. 'Assuming the woman is healthy, the biggest risk is having a Down's syndrome child,' says gynecologist Dr Melton Leong. 'The risk increases with age, and increases sharply after 35, so by 40 the risk is high.' Dr Leong explains that the risk of having a Down's syndrome baby for a 25-year-old is one in 2,000 but that figure shoots up to one in 80 after 40. Amniocentesis is the most popular method of testing for Down's syndrome. This 30-year-old procedure involves drawing fluid from around the foetus and testing the chromosomes. This is the test that Quon opted for and had in the fourth month of her pregnancy. Most doctors recommend this test; the only drawback is that it is done well into the pregnancy. 'Amniocentesis is not usually done until the 15th week [of pregnancy] and the results don't usually come back until the 17th week, so if the woman elects to abort, it is in the second trimester of the pregnancy,' says Dr Leong. Quon, like many other women, decided to cross that bridge when she came to it. There is another test available: CVS or chronic villa sampling. The advantage of this test is that it can be carried out earlier. However, it carries a greater risk to the baby. 'CVS draws cells from the placenta, some of the cells may have already divided and the diagnosis is fast - often within 24 hours - and the test is usually done at 10 weeks,' says Dr Leong. 'But CVS has a higher risk because it involves putting a needle through the placenta which could cause a greater disturbance to the pregnancy and the method has a higher foetal loss.' The bottom line, says Dr Leong, is balancing the risk of Down's syndrome against the risk of procedure. Mary Nissen, 50, is a mother of four. When she became unexpectedly pregnant at 43 she opted for CVS as she wanted to know as soon as possible whether the baby would have Down's syndrome. 'I was working in the operating room at a children's hospital in Chicago when I discovered I was pregnant, so I had everything I needed,' says Ms Nissen, who had the CVS at nine weeks. 'My doctor told me my own risk of a Down's syndrome child was one in 31, whereas in my 20s it was only one in 2,000. But the CVS told me it would be okay.' But Down's syndrome is not the only risk a 40-plus woman has to consider before going ahead with a pregnancy. 'With age, every complication in pregnancy tends to occur more frequently. The body is less adaptable to stress and pregnancy can be a big strain on the body,' says Dr Leong. An increase in blood pressure, greater stress on the kidneys, fluid retention and the chance of diabetes are all concern with older mothers. In addition, the placenta may not develop as well, leading to an increased chance of miscarriage. Dr Leong recommends that women over 40 choose an experienced obstetrician, preferably one with training in maternal foetal medicine and with the expertise to be able to monitor the growth of the baby, check on Down's syndrome and ensure that the woman does not become anaemic. 'Twenty to 30 years ago there was a lot of talk about high-risk pregnancies but times have changed. Nowadays most obstetricians are well trained and assisted reproductive technology has come a long way,' says Dr Leong. He insists that a woman in her 40s must first decide whether she is a 'suitable candidate' - based on family history and personal health. 'The woman must be in good health. A healthy woman will be able to handle the stress of pregnancy much better,' he says. Ms Nissen, a registered nurse, agrees. 'Health is more important than age,' she says. She says her own doctor was nonchalant and did not try to scare her off the pregnancy although she was well into her 40s at the time. 'My doctor didn't rule out wine. She said it was fine to have a glass if I went out at the weekend, but obviously not to have five. Some doctors do tests every two or three weeks, that's excessive, they are partly doing it to increase their income,' she says. In Britain, the number of women having children in their 40s increased five-fold between 1991 and last year. And staff at the Matilda Hospital's maternity ward say they have seen a similar increase in Hong Kong. However, friends and family may take a while to get used to the idea of another baby on the way, especially if the woman already has children. Ms Nissen had three teenage sons when she conceived her fourth, Ryan: 'One of my sons said I was crazy, in fact a lot of my friends thought I was crazy and a few said 'I'm glad it's you and not me'. Not many of them were very positive.' But are older mothers as good at parenting as they might have been in their 20s? Ms Nissen, with the experience of having three sons in her 20s, says she is now a more understanding parent. 'I am more experienced and more consistent about discipline. I am also more patient with teaching - when you are older your listening skills are better and I think you are better able to understand the needs of your child.' Quon agrees: 'Older mothers are more patient. When you are older you are more settled and not rushing around all the time, you have more time for your kids. When you are young time is ticking by and you want to do as much as you can. But when you are older you have already got a career under your belt and are more relaxed.' Part and parcel of being more settled is financial stability. 'Children are very expensive and you want to give them a good education and good things when they are growing up. The financial security of being older counts for a lot,' says Ms Nissen, who gives lectures in Hong Kong on women and health and publishes a newsletter on related issues. Women who have children later in life, and their partners, must be prepared for and committed to a change in lifestyle, warns Dr Leong. 'No matter how rich they are and how many amahs or nannies they can afford, they must pay attention to their child. And they must realise it will be a burden for the next 20 years,' he says. 'Commitment is important, especially at a time when some parents may be looking forward to more leisure time.' It is not only women's attitudes that are changing. An increasing number of men are taking an active role in child rearing. 'Some men even stay at home to look after the kids or alternate with one partner working for a few years and the other looking after the kids and then switching,' says Ms Nissen. 'Women have a right to have a career and then have babies. They know the risks and then decide to take them.'