Dr. Christopher Olson closes his eyes and plops a finger on a page in his appointment book.
Odds are, he predicts, he'll hit the name of a woman who is expecting when she least expects it-years after she thought her childbearing days were history.
In an age where birth control comes in a patch and contraception is a unit in high school health class, you might think the "oops baby" is a phenomenon that died out when our moms hit menopause. Not so. The late-life pregnancy is alive and well, born again from the belly of "temporary birth control" methods that fail, Olson says.
"I see it many, many times a week," says Olson, a practicing OB-GYN and president of the Women's Center for Health in Naperville.
More than half, 51 percent, of pregnancies among women over 40 are unintended, according to figures from the National Survey of Family Growth, compiled by the U.S. Department of Health and Human Services.
For Sheri Vodnik, a day care operator in Aurora, a fourth pregnancy would have been a catastrophe, she says. Remembering the struggles her family had with a brother and a sister who were seven and eight years younger than the first two siblings, she was determined not to repeat the pattern.
"My whole family, my mom and sisters used to tell everyone I was the 'oops' baby," says Vodnik's younger sister Shellie Mertes. "It made me feel kind of unappreciated."
Shellie, now 30, was born even after her mother believed she was pregnancy-proofed.
"In that way, it's kind of cool, because my mother had her tubes tied and I came through anyway," she says. "I was meant to be."
Now, with two much older sisters, Mertes, who also does home day care in Aurora, feels like she has three moms. But, as a little girl, being the way-baby sister was about getting chased out of Big Sissy's room, always being the nuisance, not getting invited on drives with teenage sisters.
"Whether you've been in a family with an 'oops' baby, you have a friend who's had an 'oops' baby or you just plain old don't want one, it's something couples should think about before it happens," says Vodnik, who is 38.
Jill Malan calls 3-year-old Keith her "surprise baby." Through years as a maternal health nurse at Rush Hospital, Malan had worked with dozens of women who turned up pregnant when their older children were in high school or college. Then, at 42-when her kids were 5 and 7-she learned she was adding another bady to her brood.
The Malans had given away all their nursery things-the crib, the high chair, the stroller. She and her husband, Bill, had finally made it to the point where they could enjoy taking the kids to a restaurant and on vacations.
"We were thinking 'don't tell us we have to get back to babies again,'" Malan says. "I can't tell you that initially it was joyous."
Bill faced the new addition to the family with dogged optimism.
"There's a positive side to everything," he quips. "By the time I was done changing their diapers, they'd be old enough to change mine."
Dexter and Leah Malan, now 10 and 8, were the most overjoyed members of the family when they heard they were getting a baby brother. But the siblings' delight dimmed to dismay when they found the clan no longer could take off for the zoo in the afternoon. Baby's nap time. And summer vacation? Maybe next year.
"It wasn't nearly as wonderful as they thought it was going to be," Jill Malan says. "Having a baby really put a damper on what we were able to do."
The Malans had waited until they were older to start their family. When she found out she was expecting Keith, Jill was 42 and Bill was 50.
"We thought 'How are we going to do this? We'll be nearly 70 by the time this baby leaves for college," she says.
They reworked their retirement plans. They bought new baby furniture and opened a new college savings account, which promptly plunged in value with the sinking economy, Bill says.
Jill and Bill, who live in Chicago's Little Italy, worried about the complications and risks that come with pregnancy over 35. The chances of genetic abnormality like Down's syndrome and miscarriage are far higher for late-in-life pregnancies, Olson says. Still, more than half of the women in his office are in their late 30s and 40s, he says.
"Since the risks of miscarriage are over 20 percent, a lot of women just go ahead with the pregnancy and let nature take its course," he says.
Those whose pregnancy goes full term find it's much tougher for
an older woman to tolerate the discomforts of pregnancy. Women with
other conditions that creep up with age, like diabetes and high
find their bodies taxed further while carrying a baby.
"Almost every medical condition is amplified exponentially with pregnancy over 40," Olson says. "It's just physically harder to be human incubator when you're older."
The Malans opted for the full battery of prenatal tests-amniocentesis, blood tests. They lucked out. Jill delivered a healthy baby with no complications through a normal delivery.
But carrying her last baby was far more grueling than her first two, Jill says. Though she dropped down to part-time nursing, she felt overwhelmingly exhausted.
"I was so tired, there just seemed to be no end to how tired I was," she says.
The Malans relied on occasional at-the-moment birth control. Like many middle-aged couples, they grew lax in pregnancy prevention.
"We'd been married 16 years,' Bill Malan says. "This was no honeymoon."
For parents who are certain their families are complete, Olson is prescribing Essure, a new micro-insert for permanent birth control. In a noninvasive procedure, a tiny insert goes into fallopian tubes. In about three months, tissue grows into the Essure micro-inserts to form a permanent barrier to pregnancy.
"The most important aspect is prevention," Olson says. "For those who don't want to have incisions and general anesthetic for tubal ligation or take sex steroids like birth control pills, this is a great new option."
Sheri Vodnik found it cheaper-insurance usually pays for the insert-and less painful than a vasectomy would have been for her husband. She felt virtually no discomfort and did not miss any intimate time with her husband, Jeff, after her last pregnancy.
Bill Malan, now in his early 50s, extols the joys of later-in-life parenthood. When he shows up, gray hair and all, to pick up his clan from school, Jill supposes folks figure he's their grandpa.
"Being an old parent is cool," he says. "You're more able to appreciate the simple things like the pitter patter of little feet and that full, deep laugh."
Since Keith, Bill has had a vasectomy.
"With any luck, I'll be senile by the time he's a teenager," he says.
Robyn Monaghan is a mother and long-time journalist.
See more of Robyn's stories here.