I am going with Baba Yaga on this one...... I worry that your wife might not be up for the task of pregnancy, postpartum and everyday stresses (diapers, crying, attention required to progress baby's development, breastfeeding, your life becoming all things baby and of course lack of sleep and pre-baby spontaneous anytime sexual relations!) that occur when you are the primary provider of an infant/small child. Child safety (physical, mental and emotional) is paramount. She needs to have a good support system too outside of you.
How is her paranoia doing? Is she still taking medication for the accident? These are very important factors to consider.
As far as age..... 43 is the new 35 as far as women's fertility goes (pre- pre-natal nutrition is paramount to reduce down-syndrome in women 35+)
I know many "worldly" couples starting kids in their 40s! Hubby (40) and I (35) are considering having 2 more in the next eight years too.
So if you really think this is a 'safe' choice for your wife, then have her start taking pre-natal vitamins 6 months prior to conception, eating extrememly healthy, water being her main beverage, and exercising properly for each stage (pre, natal and post) to keep up seratonin levels steady. Healthy bodies have higher chances of healthy babies.
If she is not 'ready', maybe spend the next year or two preparing to be ready. It will give her a goal to work toward and plenty of time to decide if it is a lifestyle she is up to maintaining.
This all said ....being a parent is very fulfilling. Children are delightful if you treat them as the delightful and wonderous individual creatures they are while maintaining firm boundaries that allow them to question but still know when to respect authority for their own benefit.