Having a baby at any age can be fun and exciting. It can also cause worry. For mothers who delay childbearing and pregnancy until their late thirties and early forties, there may be some added concerns to address. While the number of these women has increased steadily over the years, the number of moms over 40 is growing even more rapidly than before. This actually is beneficial from the point of view of scientists because they now have more data to address the concerns of these women.
Prior to doing any research women were told they had very grim prospects of getting pregnant and giving birth to a healthy child. Science has now shown us that this is not necessarily true. Here are some areas of concern for midlife moms:
Fertility is certainly not an issue with every mother over the age of 30. However, everyone, including men, will have a decline in fertility beginning in their thirties. This may not be a perceptible decline nor is there a set age at when this begins. Women in their late thirties and on may actually ovulate less frequently, their eggs may be harder to fertilize and they may be more likely to experience problems with endometriosis and blockages of the fallopian tubes. There have been many technological advances in fertility treatments, enabling many women who previously would have had trouble to conceive. Good preconceptional care can help you prevent and identify these potential problems before they are of concern.
Genetic testing and counseling are very personal issues. Since some rise in birth defects is apparent with maternal age, which may also slightly increase the miscarriage rate, counseling and testing are offered to most women over the age of 35. Some women and their families choose to do no testing, while other choose all the testing that is available. There is no one right answer.
Genetic counseling might be a good option, even if testing is not an option for you. This can even be done prior to conception. The counseling involves a long, detailed interview with a genetic counselor, and perhaps blood work from you and your partner.
Genetic testing can be as simple, and harmless to the baby, as the Maternal Serum Alpha fetoprotein test (also known as the triple screen). This is a screening test for neural tube defects and Down syndrome. Other potential testing amniocentesis, chorionic villus sampling (CVS) and ultrasound. Some of these tests do carry risks to the pregnancy. Talking to your doctor or midwife about the potential risks versus the benefits to you is very important in any decision you make.
Simply being over a certain age shouldn't predispose you to many pregnancy complications. Though most studies show that women over 35 have a higher chance of pregnancy complications this is usually due to preexisting conditions (like blood pressure issues, etc.) rather than simply age and pregnancy. This is where preconceptional counseling can help you find out what you need to do to get healthy before pregnancy.
Here are some hints for a healthy pregnancy:
- Take folic acid to help prevent neural tube defects
- Eat a balanced diet
- Start an exercise program
- Get all pre-existing medical conditions under control
- Avoid cigarettes, alcohol and other drugs
Labor and Birth Complications
You may have heard that there are more problems during birth for women over 35. Certain complications that occur more frequently in midlife moms, like blood pressure problems, often incur the need for interventions like cesarean section and induction of labor. While there is an increase in length of labor and prolonged second stage, which might explain the higher cesarean rates for this age group as well, many say that this is simply from the increased medicalization of birth for women over 35. Prenatal care and taking care of yourself can help prevent and lower some of these potential complications, as well as seeking out a practitioner who believes in a philosophy of normal birth regardless of age.
The Good News
The good news is that with proper and early prenatal care, preferably starting prior to pregnancy, you can have a happy and safe birth with very similar outcomes to those of women in their twenties. Many mothers who fall into this category often feel more ready for the demands of a child emotionally and financially. American College of Obstetricians and Gynecologists conclude, "Age need not be a barrier to a safe, healthy pregnancy."