For many couples who are trying to start a family, that 40th birthday can loom up ahead like a fertility cliff. Becoming pregnant between the ages of 20 and 35 may well be the ideal, but we all know that life doesn’t always work according to plan.

Becoming a mother after 40 – it CAN be safe

For many couples who are trying to start a family, that 40th birthday can loom up ahead like a fertility cliff. Becoming pregnant between the ages of 20 and 35 may well be the ideal, but we all know that life doesn’t always work according to plan.

Let us give you some positive encouragement, for a change: even though it’s far easier to become a mother for the first time at a younger age, it can be safe to become a mother after 40.

Protecting your health while pregnant

Pregnancy is not always an easy experience even for younger women, and you’re likely to feel the impact even more when you’re past 40. But you can take steps to lower the effects of pregnancy on your health.

Protect your joints

Pregnancy hormones like estrogen, progesterone, and relaxin soften the ligaments, which increases the risk that you could strain a muscle. At the same time, your larger stomach changes your posture and balance, which could put an additional strain on your joints.

Pay attention to the way you sit and stand, so that you don’t accidentally strain a muscle or harm your joints. Try to avoid lifting heavy objects past your first trimester.

Exercise

Exercise plays an important role in a healthy pregnancy. It raises your mood, helps you sleep better, and helps reduce the potential backaches, nausea, and constipation that often accompany pregnancy. According to the Mayo Clinic experts, regular exercise could even help you have a shorter labor, avoid a C-section, and lower the risk of developing gestational diabetes.

In general, healthcare professionals agree that you can continue any exercise program, but should be careful about taking up a new kind of workout during pregnancy. It’s not a good time to try to reach your peak fitness goals, though; just maintain your current level.

Some of the best workouts for a healthy pregnancy include:

  • Swimming, because it relieves the weight from your baby bump and lessens the strain on your back
  • Pilates and yoga, which improve your core strength, posture, and flexibility, and help your body balance the extra weight better
  • Strength training, which strengthens your body for labor

Rest

No matter how you slice it, you won’t have as much energy during pregnancy as you normally do, nor will you be as energetic as 20-something expectant mothers. Don’t push yourself to do more; it’s not a competition. Instead, allow yourself plenty of time to rest.

It can be difficult to get enough sleep during pregnancy, especially in the third trimester when every position feels uncomfortable, so take naps and rest as much as you can.

Miscarriage and stillbirth

The awkward truth is that the older you are, the higher your risks of a pregnancy ending in miscarriage, rising from about 18% for 30-year-olds to 38% when you reach 40 and 70% at age 45.

Chronic conditions like thyroid disease, diabetes, and high blood pressure all add to the risk of pregnancy loss, so if you’re otherwise healthy you’ll be better placed to give birth to a healthy baby. However, it’s not always clear what causes a miscarriage.

The risks of stillbirth, on the other hand, aren’t much higher for women aged 40+ than for those in their 20s — until you reach the 39th week, that is. From week 39 and on, the risks of stillbirth among the over-40s are double those of someone aged 35. For this reason, best practice in the UK is to induce older women once they reach this point in pregnancy.

Giving birth safely

The statistics show that if you’re giving birth past the age of 40, you’re a lot more likely to need interventions like a C-section, forceps, or vacuum delivery. The chances of needing a c-section double for women aged over 40.

Here are some of the reasons:

  • Older women are at greater risk of pregnancy complications like preeclampsia.
  • The older you are, the higher the chances that you have a chronic medical condition.
  • It’s common to induce older mothers once they get to term, but inductions are more likely to lead to a C-section.
  • Your baby is more likely to be in the breech position.
  • When you get older, your uterus can’t contract as strongly, especially if you haven’t had a baby before.

But don’t let minor side effects scare you. Assisted birth interventions and C-sections are safe and usually bring favorable birth outcomes. Here’s what you should know regarding the risks of birth interventions.
The risks to your health
When you have an intervention like vacuum or forceps delivery, it can raise the risk that you’ll have a 3rd or 4th degree vaginal tear, which takes longer to heal and can cause temporary incontinence. You’re also at a higher risk for blood clots, so it’s even more important to keep moving, and you ought to consider wearing compression socks. If you follow medical advice postpartum, however, you’re unlikely to experience any long-term effects.

A C-section is a surgical procedure, so like any surgery, there are risks of infection, surgical injury, and having a reaction to the anesthesia. But that said, the risks of serious harm following a c-section are very low. Choose a doctor whom you can trust, and follow all the advice you’re given about post-surgery care.
The risks to your baby’s health
It’s rare for a baby born through a C-section or assisted delivery to suffer any serious or long-term ill effects. After a forceps or vacuum delivery, your baby might have marks on their head and/or face, and/or small cuts on the face and scalp, but these all heal quickly. Some babies develop jaundice after an assisted birth.

After a C-section, a few babies develop transient tachypnea, which is a breathing problem, but it too resolves itself within a few days.
Conceiving a healthy child
The older you are when you conceive, the higher the chances of having a baby with a chromosomal defect. That’s because your eggs are older too, and their quality isn’t as high as for younger eggs. Older eggs are less likely to divide correctly during gestation, and that’s what causes chromosomal defects.

The most common chromosomal defect is Down’s syndrome, also known as trisomy 21. It’s what happens when the 21st chromosome produces three copies of itself in every cell, instead of just two. The risk of giving birth to a baby with Down’s syndrome is 1 in 1,250 if you’re aged 25, but it’s 1 in 100 when you’re 40 years old, and 1 in 60 by age 42.

If you use your own eggs that you froze when you were younger, you can lower this risk. It’s also particularly important to carry out prenatal screening for Down’s syndrome and other chromosomal issues once you’ve passed 40.

Overall, studies have found that babies born to mothers aged over 40 are 35% more likely to spend time in intensive care, more likely to have a low birth weight, and 70% more likely to be born with a medical issue.

Developing pregnancy conditions

There are a number of conditions which women can develop during pregnancy, and your risk of experiencing them does rise when you’re over 40. But much depends on how healthy you are before you get pregnant, and how well you take care of your health during pregnancy.

If you’re otherwise healthy and fit, you don’t have high blood pressure or other chronic health conditions, and you’ve conceived naturally, there’s no reason why your pregnancy should be higher risk than that of the 30-year-old in the next room.

Preeclampsia

Preeclampsia is a serious condition that’s caused by having high blood pressure, and can develop into organ damage. When you’re pregnant, the strain on your heart goes up massively, plus your body produces more progesterone which also pushes up your blood pressure and cholesterol. For women who already have high blood pressure or heart issues, that’s sometimes enough to cause preeclampsia.

Your blood pressure (hypertension) generally increases as you get older, and a lot of people aren’t even aware that they have borderline hypertension. When you’re aged over 40, the risks of developing preeclampsia shift from 3-4% to 5-10%.

But there are steps you can take to lower the risk:

  • Get your blood pressure checked on a regular basis
  • Exercise for approximately 30 minutes a day, 5 days a week (in accordance with advice from your healthcare professional)
  • Reduce the amount of sodium (salt), caffeine, and alcohol you consume
  • Eat a healthy diet that’s high in whole grains, fruits and vegetables, and potassium, and low in high-fat and processed foods
  • Quit smoking
  • Reduce the amount of stress in your life

Gestational diabetes

Women who are over 40 are four times more likely to develop gestational diabetes — a type of diabetes that only affects pregnant women — than younger women. It goes away after you give birth, but it can increase the risks of developing type-II diabetes postpartum.

You can reduce your risk, however, by paying attention to your diet. Cut the amount of sugar, red meat, and high-cholesterol foods you eat, and increase the amount of fiber. One study found that women who ate 10 grams more fiber per day lowered their risk of gestational diabetes by 26%.

Exercise also helps decrease the risks of gestational diabetes. Studies found that women who were the most active before getting pregnant cut their risk of developing gestational diabetes by up to 55%, and exercising in early pregnancy can also help lower your odds. It seems that the exercise you do before getting pregnant has a bigger impact than exercising during pregnancy.

Placenta praevia

Placenta praevia happens when the placenta doesn’t move up and away from the opening of the uterus. It can cause a rupture, leading to severe bleeding and possibly preterm labor.

Placenta praevia occurs when your blood (vascular) system can’t support the uterus to expand enough to accommodate your baby. Older women have a higher risk of vascular disease, which in turn increases your risk of placenta praevia.

There’s no specific treatment or cure for placenta praevia, although maintaining a healthy lifestyle which protects your heart and vascular system can help. It’s important to consult your doctor if you have any vaginal bleeding, and get regular ultrasounds so that placenta praevia can be spotted before it causes a serious health issue.

If your doctors suspects placenta praevia, they will avoid performing vaginal exams and recommend that you avoid sex and exercise, to reduce the risk of triggering a hemorrage. In some cases, you might be put on bed rest for the remainder of your pregnancy, to help make sure that you reach term and deliver your baby safely.

Although the risks are higher when you become a mother after the age of 40, there’s no reason to give up on starting a family, either through IVF or by conceiving naturally. Take steps to live as healthy and active a lifestyle as possible, both before and during pregnancy, and carry out all the health checks and screenings recommended by your doctor. We hope your pregnancy and birth go as smoothly as possible.