Pregnancy in your 40s: Everything you need to know

Don’t let the words “advanced maternal age” scare you – you can still have a healthy pregnancy in your forties! Here’s everything you need to know…

Pregnancy 40 years old

American women of all ages are having fewer babies than before – except for women in their 40s! According to the Centers for Disease Control and Prevention (CDC), the rate of pregnancy in women over 40 has increased by 2 percent per year since 2000 for a total of 10.6 pregnancies per 1000 women in 2014.

While there are a few extra risks to consider, plenty of women in this age group have healthy pregnancies. Here’s everything you need to know about having a baby after the big 4-0…

Fertility

The biggest obstacle most women in their 40s face when trying to conceive is their declining fertility. At age 30, a healthy, fertile woman has a 20 percent chance of getting pregnant each month she tries. By age 40, that chance has dropped to less than 5 percent per cycle.

Women over the age of 35 who have been trying to conceive for six months without success should talk to their doctor about having a fertility evaluation. Women who are over 40 should consider getting evaluated as soon as they start trying for a baby.

Thankfully, there’s a wide range of fertility treatment options available to help women conceive well into their 40s. For a complete run-down of all the treatments, success rates, risks and costs, read Fertility Treatments 101.

Risks to the mother and baby

Pregnancies in women over 40 are considered “high risk”. Not only do older women have a higher chance of pregnancy complications, but they’re more likely to have a chronic health condition such as hypertension or diabetes that will increase their risk even further.

Women over 40 are more likely to experience:

  • Miscarriage: The increased risk can be due to genetic issues related to an older egg, or to a chronic health condition
  • Chromosomal abnormalities: At age 30, your chance of having a baby with Down syndrome is 1 in 940. At 40, it’s 1 in 85. Genetic testing is available to determine your likelihood of having a baby with Down syndrome or another chromosomal abnormality.
  • Pregnancy complications: These can include high blood pressure, gestational diabetes and preeclampsia (a potentially life-threatening illness characterized by high blood pressure and protein in the urine). Women who already have a condition such as low-grade hypertension or pre-gestational diabetes are at even higher risk.
  • Placenta previa: This occurs when the placenta partially or completely covers the cervix and it can lead to severe bleeding.
  • Premature labor and preterm birth: Medical professionals previously believed that women over 40 had a higher risk of preterm birth because they had more risk factors such as gestational diabetes, placenta previa and the use of assisted reproduction technologies. But a recent Canadian study found that this age group’s risk of preterm birth is higher regardless of confounding factors.
  • Cesarean: According to the CDC, women over 40 are more than twice as likely to deliver by C-section than women under 20. This discrepancy is partly due to pregnancy complications related to the mother’s age, but also to the belief that C-sections are safer for older women.
  • Low birth weight: This can be related to being born preterm or a range of other factors.

Women in their 40s also have a higher chance of having twins or triplets due to an increase in the use of fertility treatments as well as the fact that older women are more likely to produce two eggs per cycle. Some might see this as a blessing and others a curse, but either way it’s something to consider seriously when trying to conceive after 40.

Having a healthy pregnancy

There are several steps mamas-to-be can take to reduce their risk of complications and enjoy a healthy pregnancy after 40. These include:

  • Seeking out high-quality antenatal care: It’s essential to attend every prenatal appointment and undergo all the necessary tests to ensure the pregnancy is on track.
  • Quitting bad habits: These can include smoking, alcohol and recreational drugs.
  • Eating a healthy pregnancy dietIt should include plenty of lean protein, whole grains, low-fat dairy, vegetables and fruit.
  • Taking a prenatal vitamin: The American College of Obstetricians and Gynecologists recommends taking a prenatal vitamin that includes 400 micrograms of folic acid, 27mg of iron, 1000mg of calcium and 600 international units of vitamin D.
  • Maintaining an active lifestyle: Even if you didn’t exercise before pregnancy, you can safely take up gentle activities such as swimming, walking and yoga. Aim for at least 150 minutes of moderate-intensity aerobic activity every week.
  • Keeping your weight in check: According to the CDC, if your weight was normal before pregnancy, you should gain 25 to 35 pounds (less if you were overweight and more if you were underweight).

Becoming a mother

The process of matrescence – or the transition into motherhood – can be a difficult one at any age. On the one hand, new mothers feel an indescribable love for their new baby (although this isn’t a given and can take time, especially for women who experience postpartum depression or other postnatal conditions).

On the other, the huge identity shift that they’re experiencing can bring with it a range of negative emotions, including fear, sadness, guilt, worry and disappointment. These feelings may be exacerbated in older women who are forced to give up a career they worked hard for or the freedom they’ve been used to for so many years.

At the same time, research shows that older mothers are less likely to experience postnatal depression than younger ones. They may be more confident in their parenting skills and decisions, more likely to ask for help when they need it, and more financially stable.

Having a baby after 40 might carry a few more risks, but for many hopeful mamas the rewards are well worth it.