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Pregnancy After 40: What to Expect

Written by Alexandra Benisek

In this Article

  • What Are the Risks of Pregnancy After 40?
  • What Are the Benefits of Pregnancy After 40?
  • How Can You Prepare for a New Baby After 40?

While 1 in 4 people in their 20s and 30s will get pregnant for any one menstrual cycle, only 1 out of every 10 people will become pregnant for any one menstrual cycle by age 40. At this age, you have a 44% chance of pregnancy within 1 year. This is because as you get older, the number of eggs in your ovaries decline. With age, you’re also at a higher risk for disorders that affect your fertility.

If you get pregnant at 40 to 45 years old, experts consider this a “late” pregnancy. But it’s still possible to get pregnant and deliver a healthy baby in your 40s. Childbirth at older ages has become more common too. Since the 1990s, birth rates in people aged 40-44 have gone up. To prepare for a baby at 40, it’s important to consider the risks and benefits.

What Are the Risks of Pregnancy After 40?

In people who can get pregnant, the peak reproductive years span the time between your late teens and late 20s. Your fertility will begin to go down around age 30. This process continues more quickly starting in your mid-30s. Once you reach 45, your fertility will usually be so low that a natural pregnancy is unlikely for most people.

But some women may still have a “menopause baby.” This refers to a pregnancy and delivery that happens when you’re in perimenopause, the transition into menopause (which is when your ovaries have stopped releasing eggs).

The sperm-producing parent may also have a decline in fertility with age. While this isn’t as predictable, it could still affect your chances of pregnancy at 40.

Other risks of pregnancy at 40 include complications that are more common at this age. Older women tend to have more health issues than younger women, such as high blood pressure.

This condition can put you at a higher risk for preeclampsia, which is when you suddenly develop high blood pressure and signs of organ damage while pregnant. If doctors don’t treat this, it can lead to serious or fatal problems for you and your baby.

But later-in-life pregnancies can also affect the health of your baby, even if you don’t have any health conditions. If you get pregnant at 40, you’ll have a higher risk of:

A higher birth weight of your baby. One study found that the risk of macrosomia (or a higher birth weight of your baby) goes up with age.

Placenta previa. This happens when your baby’s placenta either partly or completely covers your cervix, which is the exit area of your uterus. With this condition, you may bleed more while pregnant and during your delivery.

Gestational diabetes. This is when you get diabetes for the first time while you’re pregnant. It causes high blood sugar that can affect your baby’s health and your pregnancy.

Gestational hypertension. This is high blood pressure that develops during pregnancy. It’s different from preeclampsia, which is a blood pressure complication during pregnancy.

Miscarriage or stillbirth. You’re more likely to have a miscarriage if you’re older. At age 40, 27% of pregnancies end in a miscarriage compared to 16% for those 30 or younger.

C-section. If you’re 40 or older, you’re more likely to have a C-section delivery than a vaginal delivery.

Down syndrome. The risk of having a child with Down syndrome goes up as you age. At the age of 20, 1 in 1,480 children will be born with the condition. But at age 40, this risk goes up to 1 in 85. At age 45, your child’s risk is 1 in 35.

Need for ablood transfusion. This can help save your life in an emergency blood loss situation during pregnancy. But it comes with the risk of complications as well.

What Are the Benefits of Pregnancy After 40?

While there are more health risks with pregnancy at 40, there are also some upsides to later births. You may:

  • Have a more established career that allows you to have more time to raise a child
  • Have a better financial status at an older age
  • Want to have a child with a partner you met later in life
  • Find that you’re more mature and ready to handle the responsibility of a child

Studies have also shown that a child later in life may lower your mental decline, lengthen your life, and lead your child to have better educational results (like higher graduation rates and test scores).

How Can You Prepare for a New Baby After 40?

To prepare to have a child, it’s important to create a reproductive life plan. With this, you and your doctor can prepare for you to have children at your desired age.

If you want to get pregnant now, make sure you’re as healthy as possible. Stop alcohol, marijuana, and tobacco use. Talk to your doctor about prenatal vitamins with folic acid.

Visit your doctor to chat about your diet and lifestyle, sexually transmitted infection (STI) screening, a healthy prepregnancy weight, and any other concerns before you get pregnant. Everyone should make an appointment before they try to get pregnant, but this is especially crucial if you’re 40 and older.

If you don’t want to get pregnant now but may want to have a baby at an older age, talk to your doctor about:

In vitro fertilization (IVF). With this method, experts combine a sperm and egg in a laboratory to grow an embryo. Your doctor can then freeze the embryo for later use.

Oocyte cryopreservation. This is when your doctor freezes your eggs. They’ll take some of your eggs from your ovaries and freeze them so you can use them later in IVF.

You can still get pregnant naturally at 40, but these methods may heighten your chances of having a baby at a later age.

Benefits, Risks, and What to Expect

Having a baby after the age of 40 has become an increasingly common occurrence. In fact, the Centers for Disease Control and Preventiom (CDC) (CDC) explains that the rate has increased since the 1970s, with the number of first-time births among women ages 40 to 44 more than doubling between 1990 and 2012.Mathews TJ, et al. (2014). First births to older women continue to rise. https://www.cdc.gov/nchs/products/databriefs/db152.htm

While women are often told it’s best to have children before the age of 35, data suggests otherwise.

There are multiple reasons why women are waiting to have children, including fertility treatments, early careers, and settling down later in life. If you’re curious about what it’s like to have a baby at 40, consider all the range of benefits, risks, and other facts you need to know.

Sometimes the benefits of having a baby later in life can outweigh those of having children when you’re in your 20s or 30s.

For one, you might have already established your career and can dedicate more time to raising children. Or your financial situation could be more favorable.

You may have also had a change in your relationship status and you want to have a baby with your partner.

These are among some of the most common benefits of having a child at age 40. However, some research suggests potential other benefits, including:

  • reduced cognitive declineKarim R, et al. (2016). Effect of reproductive history and exogenous hormone use on cognitive function in mid‐ and late life. DOI: 10.1111/jgs.14658
  • longer life spanSun F, et al. (2015). Extended maternal age at birth of last child and women’s longevity in the long life family study. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4270889/
  • better educational outcomes in children, such as higher test scores and graduation ratesBarclay K, et al. (2016). Advanced maternal age and offspring outcomes: Reproductive aging and counterbalancing period trends. DOI: 10.1111/j.1728-4457.2016.00105.x

Due to advances in technology surrounding fertility, pregnancy, and delivery, it’s possible to safely have a baby at age 40. However, any pregnancy after age 40 is considered high risk. Your doctor will monitor you and the baby closely for the following:

  • high blood pressure — this may increase your risk of a pregnancy complication called preeclampsia
  • gestational diabetes
  • birth defects, such as Down syndrome
  • miscarriage
  • low birth weight
  • ectopic pregnancy, which sometimes happens with in vitro fertilization (IVF)

Advancements in fertility technological have been a driving force in the increase in women waiting to have children. Some options available to women include:

  • infertility treatments, such as IVF
  • freezing eggs when you’re younger so that you can have them available when you’re older
  • sperm banks
  • surrogacy

Even with all of these options available, a woman’s fertility rate does decrease significantly after 35 years of age. According to the Office on Women’s Health, one-third of couples after the age of 35 experience fertility issues.Infertility. (2018). https://www.womenshealth.gov/a-z-topics/infertility This may be attributed to the following risk factors that increase with age:

  • fewer number of eggs left to fertilize
  • unhealthy eggs
  • ovaries can’t release eggs properly
  • increased risk of miscarriage
  • higher chances of health conditions that can impede fertility

The number of egg cells (oocytes) you have also decreases significantly after the age of 35. According to the American College of Obstetricians and Gynecologists (ACOG), the number drops from 25,000 at age 37 to just 1,000 at age 51. Female age-related fertility decline. (2014). https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Female-Age-Related-Fertility-Decline During puberty, you have between 300,000 and 500,000 oocytes.

It can take some time to get pregnant, regardless of age. But if you’re over 40 years old and you’ve been trying unsuccessfully to have a baby naturally for six months, it may be time to see a fertility specialist.

A fertility specialist will run tests to see if there are factors that are affecting your ability to get pregnant. These may include ultrasounds to look at your uterus and ovaries, or blood tests to check your ovarian reserve.

According to ACOG, most women after age 45 can’t get pregnant naturally.Having a baby after age 35: How aging affects fertility and pregnancy. (2018). https://www.acog.org/Patients/FAQs/Having-a-Baby-After-Age-35-How-Aging-Affects-Fertility-and-Pregnancy

If you are experiencing infertility, talk to your doctor about the following options to help determine if one is right for you:

  • Fertility drugs. These help with hormones that can assist with successful ovulation.
  • Assisted reproductive technology (ART). This works by removing eggs and fertilizing them in a lab before inserting them back into the uterus. ART may work for women with ovulation issues, and it can also work for surrogates. There’s an estimated 11 percent success rate in women ages 41 to 42.Infertility. (2018). https://www.womenshealth.gov/a-z-topics/infertility One of the most common types of ART is IVF.
  • Intrauterine insemination (IUI). Also called artificial insemination, this process works by injecting sperm into the uterus. IUI may be especially helpful if male infertility is suspected.

Just as it’s statistically more difficult to conceive after the age of 40, pregnancy itself can also be more challenging as you age.

You may have more aches and pains due to joints and bones that are already starting to lose mass with age. You might also be more susceptible to high blood pressure and gestational diabetes. Pregnancy-related fatigue may be more pronounced as you get older, too.

It’s important to talk to your OB-GYN about what else you can expect during your pregnancy based on your age and overall health.

Vaginal delivery may be less likely after the age of 40. This is primarily due to fertility treatments that can increase risk for premature birth. You may also be at an increased risk of preeclampsia, which may necessitate a cesarean delivery to save both mother and baby.

If your baby is delivered vaginally, the process may be more challenging as you get older. There’s also an increased risk of stillbirth.

Many women do successfully deliver healthy babies at or over the age of 40. Talk to your doctor about what to expect, and come up with a backup plan. For example, if you’re planning a vaginal delivery, talk to your partner and support group about what help you’ll need if you require a cesarean delivery instead.

Age in and of itself does not increase your risk for multiples. However, women who use fertility drugs or IVF for conception are at a higher risk of twins or multiples.Infertility. (2018). https://www.womenshealth.gov/a-z-topics/infertility This is because of the way the medications increase ovulation.

Having twins also increases the risk that your babies will be more prematurely.

Getting pregnant after age 40 can take longer for some women than others. Still, your fertility specialist will need to work with you quickly since your fertility rate drops dramatically in your 40s.

If you’re unable to conceive naturally, you’ll want to consider whether you’re up for potentially multiple tries with fertility treatments and if you have the means to cover the treatments.

Having a baby at 40 is much more common than it used to be, so if you’ve waited to have children until now, you’ll have a lot of company.

Despite the challenges it can take to conceive, having children in your 40s is definitely a possibility. You’ll want to talk to your doctor about all your individual risk factors before starting a family at this stage in your life.

Pregnancy after 40: how to prepare and give birth to a healthy baby

Is there an ideal age for pregnancy and childbirth? "Yes!" — experts of the department of assisted reproductive technologies (ART) of the Veresaev hospital are sure.

“The most favorable age for conceiving, bearing and giving birth to a baby is 20-35 years old, but theoretically, if a woman is in good health, she can become a mother even at 60 years old, but here you need to understand that getting pregnant at this age is possible only with the help of assisted reproductive technologies using donor or previously frozen eggs. The most “adult” pregnant woman after IVF was 52 years old,” says Karina Grigoryan, head of the ART department, obstetrician-gynecologist, doctor of the highest category, candidate of medical sciences. nine0003

What changes in a woman's body after 40 years and how it can affect conception, pregnancy and child?

The probability that women of the older reproductive group have various chronic diseases, including hypertension and diabetes, is high. Such pathologies tend to worsen during pregnancy, which means they can become a formidable complication for the mother and fetus.

In principle, the chances of conception decrease with age. This is due to changes in the reproductive system - the uterus, ovaries. The regular "aging" of germ cells increases the number of complications during pregnancy and can lead to fetal malformations:

  • Genetic and non-genetic
  • Preeclampsia, which in turn leads to increased blood pressure, disruption of the kidneys, edema, impaired blood flow in the vessels of the uterus, placenta and umbilical cord of the fetus

Of course, the capabilities of modern medicine, in particular, prenatal screenings allow timely diagnosis of pathological conditions on the part of the fetus and the pregnant woman, which means making the right decision on the further medical support of the woman in a timely manner. nine0003

Does pregnancy rejuvenate the body?

So says the popular rumor and partly we can agree with it.

It is known that the placenta, which is formed by the 12th week of pregnancy, has a powerful hormonal secretion. A high concentration of the female sex hormone estrogen has a beneficial effect on the appearance of the expectant mother.

What are the features of the course of pregnancy in a future mother 40+?

The main feature is an increase in the frequency of complications during pregnancy. Unfortunately, the risk of genetic diseases in a child increases several times - Down syndrome, Edwards, Patau, etc., heart defects and the central nervous system of the fetus. Therefore, the course of pregnancy at this age should always be under the close supervision of obstetricians and doctors of prenatal diagnosis. nine0003

Are there any diseases that are considered a contraindication to pregnancy 40+?

Contraindication to pregnancy is not age, but first of all the presence of severe chronic diseases, and they can be observed both in women over 40 years old and in very young patients. We are talking about such pathologies as multiple sclerosis, uncompensated and not treatable hypertension, severe heart disease, genitourinary system, mental, oncological diseases, etc. nine0003

How to prepare for pregnancy after 40?

If we are talking about a planned pregnancy, then in the pregravid period, the expectant mother is recommended to undergo a thorough examination: laboratory tests, a visit to a gynecologist, a therapist, ultrasound of the abdominal organs, kidneys, thyroid gland, vessels of the lower extremities and mammography.

If it's a second or third pregnancy after 40, does it carry the same risks as the first? nine0010

In a multiparous woman after 40 years, the body is “adapted” to pregnancy, the frequency of complications may be lower in general, but in this case we are not talking about fetal malformations, the risk of which does not depend on the number of previous births.

"Late" delivery is an indication for caesarean section?

The woman's age is not an indication for operative delivery. Many of our patients of the older reproductive group, including those who became pregnant with the help of IVF, gave birth themselves, naturally, and the birth went smoothly. nine0003

What are some of the postpartum issues that a 40+ mother may encounter?

If a woman was planning a pregnancy, had a complete examination, correction of pathological conditions, then the recovery postpartum period will run smoothly for her. Maybe not as fast as in 20-25 years, but quite successfully.

If we talk about women entering pregnancy with many chronic diseases, not examined, then we can expect various "surprises" in the postpartum period. nine0003

In any case, all mothers need care, support and help.

Pros and cons of pregnancy after 40?

Of course "for" with both hands. All women have successful pregnancies and healthy babies.

To learn more about assisted reproductive technologies available at the ART department of the Veresaev hospital, please call the single contact center: 8 (499) 450-55-81 (ext. 8).

Late children return youth - articles from the specialists of the clinic "Mother and Child"

The number of women who gave birth to their first child between 30 and 40 years has almost tripled in the last 20 years. In addition, the number of first-time mothers after 40 years has increased by almost 50%. And physicians are forced to reckon with it. Gradually, the offensive word “old-timer” disappeared from their vocabulary, and childbirth in adulthood is no longer considered something out of the ordinary.

Increasingly, women are postponing childbirth while studying or moving up the career ladder. The number of early births (up to 20 years old) in all civilized countries is steadily falling (Russia, however, is an exception). nine0003

Numerous studies have shown that pregnancy and childbirth after 35 do not pose such a serious danger as previously thought. The average portrait of a woman in her thirties who is preparing to become a mother has changed a lot lately. As a rule, she belongs to the middle class, is well educated, takes care of her health. Her body is not worn out by numerous births.
It has always been believed that later children are more likely to be born prematurely, gain less weight and get sick more in early childhood. Recent research has cast doubt on this. nine0003

American doctors who observed 4 thousand women in labor in one of the hospitals in New York came to the conclusion that a woman over 35 years old, if she is physically healthy and has not had miscarriages, has a chance to give birth to a normal healthy child (even if this is the first birth) almost the same as a 20-year-old.

For a middle-aged woman who has devoted all her young years to a career, pregnancy is an opportunity to try herself in a completely new way. In addition, she is more likely to find support from her husband, since a mature man is psychologically more prepared for the role of a father than a young one. nine0003


As you know, psychological readiness for motherhood comes much later than biological. According to psychologists, pregnancy in adulthood is much more favorable than in early youth. A woman perceives her condition more calmly, less prone to stress, less likely to experience internal conflicts. She is more disciplined and lives in harmony with herself. Many consider the birth of a child a gift of fate or a blessing from God.

nine0087 Older women, most of whom married late, as a rule, stand firmly on their feet, have reached a certain level in their professional activities, and are confident that they will return to work some time after giving birth. All this allows them to look to the future with great calmness and optimism. A middle-aged woman who has devoted all her young years to a career may look at pregnancy as an opportunity to try herself in a completely new capacity. In addition, she is more likely to find support from her husband, since a mature man is psychologically more prepared for the role of a father than a young one. As a rule, middle-aged parents, unlike young ones, devote more time to raising a child. As a result, many "late" children are ahead of their peers in their intellectual and physical development. The secret here is in the atmosphere of love and mutual understanding in the family where the long-awaited baby appeared. nine0003


American psychologists conducted a survey among women who became mothers before the age of 20 and between 30 and 40 years. Both were asked to answer the question of whether they would give birth at the same age if they could make a new decision. More than half of those whose children were born before the age of 20 answered “no”, and the majority of older mothers expressed confidence that they had chosen the optimal time for the birth of a child.

Hollywood star Kim Basinger first became a mother when she was already over 40. Actress Beverly D * Angelo, a friend of Al Pacino, gave birth to his charming twins when she was 49. The famous actress Marina Neelova had a daughter when she was 41 years old. And there are many such examples.


Doctors today can help even those women whose reproductive period has ended. Various methods are used for this: hormone therapy, implantation of a donor egg in the uterus. Muscovite Natalya Alekseevna Surkova got into the Guinness Book of Records, becoming a mother at the age of 57. She already had two adult children. Recently, a 66-year-old woman from Romania gave birth to a child. For many years she taught at the University and wrote books for children, but she had no babies of her own before. True, doctors are not particularly enthusiastic about the increase in the number of mothers-grandmothers: the risk of complications and the responsibility of the doctor who “leads” such a woman in labor are too high. nine0003

Of course, late motherhood has its problems. Women over 35 are more likely to experience health complications during pregnancy, especially diabetes and high blood pressure. These complications occur in approximately 6% of women over 35 years of age compared to 1. 3% in younger women.


Another problem: the "solid" age of the parents increases the risk of developing anomalies in the fetus, the birth of children with severe hereditary diseases. Therefore, all primiparas over 35 years of age are usually offered an amniocentesis in the second trimester of pregnancy - an analysis of amniotic fluid. This allows you to identify about 200 hereditary diseases associated with a violation of the chromosome set. nine0003

You can also find out the degree of risk of such diseases using the "triple" test - it is done around the 16th week of pregnancy. For analysis, blood is taken from a vein. Women of older reproductive age do not recover from childbirth as quickly as younger women. For some of them, after decades of taking care of themselves, it can be difficult to get used to the fact that the baby, especially in the first months, requires constant care and attention.


Another disadvantage of late childbirth is that parents have to limit themselves to one child or have a second one when the first one is still very small - after all, the time allotted by nature for acquiring offspring is not unlimited. nine0003

Should I do a Caesarean section?

In women over 30-40 years of age, childbirth can be more difficult and protracted than in younger women - this is the generally accepted opinion. In fact, any experienced obstetrician can testify that in many cases, older mothers do an excellent job with minimal medical help. Often and, by the way, not always justified, at this age they offer a caesarean section. This does not raise questions if there are medical indications for surgery or a woman managed to get pregnant only with the help of doctors. Then, trying to eliminate any risk to the baby and taking into account the aggravating factors, the doctor makes such a decision. nine0003


Recent studies have shown that, on average, the duration of labor for older mothers exceeds the duration of labor for young mothers by only 45 minutes. And at 40, you can not be afraid of difficult childbirth if you are well prepared for them physically and psychologically.

Where to start?

If for some reason you put off the birth of your child, you should prepare in advance for his possible birth.
Try to get rid of bad habits if you have them. By the age of 35, we have time to experience a stronger impact of adverse environmental factors than by the age of 20.

Should we add to them the harm from smoking and alcohol? Watch your health, do not start even trifling, at first glance, diseases. If you treat a cold rather than endure it on your feet, you are much more likely to keep your kidneys and heart healthy, organs that take a lot of stress during pregnancy.
Control your weight and maintain muscle tone. Go in for sports or exercise. Excess weight creates additional problems during gestation. nine0003


It should be borne in mind that after 35 years, the ability to bear children gradually decreases. Experts believe that at this age it may take 6-12 months to conceive instead of four. Before you decide it's time to start procreation, visit a therapist. Sometimes a woman is being treated for infertility for years, during which time she develops various ailments. These diseases may not cause much concern, but they can interfere with the normal course of pregnancy. nine0087 During pregnancy, you will need to be more attentive to yourself than younger women, to strictly monitor your diet and regimen.


It is worth taking seriously the choice of a doctor and a maternity hospital. It is desirable that the clinic be equipped with everything necessary in case you need urgent help for a newborn.

"If you want to preserve beauty, have a child at forty," say the French. If a woman is healthy, during pregnancy she blossoms. In this magical way, estrogens act - female sex hormones, the production of which increases several times. In addition, the eggs of a pregnant woman are not "spent", so aging seems to be suspended. Menopause in women who have become mothers in adulthood may come later. Raising a baby provides a unique opportunity to turn from a middle-aged woman into a young mother. nine0003

Such parents usually go through the so-called midlife crisis painlessly - they just don't have time to delve into their problems.

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