Women in the United States are having fewer babies, except for one group — those in their late 30s and early 40s.

According to the Pew Research Center, women are more likely to have children now than they were a decade ago, but many are waiting until later in life. The average age at which a woman has her first child has, therefore, risen from 23 in 1994 to 26 in 2018.

This change may be partly due to the fact that many women are delaying marriage, pursuing further education, and participating more in the labor force.

Men are also having children later in life. The average age of a first time father has increased from 27.4 in 1972 to 30.9 in 2015.

While fertility rates are rising among older parents, infertility remains a problem. According to the American College of Obstetricians and Gynecologists, women’s fertility starts to decrease gradually but significantly from the age of 32 and then reduces more rapidly from the age of 37.

Male fertility also declines with age, but the drop is more gradual. Most men remain fertile into their 60s and even their 70s, although the rate of birth abnormalities increases as the male partner ages.

There are no direct health benefits of having a baby after 40. However, delaying pregnancy may have several results that could improve a woman’s mental and emotional well-being.

A 2015 analysis suggests that support from a partner, reduced chronic stress, and a high quality relationship can lower the risk of postpartum depression.

People who wait until they have a good job with health insurance may also be able to afford higher quality medical care.

People with paid leave or their own company may be able to take longer parental leave, which may allow them more time to bond with the baby and heal from giving birth.

Greater stability in a person’s job, life, or marriage may also promote better health. A new parent who worries less about money may experience less stress.

Age increases the risk of infertility because egg quality declines. The risk of medical conditions that have an association with infertility also increases. These include:

• endometriosis
• uterine fibroids
• disorders of the fallopian tubes

In women 40 years or over, the risk of pregnancy complications, such as high blood pressure, preeclampsia, and gestational diabetes, increases.

The rate of birth abnormalities or genetic conditions in the baby also increases. At a maternal age of 40, the chance of having a child with Down syndrome is about 1 in 100, and by 45, it rises to 1 in 30.

Historically, research on age-related pregnancy and fertility complications has focused on women. However, emerging research shows that infertility increases with age for both men and women.

A 2019 study found that:

• Older fathers have higher rates of infertility, even when their partner is under 25.
• The partners of men over 45 have a higher risk of preeclampsia, preterm birth, and gestational diabetes.
• Men over 45 are more likely to father children with birth abnormalities, low birth weight, and a low Apgar score — a measure of the baby’s general health at birth.

The success rate of infertility treatments declines with age, as well. After 40, women have about a 5% chance of pregnancy per intrauterine insemination (IUI) cycle. The success rate per in vitro fertilization (IVF) cycle is less than 20%.

For healthy women over 40, advanced age does not necessarily change how the pregnancy feels or progresses.

Most women experience a range of symptoms during the first trimester, including morning sickness. There is no evidence that these symptoms are worse or different in women over 40.

The first trimester may be more stressful for other reasons, though. Older age carries a higher risk of pregnancy loss, especially for women who have previously had miscarriages.

A 2019 study found that the risk of pregnancy loss was 53% in women over 45, compared with 10% in women aged 25–29.

As the pregnancy progresses, women 45 years or over have an increased risk of experiencing pregnancy-related complications, such as:

• gestational diabetes
• high blood pressure
• preterm delivery

For this reason, a doctor or midwife may recommend increased medical monitoring. This monitoring may include additional prenatal appointments or tests.

Some women may also choose genetic testing to assess the chance of having a baby with a birth abnormality.

Despite these increased risks, women over 40 can and do have healthy pregnancies. A 2015 study found no increased risk of pregnancy complications in healthy women aged 40 or over with quality prenatal care.

Merely being over 40 does not necessarily affect delivery. In fact, research has shown that pregnancy and birth outcomes over 40 do not differ significantly from those of younger women, as long as a woman over 40:

• has quality prenatal care
• does not have chronic medical conditions
• attends regular prenatal appointments
• maintains a healthful lifestyle
• has the baby in a prenatal center

This means that, for healthy women, conceiving after 40 may be no more dangerous than conceiving earlier in life. However, the rate of cesarean deliveries was higher among women over 40.

Other research has shown that rates of complications in women over 40 are higher, though. A 2017 study in Berlin that compared the outcome of women delivering over the age of 45 to that of 29-year-old women found that:

• The younger women needed fertility treatments at a rate of 3%, compared with 34% in the older group.
• 28% of older women, compared with 11% of younger women, had a preterm delivery.
• 59% of older women had a cesarean delivery, compared with 29% of younger women.

Cesarean deliveries may have an increased risk of additional complications, particularly for older women. A 2019 study linked cesarean deliveries to a higher risk of severe complications, such as stroke, embolism, and hemorrhage.

While cesarean deliveries can be lifesaving, pregnant women should discuss the potential complications with their healthcare provider. Avoiding elective cesareans may help reduce birth complications.

The process of conceiving after 40 is no different for many people. For heterosexual couples to conceive, the couple must have intercourse during the woman’s fertile window. This window includes the days leading up to ovulation and the day of ovulation.

Using ovulation predictor tests can help pinpoint the release of eggs. Monitoring basal body temperature can help a person check whether they have ovulated. Doing this is important as a woman ages, as some women stop ovulating or do not ovulate as frequently.

To monitor basal body temperature, people can take their temperature at the same time each morning as soon as they wake up. It is important to do this immediately in the morning, after at least 3–4 hours of sleep, and using a digital thermometer.

After ovulation, the average temperature rises slightly by 0.5–1°F and remains elevated until a woman gets her period. The temperature then returns to baseline.

Basal body temperature is not always an accurate measure of ovulation. Several factors, such as stress and alcohol consumption, can affect the measurements.

Women who are single or in a same-sex relationship may choose fertility treatments such as IUI or IVF. These treatments are also an option if one person in a relationship has infertility.

If either partner has any preexisting conditions, such as diabetes or polycystic ovary syndrome (PCOS), they should see a doctor for testing before trying to get pregnant.

If a woman believes that she is not ovulating, she can see her doctor to check.

Most doctors recommend that women over 35 see a fertility expert after trying for a baby for longer than 6 months with no results.

People in their 40s may find that seeking fertility treatment as soon as possible can help them have a successful pregnancy.

Many people over 40 are able to have healthy, safe pregnancies, and are glad that they waited. With the right healthcare and a healthful lifestyle, people can have positive outcomes.

Pregnancy after 40: problems and risks |

Among those seeking to experience the happiness of motherhood in IVF clinics, the proportion of women aged 35-49 is steadily increasing. These patients are at high risk for obstetric and gynecological pathology. And I want to talk about the problems, complications, and risks, leaving aside all the perks and benefits associated with late pregnancy.

Women over 35 who decide to get pregnant often face the fact that conceiving at their age is associated with significant difficulties, because fertility begins to decline after 30 years. There are actually no strict age limits after which conception is impossible. Although everyone knows that years do not contribute to reproductive functions - both men and women. To a greater extent this applies to women. It's all because of the capricious process of ovulation. Over the years, changes in hormone-producing and structural tissues of the ovaries occur in women, the number of ovulations decreases, and an increasing number of menstrual cycles pass without the formation of an egg, and pregnancy in such a cycle is impossible. nine0003

Fertilization of a mature egg also becomes difficult - due to problems associated with the patency of the tubes, in which the entry of the egg into the uterine cavity becomes impossible. Hormonal imbalance leads to the development of specific diseases, in particular endometriosis, which makes implantation of the embryo difficult, etc.

Among the concomitant pathology (extragenital), the most common at the age of 40 are:

• myopia of varying degrees
• arterial hypertension
• anemia of varying severity
• diseases of the digestive system and kidneys
• Endocrine pathology: hypothyroidism or hyperthyroidism, impaired glucose tolerance, obesity.

These diseases can prevent pregnancy, and can also progress, worsen the quality of life and lead to adverse consequences.

Take control

During pregnancy, the woman and the fetus are a single organism, and almost all the problems of the expectant mother in one way or another affect the child. There are some of the most common dangers that await a pregnant woman at a late reproductive age: arterial hypertension, miscarriage (miscarriage), diabetes mellitus and fetal pathology.

Hypertension itself is a fairly common complication of pregnancy, but if a woman has previously suffered from this disease, pregnancy can worsen her general condition, increasing the risk of preeclampsia or preeclampsia (a condition characterized by high blood pressure, swelling and the presence of protein in the urine) . The most severe manifestation of preeclampsia - eclampsia (convulsions) - can seriously disrupt the functioning of the nervous system. Throughout pregnancy, you must constantly follow all the doctor's recommendations for drug therapy and lifestyle. In no case should you refuse to take prescribed medications on your own! nine0003

In women with diabetes mellitus during pregnancy, the risk of: preeclampsia, preterm birth, placental complications, specific fetal damage - diabetic fetopathy, stillbirth increases. Such a woman needs to be constantly monitored by an endocrinologist, take appropriate therapy and follow a diet.

Placental problems (chronic placental insufficiency, previa, placental abruption). Your attending physician can see and solve this problem in a timely manner if you are regularly observed and follow all the recommendations. nine0003

Risk of chromosomal abnormalities in the fetus . This is due to various and not fully understood reasons, including the aging of germ cells, and the increasing time of exposure to the human body of various pathogenic factors and toxic substances with age. To determine if your future baby has a predisposition to any diseases, it is very important to conduct a genetic analysis at the time of planning. After reviewing the results, the doctor will be able to understand what dangers await your child in the future. nine0003

The modern development of prenatal diagnostics gives a woman the opportunity to examine the fetus at a fairly early stage of pregnancy and identify (and more often exclude) possible deviations.

Fortunately, 96% of mothers over the age of 35 give birth to absolutely healthy children. 4% are congenital disorders that do not pose a threat to life and health.

Therefore, when planning a pregnancy in the period of maturity, a woman should undergo a thorough examination, and during gestation be under continuous supervision by a gynecologist and a specialist doctor. nine0003

Despite the above risks, you should not be afraid. Most women who plan a late pregnancy give birth to healthy babies. It just takes a little more effort, attentiveness and composure than younger mothers.

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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. nine0003

“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 lead 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 primarily the presence of severe chronic diseases, and they can be observed both in women over 40 years of age 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 preconception 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? nine0098