Women pregnant at 40
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.
What I Learned From Being Pregnant in My 40s
Motherhood wasn’t always a top priority for Leslie. With a successful law career, family nearby, and lots of friends, she was happy with how things were.
Her perspective changed when she met her partner Aaron. After two years of dating, they decided to try for a baby – but being in their early 40s, they didn’t expect it to be easy.
From that moment on, Leslie’s experience was full of surprises. She shares her story with ACOG in this edited interview.
ACOG: Where does this story start, for you?
Leslie: I was never one of those people who said, “I have to have a kid, I have to be a mom.
” I was very content with the way my life was.
And then I met Aaron, who’s now my fiancé. I had just turned 40, and he was 41. We just started talking about it. He was very used to being around a lot of kids – and as an only child, I didn’t grow up with any of that.
Leslie decided to have prenatal genetic testing because of her age.Aaron is the only person I would have considered doing this with. I joke that he’s more maternal than I am. So we said, “OK, let’s give it a shot. If it happens, great. If it doesn’t, we’ll still have a great life.”
ACOG: Did you have any trouble getting pregnant?
Leslie: I completely expected that I would not be able to get pregnant easily. I had frozen my eggs when I was 37, just because I didn’t know the direction my life would take. So that was our back-up plan. We decided we would try on our own for 6 months, and then maybe we’d try with the frozen eggs.
But we were very lucky, and I got pregnant on the first try.
We found out over Thanksgiving weekend in 2017. Aaron was like, “Are you excited? I can’t tell!” And I totally was, but I was also just in utter shock.
ACOG: What concerns did you have about being pregnant over 40?
Leslie: We were definitely concerned about the possibility of genetic defects. We knew the risk of having a baby with a birth defect gets higher as you get older. But early on, we had genetic testing for chromosomal abnormalities – starting with a blood panel screening at 12 weeks.
While that test didn’t uncover anything concerning, I decided, due to my age, to have an amniocentesis at 16 weeks. This was a big decision, and I spoke extensively with the genetic counselor to think through it. Ultimately, I did it for the peace of mind – and everything came back fine, thank God. I was very grateful that we were forced to talk about those potentially hard choices as part of my prenatal care.
Otherwise, I did the best I could to take care of myself.
I took prenatal vitamins and stuck to my usual healthy diet. I planned to exercise regularly too, but to be honest, fatigue usually got in the way.
ACOG: How did your pregnancy go?
Leslie: My only risk factor was my age. I had no high blood pressure, no preeclampsia, no gestational diabetes. But I had more appointments and ultrasounds, plus the genetic testing.
I have to admit, I didn’t love being pregnant. I had morning sickness in the first trimester, and then I was just exhausted until the end. I felt very big and swollen. Everything ached.
ACOG: Did you have any complications with delivery?
Leslie: I delivered a healthy baby boy 2 weeks before my due date. I didn’t have any contractions or other early signs, and then one Saturday morning my water broke in a giant gush. They tell you it won’t be like the movies – but it was exactly like that!
Once we got to the hospital, I took oxytocin to induce labor and eventually I got an epidural.
I dilated to 10 centimeters and started pushing. They could see the crown of Bailey’s head but no matter what we did, he just wasn’t coming out. They even tried suction, to no avail.
At about 11 pm, the ob-gyn on call recommended a cesarean. I felt really deflated about that after going through all that labor. I felt like I had failed, even though I know I hadn’t. My baby was born healthy and well. And needing a cesarean delivery had nothing to do with my age. That could happen to anybody.
ACOG: What did you learn from this experience?
Leslie: Many women don’t have an easy time getting pregnant at my age, so I don’t want to make this sound like it will apply to everyone. But I didn’t know what my body was capable of until I tried. Women in their 20s can have fertility issues, and then there’s me, getting pregnant on the first try at 42.
I never imagined I would end up with this little family. But now that we have Bailey, I can’t imagine it any other way.
Published: October 2020
Last reviewed: October 2020
Copyright 2023 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.
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.
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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.
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Childbirth at 40+: doctor about late childbirth
Obstetrician-gynecologist of the highest category Pilipenko Lyudmila Nikolaevna spoke about the risks of late motherhood and modern methods of preventing them
Childbirth at 40+ is trending today . Why, forty are enough examples of successful childbirth even after fifty years. The reasons for this reproductive behavior are many and usually complex. It can be economic, psychological, and any other reasons. But - most importantly - the level of modern medicine and new reproductive technologies make later motherhood physically possible. nine0003 And indeed, in recent years, childbirth at the age of 40 is no longer surprising, it has become quite commonplace. Moreover, in many developed countries of the world, in particular in Great Britain and the USA, the number of women who gave birth after 40 already exceeds the number of those who became a mother before the age of 20. The development of reproductive technologies and advances in medicine are shifting the female age of childbearing further and further. Since pregnancy and childbirth place an enormous burden on all organs and systems of the mother's body, the question arises: how safe is very late motherhood for the woman and for the child? Women over 40 have significantly higher rates of complications during pregnancy and childbirth than those who give birth at a younger age. If you decide to postpone motherhood until after 40, be prepared for the fact that pregnancy and childbirth can be associated with high risks. The decision to give birth after 40 certainly needs to be approached with even more awareness than a pregnancy at a young age. On one side of the scale - a new page in life and a lot of positive emotions, and on the other - a high risk of chromosomal abnormalities in a child. From the point of view of nature, everything is quite clear: it is better to give birth to children from 23 to 35 years. Because young women have better egg quality, the probability of chromosomal pathology in the fetus is less, they themselves still have a lot of strength and health not only to successfully carry and give birth to a baby, but also to get up at night in the first years. Starting from the age of thirty-five, it can be said that the countdown begins, and the woman's fertility is slowly falling, and the risks are becoming more and more. nine0003 A woman who decides to give birth after the age of forty should understand the peculiarities of such a pregnancy and try to reduce these risks in every possible way. The risk of pathologies in the fetus increases Starting from the age of 35, and especially after 40, the likelihood of a chromosomal abnormality in a child increases. These can be both relatively common pathologies such as Down syndrome, Patau or Edwards, and more rare ones. Let's take Down's syndrome as the most common and compatible with life. That's why all these categorical statements “Did you get pregnant at 40? You're having a baby with Down's Syndrome!" far from the truth. Yes, the risk increases, but the probability is still not critical. In addition, there are modern, highly accurate and safe methods for testing the fetus for genetic abnormalities. For example, a non-invasive prenatal test is performed, that is, a test on the mother's blood, starting from 10-11 weeks of pregnancy. Fetal DNA is isolated from the mother's blood and they look for genetic abnormalities - both frequent and quite rare. nine0003 Of course, there are more traditional and also quite accurate research methods, but they are associated with a risk to the fetus, because tissues are tested that are previously removed from the uterine cavity. There are also screenings that are carried out in the first and second trimester in antenatal clinics for blood and ultrasound. Their accuracy is quite low, and if it is important for you to know about the presence or absence of a chromosomal abnormality in the fetus, then it is advisable to use more accurate methods. nine0003 50% of late pregnancies are terminated before 12 weeks Also, in parallel with the increase in the likelihood of pathologies, the frequency of abortions in the early stages is also growing, that is, these are interconnected things. Half of all late pregnancies are terminated before twelve weeks. Accordingly, it will be either a frozen pregnancy or a miscarriage. Caesarean section will help avoid intrauterine death of the fetus In addition to genetic defects in the embryo and early termination of pregnancy, women of the older age group may experience a number of other problems associated specifically with age and health. It is authentically known that in pregnant women older than 39 it is advisable not to wait for forty weeks, but to give birth earlier. Because, starting from the thirty-ninth week, the percentage of intrauterine death of the fetus increases: the placenta works under heavy load, the body has practically spent all its strength on pregnancy. In a normal situation, the body understands that its resources are not enough, and childbirth begins. In patients of the older age group, the “time to go” mechanism may not start, and the fetus simply dies in utero. And this is a normal child, with a normal set of chromosomes, just the placenta in the last stages no longer copes with its function, and the “lever” for the onset of labor does not work. The main thing is a healthy lifestyle In general, the outcome of pregnancy and childbirth depends on how healthy the woman is. At forty years old, different people's body can be preserved in different ways. The place of residence of the family plays a significant role: it is one thing when a woman lives in nature, eats natural products, moves enough, and quite another when she lives in a metropolis, eats food from the nearest supermarket, is little in the fresh air, but sits a lot at the monitor and nervous. nine0003 But this does not mean that if your health is not very good, you should not dream of a child. Even in the most difficult cases, healthy children are obtained, although such pregnancies are, of course, more difficult to conduct. This is done in our medical center by several specialists at once: an endocrinologist, a therapist, a gynecologist. Preventive medical examinations should be carried out regularly. nine0003 Do not think that when you are 40 years old, that's it, you can't give birth. When deciding to give birth at a later age, a woman needs to undergo a complete examination. That is, not only to look at the reproductive system, but also to check the heart, blood vessels, hormones, and so on. It is equally important to start (at least start!) Leading a healthy lifestyle: quit bad habits, start eating right and love physical activity. Our Avicenna Medical Center has been successfully specializing in the treatment of infertility and miscarriage for more than 11 years, as well as in preparing women for pregnancy and further management of pregnancy. nine0003 Obstetricians - gynecologists together with a urologist - andrologist and narrow specialists solve numerous problems of future parents so that a healthy long-awaited baby is born.
Bridget Nielsen gave birth at 54, Janet Jackson at 50, Halle Berry at 47, Rachel Weisz at 48. 
So, if a 30-year-old mother has a chance of having a baby with Down syndrome is about one in 800, then by the age of 40 we are already talking about a ratio of one to a hundred, and at 44 years old - one to 25. 
It can be a whole baggage of gynecological diseases, some operations, uterine fibroids that occurred at the age of 38-40 years. And all this can have an impact on the course of pregnancy, on the risks of bleeding during childbirth, even on the birth itself. nine0003 
Therefore, doctors recommend such women to have a caesarean section at a period of 38-39weeks. 
We live in an iodine-deficient area, and the longer we live in it, the more likely it is that thyroid disorders will accumulate, such as hypothyroidism. 
