Am I too old to have a baby?
At The Birth Team we have looked after many women who have chosen to embark on motherhood at the older end of their reproductive lives. If you are over 35, or thinking about delaying having a family until later, this information may help you in your decision-making about when is the best time for you to have a baby.
Regular ovulation starts in the early teens and there is a gradual reduction in frequency of ovulation which becomes more pronounced around the age of 40, affecting the ability to conceive by half. This reduction starts at about 32. At 30 the average woman has a 1 in 5 chance of conception. At 40 this is 1 in 20.
Whilst overall maternal health has improved a lot over the decades, older mothers are more likely to have existing medical conditions or statistically to be overweight. The likelihood of multiple pregnancies – twins or more- also increases with age naturally and older mothers are also often pregnant by IVF due to age-related fertility problems.
A woman is born with all the eggs that she will ever have, so as time goes by her eggs age too, which increases the risks of her baby having chromosomal abnormalities such as Trisomy 21 (Down syndrome) Trisomy 18 (Edwards syndrome) and Trisomy 13 (Patau’s syndrome).
These conditions arise from the baby having 3 rather than 2 of the particular chromosome.
Women who choose to have screening tests in pregnancy and who are at increased risk may benefit from paying for a test not yet routinely available on the NHS which looks for fragments of the baby’s free fetal DNA in the maternal blood as well as having the routine 12 week nuchal scan. The DNA test (which is a non invasive blood test) is generally done from 12 weeks. It has significantly reduced the need for sampling fetal cells by removing amniotic fluid by aspiration (amniocentesis) or sampling a small piece of developing placenta ( chorionic villus sampling) both of which carry a small miscarriage risk but give a definite diagnosis. Free fetal DNA testing carries no risk and has a tiny error rate. The risk of a 20 year old having a Down syndrome baby is less than 1000-1 but this increases to 100-1 at 40 and10-1 at 50 years of age
At 40 the risk of miscarriage is greater than the risk of live birth as nature often rejects abnormality
So before attempting to conceive as we talked about more fully in the previous blog “getting ready for pregnancy“ start Vitamin D and Folic acid.
Stopping smoking and alcohol, optimizing your weight and generally getting yourself in the best state of health that you can to be fit and well for your pregnancy journey will make a big difference. Reviewing any medications that you might be on with your GP or specialist is also very important.
Prepare for a life change!
Independence and control freedom at work in your relationship, home life and work will change. Finances will change with a work break or giving up but reserves may be better than a younger mother as more income may have been put away
Be aware that older pregnant mothers have an increased chance of diabetes of pregnancy, raised blood pressure, pre-eclampsia and late stillbirth. The increased risk of stillbirth is a reason why baby’s growth is monitored more closely in late pregnancy and why induction is often offered by 40 weeks to reduce this risk. It is an offer, but informed maternal choice via a discussion with a senior specialist healthcare provider with regards to timing is the main factor in this decision.
Private pregnancy in older mothers appears to be commoner to us at The Birth Team as often there has been difficulty in conception or IVF pregnancy. Although all babies are precious the concern regarding the baby’s well-being and that pregnancy may not happen again increase the wish for continuity of care that The Birth Team specifically can provide. Similarly the request for planned Caesarian section which cannot always be granted in the NHS is listened too and granted after informed consent.
Bleeding heavily after delivery is commoner in the older mother and precautions are taken to reduce this risk.
You will have perhaps more aches and pains but there is no reason why a healthy pregnancy and birth won’t happen.