By James N. Martin, Jr, MD
President, The American Congress of Obstetricians and Gynecologists
Many women in the US today are choosing to have babies later in life. Although the majority of births are still by women in their 20s, birth rates among women in their 30s and 40s are the highest they’ve been in decades.
Women in their 30s and 40s have a very good chance of having a normal pregnancy, but certain factors that may complicate a pregnancy are more likely in older women than in younger women.
It may be harder to get pregnant. A woman’s fertility begins to decline in her early 30s. Eggs may not release from the ovaries as frequently, or they may not be as easily fertilized. Women over 35 are also more likely than younger women to have blockages in the fallopian tubes or conditions such as endometriosis and fibroids, all of which could make pregnancy harder to achieve.
There is an increased risk of birth defects or genetic disorders. As a couple ages, they have a greater chance of having a baby with a birth defect or inherited disorder, such as spina bifida. Your doctor may refer you to a genetic counselor or a doctor who specializes in genetics to assess your risk and help decide if genetic testing is appropriate. An ultrasound exam—called a nuchal translucency test—may be recommended at about week 10 or 11.
You may also be screened for chromo-somal problems during your pregnancy.
Common tests used are amniocentesis and chorionic villus (CVS) sampling. With amniocentesis, a small amount of the fluid that surrounds the baby is removed. With CVS, a small sample of the placenta is removed and tested.
Uncontrolled medical conditions can spell trouble. Medical problems that can complicate a pregnancy, such as high blood pressure and diabetes, are more common in older women. These conditions may lead to small or preterm infants and can also endanger the mother’s life.
Older women should be aware of the unique challenges that they may face during pregnancy. Talking to your doctor when planning a pregnancy can help you avoid or minimize some complications associated with later childbearing.
Before you become pregnant, try to schedule vaccinations and work on getting current medical problems under control. Your doctor may also suggest that you lose weight if you’re overweight and that you begin taking a folic acid supplement, eat a healthy diet and exercise regularly, reduce your stress levels, and get plenty of rest. Once you become pregnant, get to your doctor early and often for prenatal care. Regular prenatal visits will help you to have the healthiest pregnancy possible.
For more information, the ACOG Patient Education Fact Sheet “Later Childbearing” is available at www.acog.org/For_Patients.aspx. ?
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