Her life is about to change in the most incredible way. She has just become pregnant. She is thrilled, exhilarated, and cannot wait for the big day to arrive. There is only one thing dampening some of her enthusiasm. She is pregnant at 40 and is scared. Why? Well, in spite of people telling her 40 is the new 30, she also has read and been warned about all the risks associated with having a baby at 40 or after. Understandably, she is concerned. Most women today take extraordinary good care of themselves and their bodies. They are in great shape, exercise and eat well. So why all the fear? Well, there are still some risks that are common for women after they hit the 40 mark even if they are in fantastic health.
For whatever reason, she did not have children younger. Maybe she was working on establishing her career. Maybe she didn’t want to do it alone, and waited to meet Mr. Fantastic to raise children with and only met him later in life. Or maybe she wasn’t sure if kids were for her earlier on. Lots of women have questions of whether they want to or desire to become Moms. It is not an easy decision for everyone to make. Regardless, now she is both excited and a little terrified to find out she is pregnant and may end up with complications and problems in pregnancy and labor. What are things she needs to be concerned about? What are the things that are just plain old silly to worry about. Here are 15 things she needs to think about if pregnant at 40:
15Added Genetic Risks
There are proven risk factors unfortunately, in a lot of cases for women who have a baby at or after 40. It is not the case for every woman of course, especially if she is in tip top shape, but in general after 40 a woman’s chance for genetic abnormalities do go up. It is important that she meets with a genetic counselor or a fertility doctor, and that both she and her partner get tested and see what exactly the risk factors are. This way they can make the best and most informed decision on what to do next. There will be different tests she may be asked to do, but at least she and her partner will know where they stand in the pregnancy and how to handle the rest of the pregnancy and what comes after. This is not easy to do, but it is very important that she and her partner are aware of risks so there are no surprises later on.
Chromosonal abnormalities are also very common after 40. A woman’s eggs have trouble dividing as she gets older. These can cause unusual fetal development. Many women over forty have an increased chance of having a baby with a chromosome problem. The risk is 25 in 1000 women at 40. It is recommended that a 40 year old have her fertility tested and along with the sperm of her partner. This way at least they will be sure of their risk factor and be able to make the best decision for themselves as a couple. There are also easy ways to detect chromosomal abnormalities early on in pregnancy by doing CVS (chorionic villus sampling). There is a small risk for miscarriage in doing this test for women over 40, as would an amniocentesis. This is recommended if the woman’s doctor or fertility specialist feels her baby may be at risk for problems.
13Getting Things Under Control
This one is extremely important. If a woman has heart issues, diabetes, fibroids, or any other health conditions that could compromise hers or her baby’s health, it is important to ideally get those under control before pregnancy, but if she hasn’t, then it would be crucial during pregnancy. Other things that are equally important are thyroid disease, high blood pressure, and obesity. Most likely a woman will have done the former. The latter would have been looked at before becoming pregnant, particularly if she sought the help of a fertility specialist to get pregnant. If not, it is very important that she makes sure her health is one hundred percent under control and she is operating at her best health level, so that she can have as easy and uncomplicated a labor as possible. Most women would do this automatically, as they know the risks to themselves and their unborn babies.
12No Skipping Allowed
This is something that is important for all women of childbearing age. After all, many don’t know when they will become pregnant, and the sooner a woman starts to take care of her health with good diet, exercise and vitamins, the better her fertility will be. That being said, once she becomes pregnant, it is even more important that she takes a prenatal vitamin with folic acid. It has been known to prevent neural tube defects, such as spina bifida. This does not mean the pregnancy will go one hundred percent smoothly or that her baby won’t have problems, but it does help decrease the risk. Everything she could do to decrease her risk would be helpful for herself and her unborn child. At any age folic acid is recommended for pregnant women, but once she is 40, she needs to do all she can to ensure as healthy and safe a pregnancy as she can.
11Added Risk Of Preeclampsia
Then there is the elevated risk of pre-eclampsia in pregnancy at or over 40. This is a serious condition that causes high blood pressure, swelling in the face and hands and protein to appear in urine. It can impair the woman’s nervous system and can even cause seizures, strokes and other complications. The risk is higher in women over 40 having their first baby. Experts do not know why. This is something she will definitively be monitored for by her doctor and that a woman needs to be well aware of as part of her risk in a later life pregnancy. It may very well not happen, but if she notices any of the symptoms mentioned, it is important she tell her doctor immediately and precautions can be taken as well as medical help given to her and her unborn baby. Her team will do all they can to help her have as healthy and safe a pregnancy as possible.
10More Can Go Wrong During Labor
As with other issues, there are risks of labor problems developing too for women who are 40 and over. A lot of times women run into complications and need to be induced. With induction, a caesarian section must be performed in many cases, or sometimes mom-to-be is more likely to have a forceps or vacuum-assisted delivery. Older women also may have more risks for prolonged second stage labor and fetal distress, too. Labor problems in general are higher for women over 35 and 40, especially if it is their first. There is unfortunately also a higher risk of stillbirth that could occur.
Most women, whether they are having an uncomplicated pregnancy or not however, will be followed closely by their obstetrician or mid wife. They will be able to see if there will be any issues that could potentially develop and how best to handle them. If a woman is in good health, it is not all necessarily bleak. She just needs to be aware of what could happen.
9Hospital Birth May Be Safer Option
As mentioned above, there are higher risks for women in the 35 and over category. It does not mean she cannot have a home birth, but due to increased risks all around, a hospital birth may be the safest option. This way, should complications arise in her health, with baby or with labor, she will have top notch medical help there to get her and baby through labor and delivery safely. Many hospitals have no trouble with doulas and midwives being present to make labor and delivery as natural a process as possible. She may even be able to use all types of natural ways of handling labor pain in a hospital setting, and as long as there are no issues with movement, she could move around, walk, sit on birthing balls, or soak in a tub to help ease her labor discomfort. Again, it depends on the woman’s and baby’s situation, but flexibility can be used as long as she is being monitored closely.
8Added Risks To Mom's Health
Unfortunately with age comes a risk in maternal health problems. Again, this does not apply to all women, but the risks would include possibility of high blood pressure, pre-eclampsia, gestational diabetes, placentia praevia, and having a baby of low birth weight. A woman’s blood pressure and urine will be constantly monitored throughout pregnancy to ensure that everything is going smoothly. If her health care practitioner feels that she could benefit from seeing a consultant or specialist, that will also be offered. Many women in their forties go on to have healthy pregnancies and labor despite the scary statistics.
It is just important that a woman knows her risks going in, and that she will get proper care should her pregnancy be deemed a high risk one. There are tests that will be performed and her risks and options will be made available to her so as a mother- to-be, she could make the best decision for her and her baby.
7Baby Can Be Born With Low Birth Weight
This is a risk factor due to a woman’s age, as well as if she and baby experience any complications during the pregnancy. With modern medicine today, however, there are lots of options available should the baby be born prematurely or at a low birth weight. Many babies thrive and do very well, as long as early intervention and quality care is given to them and their mothers upon birth. If a woman has had very good medical care throughout her pregnancy, and knows hers and her baby’s risks, chances are she would have been doing all she can to ensure that baby will do very well once in the world. Regardless, she and baby will get quality care during childbirth and afterwards along with tips on helping baby gain weight and thrive outside the womb. There are many small babies that catch up quickly in terms of growth and development going on to lead happy and healthy lives.
6Risk Of Baby Coming Too Early
This again is another risk for babies who may be born premature due to issues in utero, either from complications on either baby or Mom's part. Again, throughout pregnancy, a woman’s condition will be monitored closely, her risk of pre-term delivery or not will be made known, and she will be told what symptoms to look for that could signal danger or problems. Following this advice closely, would help her have as safe a delivery as possible, and medical staff would be on hand to support her and baby so that baby can come into the world as easily and with as little complications as possible.
A hospital will have a record of all of a woman’s health issues and her state during pregnancy, so she and baby would receive the best care possible. Should baby really come early in spite of efforts for him/her to stay in utero longer, hospitals are well equipped to give them the best chance to grow strong and thrive with Mom being able to have direct physical contact to strengthen the bond between the two.
5Anxiety About Being Singled Out
This may not be an obvious one at first to a woman about to have a baby at 40, but will have popped into her mind at some point or another. Many women worry that as older Moms, they will be one of the oldest Moms in their future child’s class at Parent/Teacher Interviews, or perhaps get mistaken as grandma out with her child at a store or other social function. This has happened in the past to older Moms and Dads in other decades, but is now becoming less common as women and men are having babies later in life.
Still, that nagging worry may be there and an older Mom may feel she may not fit in with her younger Mom peers. However, the important thing is that Mom and baby are healthy and happy, and Moms need not worry about the “right age” to have a baby. Every woman is ready in her own time and needs to pace herself. Every family is also ready at their own time, and acceptance of that needs to be the new norm all around.
4More Doctors. More Tests.
If a woman does not like to go to see doctors and do lots of tests, she may be out of luck in this case. As a woman of 40, she will most likely have to undergo extra doctor’s appointments and added tests while pregnant. This is not fun for sure, but she will know that she is doing it to ensure the safety and health for herself and her baby. She will have her obstetrician, midwife and/or other specialists advising her along the way on what courses of action she could take, and what is in hers and baby’s best interest.
Of course, all final decisions on her pregnancy rest with her, but she will have the right to ask for any clarifications on any issues that are confusing or worrisome. There will be lots of technical terms thrown around, but she will be well informed of what tests are being done and why. In the end, she knows it is helping her have as healthy a pregnancy and delivery as possible.
3Needing Extra Support
This is crucial. It is important for women of all ages who are pregnant to get support around them from family and friends. However, as an older Mom-to-be, with higher pregnancy and delivery risks, there is obviously more stress associated with being pregnant. Along with a great medical team, a woman also needs a great personal team of cheerleaders to help rally her spirits when she is feeling scared, discouraged, or nervous. They would be there to help her through some of the tough or more uncomfortable moments by offering love, praise, support and even making jokes to help her keep her sense of humor and positive attitude in check.
Life is never easy and has its ups and downs. A woman who is calm, rested and taking care of herself mentally, physically, and spiritually, will be that much more able to handle the ups and downs of some pregnancy issues and make better decisions as well.
2Increased Likelihood For Induction
Induction will not always happen. Many women 40 or over do go into labor naturally and all proceeds in a standard way. But, there is a higher chance that older women may have to be induced. Even then, with some inductions women will still go into labor naturally afterwards, however some do end up needing a caesarian section in order to deliver safely. Though it is a surgery, it is not the worst thing that could happen. Most caesarian sections go very smoothly. A woman is monitored closely throughout the procedure as is baby.
If she has been in reasonable or excellent health throughout her pregnancy, the usual precautions will be taken as they would for any surgery. If there were moderate or more serious health issues throughout the pregnancy, the situation will be even more closely monitored to ensure as quick and easy a delivery with as little complications as possible. She will be in good hands with her medical team, and most women go on to recover smoothly from caesarian sections.
1Needing An Adaptable Birth Plan
Finally, having a good birth plan can make all the difference. This does not mean having one option for one’s baby to come into the world, but rather several flexible options for a healthy and safe delivery. A woman could have one plan that unfolds with a natural childbirth without drugs if that is what she wants and feels is best if there are no complications. Consequently, it is also a good idea to have a birth plan with medication in place just in case complications do arise. It does not make her stronger or weaker if she uses or does not use drugs to help with labor. She is doing what is right for her and her baby in that moment.
Sharing this birth plan with everyone on her team, medically and personally, will go a long way in helping a woman stay calm, positive and flexible too. Remember, it does not matter how baby comes into the world. That is not what makes a mother. A mother is someone who loves, nurtures and cares for her child with everything she has in her. As long as she and baby are healthy and safe, that is all that matters.
There are 15 things to think about if pregnant at 40. The most important thing a woman can do, however, is not to stress too much. It does sound easier than it is, but only if she is completely relaxed, listening to her gut and body, and making sure she is surrounded by great people giving her good medical care, will she most likely have a successful pregnancy and delivery.
Sources: Women's Health Mag, The Adventurous Writer, BabyCenter, BabyCentre UK
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