Having a Healthy Pregnancy in Your 40s

Mother and newborn baby
Catherine Delahaye/Getty Images

There is no one perfect time to get pregnant. Many people, though, have often been told that having a baby after you are 35 increases many risks. This might have led you to believe that there are not many mothers who have babies after this point. The truth of the matter is that many women are having babies in their 40s.

How Many Women Have Babies in Their 40s?

You might be surprised to learn that not only do women have babies in their 40s, but the rate of women having babies in this decade of life has been on the rise for decades.

The last year we have data for shows us the highest number of women yet, about 11 babies for every 1,000 women in the 40 to 45 age range, and slightly less for 46 plus.

Overall the birth rate is declining, but this age category is bucking the trend. This means that you are very likely to find other mothers your age in your childbirth class, prenatal groups, and parenting circles.

Getting Pregnant in Your 40s

One of the biggest barriers to a pregnancy in your 40s is your fertility. Certainly, there are women who have no issues getting pregnant well into their 40s. Though statistically speaking, you are less likely to get pregnant and more likely to need the aid of fertility treatments the older you are when you are trying to conceive. About one-third of women over 35 will seek the help of a fertility specialist, and that number increases with age—half of women trying to conceive in their early 40s will do so.

It is also important to note that the age of your partner does impact the health of your pregnancy.

Fertility treatments may mean a lot of things to a lot of people. It can mean anything from conceiving while taking oral medications and having regular intercourse to using donor eggs and trying to conceive with in vitro fertilization (IVF).

In general, after the age of 35, if you have not conceived after 6 months of well-timed intercourse with no birth control, you should seek the help of a fertility specialist.

One thing of particular interest will be the supply and quality of your eggs. The number of eggs and the health of said eggs diminishes the older you get. There are tests your doctor can do that can estimate how well your eggs are holding up, and this would be a part of your fertility testing.

Your chances of getting pregnant without fertility help in your 30s is about 75 percent in any one cycle. That number is about 50 percent in your early 40s and drops to only a percent or two by the time you are 43.

The Chances of Having Twins in Your 40s

One thing that is more common in pregnancies for women in the 40s is the chance of having multiples, including twins. While it may be easy to chalk this up to fertility treatments, there is also a natural increase in the rates of multiple pregnancies, even without using fertility medications or treatments. This is something to keep in mind as you plan for pregnancy.

Staying Pregnant in Your 40s

Every pregnancy carries the risk of miscarriage, and that risk does go up with age.

Part of that risk in your 40s is that you are more likely to have a chronic condition at this point in your life than previously.

A chronic condition like diabetes, high blood pressure, or thyroid disease can complicate your pregnancy and potentially increase the risks of miscarriage and pregnancy loss, including stillbirth. This is one of the reasons that preconceptional care is very important.

By meeting with your practitioner prior to pregnancy, you can minimize these risks by getting a chronic condition under control. You may also have a medication review to see which medications you're taking would be compatible with pregnancy.

You may find newer medications to switch to and take time to ensure they work for you before attempting a pregnancy.

There is also simply a higher risk of miscarriage from genetic issues. The older you get the more likely you are to have a genetic issue, which means that the miscarriage rate is higher.

The Body Changes in Your 40s

Pregnancy certainly changes your body. Women who have experienced pregnancies earlier in their lives and later in their lives are quick to admit that a pregnancy in their 40s is often more physically challenging than a pregnancy in their 20s or 30s.

One of the biggest risks to your comfort with a midlife pregnancy will be your overall fitness level. Someone who has been very active and has few daily aches and pains, in general, is more likely to have a fairly normal course with pregnancy-related physical symptoms. If you are someone who has started to feel the pull of middle age and has common aches and pains, you may find that some of the physical symptoms of a changing pregnant body are more complicated for you.

The good news is that if you are already exercising, there is usually no reason to stop. A healthy program of exercise can help you have a safe and easy pregnancy. Your doctor or midwife can advise you on what alterations you need to make to your scheduled workouts.

Keep in mind that moving is one way to alleviate the stress and strain of pregnancy on your body. Even if you are new or newer to exercise, there are things that you can do to reap the benefits. Swimming, walking, and yoga are three things that many practitioners recommend to women who have not been exercising much prior to pregnancy or for women who are having some setbacks in the workout schedules.

The Emotional Changes of Pregnancy in Your 40s

Pregnancy alters your emotion via hormones. The mood swings that can accompany pregnancy are well known. This should not be much different due to age. Though, as a more mature woman, you probably have something your younger counterparts do not—the ability to cope with these changes more effectively.

Some of the things that can lead to emotional irritability in pregnancy surround finances and relationships. While age is certainly not a cure-all for these woes, chances are you are more likely to be settled into a relationship and/or are more financially secure. This might mean that some of the stress many young people feel about finding a house or a stable job is something that you may not be dealing with at this stage of the game. Though it is important to remember that pregnancy can be stressful even when your life seems on track.

Finding other women who are close to your age and are having babies can provide a big benefit. While you may be one of the older mothers in playgroup, you won't be alone. Make friends with other older mothers in addition to other mothers. This will help you have someone to share your unique issues with.

Financial Stability With Pregnancy in Your 40s

One of the main reasons women say that they have delayed having children into their 40s is to ensure that they are financially stable. This may mean different things to different people.

Perhaps you had a job that required a lot of travel when you were younger. Maybe you wanted to reach a certain level in your company before you felt like you could have a baby. There might also be a certain level of financial status you wanted to be able to achieve first—a home, a college fund, a certain amount in your retirement account. There are many reasons you may have delayed childbearing intentionally.

The Risks of Pregnancy in Your 40s

Pregnancy in your 40s is potentially more complicated. The healthier you are at the beginning, the less likely you are to experience complications, but even healthy women who do all of the right things can have complications in pregnancy.

Complications from a pregnancy in your 40s can include an increased risk of:

Talking to your doctor or midwife about your medical history in combination with a physical exam, and consistent prenatal care can help to not only mitigate some of the risk, but can also help spot a complication early if it does occur.

This heads-up when a complication is starting is very beneficial to the health of your pregnancy and baby. It can buy you time for additional medical treatment that can prevent or delay the complication. An example might be that the earlier you diagnose preterm labor, the easier it is to stop. That also allows you to consider treatments to hasten the maturation of the baby's lungs, should he be born early.

It is also extremely important that you realize that an increased risk of having a complication is not the same thing as saying that you will absolutely have a complication.

Genetic Issues of Pregnancy in Your 40s

Genetic tests are increasingly more common for pregnant women of all ages. The number of screening tests that are now available has changed how we use genetic testing.

However, in your 40s, genetic screening and testing is something that becomes even more prominent. According to the National Down Syndrome Society, a woman at 40 has a one in 100 chance of giving birth to a baby with Down syndrome, or a 1 percent chance. That number jumps to one in 10 or 10 percent by age 49.

Genetic screenings will be offered during your prenatal care appointments. The test results are given in a way that would tell you about the likelihood of your baby being born with a genetic problem in comparison to your age. Your screening might say that your blood tests indicate your risk of having a child with Down syndrome is one in 200 for this pregnancy. This would be considered a negative screening because your actual risk was better than your statistical risk (one in 100 for a woman at 40).

If your test had said that this pregnancy had a one in 80 chance of resulting in a baby with Down syndrome, this is considered a positive test. This means that your risk of giving birth to a baby with Down syndrome is higher than your statistical risk. Genetic screening does not say with certainty that your baby has a genetic problem, it merely calculates the risks compared to your age group.

Genetic screening is great for some families because it does not pose risks to the mother or baby from the procedure. It can help you decide if genetic testing is more appropriate for your family. Genetic testing provides you with an accurate picture of your baby's genetics and a diagnosis. The trade-off is that there is a potential risk to your baby from the amniocentesis or chorionic villus sampling (CVS).

Labor and Birth in Your 40s

With getting pregnant and staying pregnant out of the way, it's time to think about having the baby. The news is similar—labor has a higher risk of being more complicated and resulting in more complications for you. One good bit of news is that if this is not your first baby, the risk of preterm labor and birth is less than a mother having her first baby over 40.

What makes labor and birth more complicated in your 40s is largely your health. A woman who has a chronic condition is more likely to experience complications than a woman who does not. Though chronic conditions are only a piece of the puzzle.

Some of what is going on is that there is a mental belief about older mothers that can also increase the risks of some outcomes like induction of labor or cesarean birth. This is something that you will want to talk to your doctor or midwife about. Finding a practitioner who is experienced in birth with older mothers might be helpful. Your attitude also matters. Using positive pregnancy affirmations can be helpful at reminding yourself about your goals for this pregnancy.

You are more likely to be induced because of pregnancy-related complications or because of concern over the continuing pregnancy. The cesarean birth rate for a woman in her late 20s is about 26 percent, and that number doubles to 52 percent for women over 40. This is not to say that you will absolutely be induced or have a cesarean section, but simply that it is more likely. Your health, your choice of practitioner, a bit of luck, and the choices you make surrounding your pregnancy will all play into it.

Baby’s Health After Pregnancy in Your 40s

The main thing most people are concerned about is the health of the baby. While a baby resulting from a pregnancy in your 40s is more likely to have some complications, the good news is that with good care, watchful eyes, and modern technology, the vast majority of these babies are born healthy. Again, it is important to keep in mind that an increased risk of a complication is not the same thing as having that complication guaranteed.

A Word From Verywell

While there are certainly some challenges to overcome in your 40s when it comes to getting pregnant and having a baby, you are not alone. The number of women who are having babies at this age is increasing. With proper prenatal care the chances of you having a healthy baby are still great. Take that to heart and enjoy your pregnancy as much as you can.

Sources:
American College of Obstetricians and Gynecologists. Having a baby after age 35. FAQ060. 2015.

Bayrampour H, Heaman M, Duncan KA, Tough S. Advanced maternal age and risk perception: a qualitative study. BMC Pregnancy Childbirth. 2012 Sep 19;12:100. doi: 10.1186/1471-2393-12-100.

Lisonkova S, Janssen PA, Sheps SB, Lee SK, Dahlgren L. The effect of maternal age on adverse birth outcomes: does parity matter? J Obstet Gynaecol Can. 2010 Jun;32(6):541-8.

Lisonkova, S., Potts, J., Muraca, G. M., Razaz, N., Sabr, Y., Chan, W.-S., & Kramer, M. S. (2017). Maternal age and severe maternal morbidity: A population-based retrospective cohort study. PLoS Medicine, 14(5), e1002307. http://doi.org/10.1371/journal.pmed.1002307

Martin JA, Hamilton BE, Osterman MJK, et al. Births: Final data for 2015. National vital statistics report; vol 66, no 1. Hyattsville, MD: National Center for Health Statistics. 2017.

NDSS. Undated. Incidences and maternal age. National Down Syndrome Society. Last accessed June 30, 2017.

Continue Reading