Age and conception
Late pregnancies have slightly higher risks than others but in general if women follow the recommendations of their doctor or midwife, they experience normal pregnancies. Once pregnant, the progress is more or less the same, it is mostly during preconception that they face the greatest challenge.
There is no doubt that the fertility rate declines with age. After 35 years old, the aging tissues and decreased egg production decrease the fertility rate without annihilating it but many women decide to become a mother for the first time anyway or add to their family after 35 and even in their forties. In Quebec, according to the Quebec Institute of Statistics, the average age of new mothers is 29. It means that many new pregnancies occur when women are in their thirties. This is a new phenomenon observed over the world and it is probably due, in part, to advances in obstetrics and new social conditions.
Of the 74,200 new babies in Quebec, in 2004, 10,771 had a mother over the age of 35. But even if the possibilities are there, it remains that the biological clock is ticking louder and the medical data is explicit: the chances of getting pregnant are lower for older women. In fact, an older woman can wait many more cycles before getting pregnant than women in their twenties.
The quality of eggs is an important aspect of the fertility adventure too. A woman is born with about 400 000 eggs for her whole life. So, when she is 40, she produces eggs that are her age… 40 years old. In addition, each month, an egg reaches maturity. Ovulation is responsible for the diminution of eggs but you must know that a majority of eggs is absorbed by the body so by the time you are 50 or 60 years old, there are no eggs left.
So, even if the menstrual cycle continues to be regular in the forties, it is possible that it shortens its duration, lowering the chances of fertilization.
Background and perceptions
There is no ideal age to have a child and there are many valuable reasons to postpone or wait. Claudine didn’t have a serious and stable partner before her mid-thirties. Vicky’s boyfriend wasn’t sure if he was ready for the responsibilities of being a father. Isabelle’s financial stability wasn’t good and Julie intensely invested herself in her career for over ten years before she realized that she wanted children. Like Melanie, many women only recently discovered their maternal instinct or, like Sophia, some women have been hesitating for years…
Approximately one woman out of five seriously starts trying for a baby only after their mid-thirties. Although it is not too late, it may be a different adventure than for a woman in her twenties. The risks of miscarriage are higher and the medical monitoring is more important. Many women also wonder if they waited for so long that it is now too late and they missed the boat. The big questions are there but so is the intense desire.
Having a child just before turning 40, it is said that women has had time to know themselves, to fulfill their aspirations and to know what they truly want. 40 years old is the age of reason, the age of decisions and the age when our priorities are well established. Often, these mothers are willing to be fully involved and to relax a little as they had enough time to settle financially and emotionally.
However, the questions may me more about the age. “Would I be okay at 50 with a pre-teen?”, “And what if I can’t get pregnant?”, “Would I dare to go in a fertility clinic if that little + never appears?”, “Is adoption an alternative for us?”. Would it look like a child at all costs or like a long-awaited child?”.
Despite all the detours and pitfalls of your journey, trust yourself and discuss the situation with your partner. Read and learn! One day, perhaps soon, you will have a little baby to cuddle!
Risks
No pregnancy is 100% safe for the mother and for the child but the older the mom, the higher the risks. Good medical care will limit the risks.
All risks must be weighed against the overall health of the mother, her family history, her environment and, of course, her age.
Hypertension
After 35, the risks of hypertension are twice as high as for a 20 years old woman. It can lead to preeclampsia and endanger the life of the mother and child. When hypertension is diagnosed and treated, the risks are limited.
Diabetes
As with hypertension, the risk of developing gestational diabetes is twice as high after the age of 35. The risks for the health of the mother and child are lower if diabetes is diagnosed and treated.
Miscarriage
After 40 years old, one pregnancy out of four ends with a miscarriage during the first three months.
Chromosomal abnormalities
The risk for the foetus to have a chromosomal abnormality is higher if the mother is more than 35 years old but this risk is still under 1%. The most common abnormality is Trisomy 21 and it is detectable through a prenatal screening test and amniocentesis.
Tests
Although a majority of late pregnancies evolve normally, the risks for the health of the mother and the child are higher.
A doctor should see any woman who wants to get pregnant or who is already expecting a child. The older the mother is, the more important the medical monitoring is.
First, the doctor will do a complete check up to check your blood pressure (to prevent preeclampsia) among other things. He will also check if you suffer from diabetes.
Then, you will be offered a prenatal screening test designed to inform the expecting mother of the risk that her foetus is affected by Trisomy 21. This test costs between 200$ and 400$ and is covered by many insurance companies. Based on the result, the doctor may recommend an amniocentesis. This test is free for women over 35 and is more precise than the prenatal screening but it has a 1% risk of causing a miscarriage.
Delivery
It is proven that the risk of premature delivery and caesarean section increases with age. It is also true for spotting and problems related to the placenta.
