Mom in her 40s (and something)

Motherhood knows no age, and if it's knocking on your door after your 40th birthday, you have more reason to welcome it. But do you need to be more careful than a younger mom-to-be, and what should you keep in mind?

 Starting this article, I couldn't help but wonder how many of the women in my circle are approaching forty and believe they still have time to have children. According to many, highly qualified experts in the field, gynecologists, the majority of women today either have their first child at a very young age, around 25, or then delay it for at least a decade. Certainly, women who decide - or happen to - have a child at an older age, between 35 and 45, are influenced by developments in the field of medicine and the new data that make pregnancy safer at the age of around 40 or even a little later. But what exactly is true, in the end? And what - above - should a woman who becomes pregnant after her fortieth birthday pay attention to.

Does age affect the progress of pregnancy?

What age definitely affects is the ability to conceive. As we get older, and after the age of 25, it becomes a little more difficult to conceive a baby every year. The big difference in the ability to conceive, however, occurs after 35. So, when a woman after 40 conceives, is healthy, goes to the gynecologist regularly and follows his advice, is monitored with the necessary tests, the chances are that she will give birth to a very healthy baby. 

Another reason why we talk about possible pregnancy complications in a woman over 40 is the increased number of pregnancies after IVF, and the possibility of multiple pregnancies associated with it. Thus, there is an increased chance of a baby being born with low birth weight or prematurely. 

In general, in a pregnancy after 40, there is a higher chance of miscarriage and chromosomal abnormalities (which are linked), an increased risk of developing preeclampsia, a condition that includes high blood pressure and high levels of protein in the urine, and gestational diabetes. Regular check-ups with your doctor, a balanced diet, and weight control go a long way in preventing and avoiding these two conditions.

Do you need to have additional tests?

Every pregnancy is unique. However, there are basic tests that every pregnant woman undergoes, and these are those that are done to monitor her own health and those that have to do with the health and development of the fetus. The usual tests during pregnancy include blood and urine tests approximately every month, blood pressure measurement and at least four ultrasounds to examine the fetus: the first at around 7 weeks to confirm heart function, the second at around 12-14 weeks, to examine the nuchal translucency associated with the appearance of Down syndrome, the third at around 20 weeks which is the level B ultrasound that thoroughly checks the development of the fetus's systems and body and a third towards the end of the pregnancy to make sure the doctor that everything is continuing properly. In pregnant women over 40 years of age, another test, amniocentesis, is performed around between the 16th and 18th weeks. This test checks for possible chromosomal abnormalities, which are common in older expectant mothers.  

If you are pregnant with twins, your gynecologist will want to see you more often, especially in the third trimester, to monitor the development of the fetuses and the possibility of premature birth. 

Normal birth or cesarean section? 

And here the increased rate of IVF casts a cloud over births! Many women who give birth after 40 have become pregnant with IVF, which most of the time “forces” a cesarean section. So it is not easy to say what the rate of cesarean sections is in women over 40 who have become pregnant naturally. However, according to experts, age alone is not a factor for cesarean section, since all indications are in favor of a natural birth. 

If this is not your first pregnancy

Gynecologists agree that when a woman has given birth again, the body “remembers” and the likelihood of complications is reduced, even if the pregnant woman is over 40. However, this does not mean that you should pay less attention to your doctor's monitoring, the necessary tests, and the precautions he or she will recommend. 

May everything go well!

• Follow a balanced diet: small and regular meals, lots of fruit and salads, grilled meat, fish or chicken, and for snacks, prefer yogurts with nuts and honey or with cereals, mixed nuts and dried fruit in small quantities.
• Try to exercise daily at a gentle pace. Walk wearing comfortable sneakers or swim. These are the best forms of exercise for pregnancy and in addition to physical health, they will help you feel much better psychologically.
• Try to rest as much as possible. Lie down on the bed or couch and prop your feet up on some pillows to keep them elevated, ask your partner to massage your feet, relax by listening to your favorite music, and generally do things that please you and help you feel better.
• Don't skip your scheduled visits to your gynecologist and report any symptoms that concern you. It's better to be a little extra careful than to ignore any sign.

By Eleni Daskalaki

Source: Dr. Ioannis Kalogirou DRCOG,DFFP

Obstetrician – Gynecologist Surgeon

Doctor of the University of Athens