Pregnancy App Article: "Pregnancy over 40"

Week 9
Week 39
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Pregnancy over 40
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Is age just a number?
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More women are embarking on motherhood later in life, with pregnancies over the age of 40 on the rise.

There are plenty of mums who have brilliant things to say about later parenthood. But if you are pregnant and entering your fourth decade, there are a few risks which are increased during pregnancy, and it's worth being aware.

Monitoring your pregnancy
You may be seen by a doctor or obstetrician rather than a midwife at antenatal appointments, particularly if this is your first pregnancy. 

To describe the fact that you're a first time mother over 35, medics might refer to you charmingly as 'elderly primagravida' – resist the urge to lamp them. 

You may be considered higher risk, in which case your doctor will recommend further tests in addition to the regular checks and scans all pregnant women go through. These are optional, but they may be able to pick up on certain irregularities which standard checks cannot. 

Risks for the baby
The chance of any chromosomal abnormality rises from one in 500 at the age of 20, to one in 60-70 at age 40, according to NICE.

Probably the most well-known chromosome abnormality is Down's syndrome. The risks based on maternal age are:
25 years - 1 in 1,300
30 years - 1 in 900
35 years - 1 in 350
40 years - 1 in 100
45 years - 1 in 30

Risks for the mother
There are some increased health risks for older mothers, particularly those with a history of high blood pressure, diabetes or other chronic disorders. In some cases, these can lead to complications during pregnancy or labour.

High blood pressure and pre-eclampsia: There is a higher chance of it affecting women over 35, so your blood pressure will be checked at every appointment.

Gestational diabetes: If you are at high risk you will be given a glucose tolerance test, which involves two blood tests after fasting, at 28 weeks or earlier.

Miscarriage: Approximately 1 in 5 pregnancies will end in miscarriage and the rate is increased in women over 40. This can be linked to chromosome abnormalities, though the cause is often not identified.

Risks in labour
Premature birth: If you're pregnant over 35, the chance of a premature birth is higher. In England and Wales, 9.5% of premature births are to mothers aged 40 and over. Women pregnant with multiples are also nine times more likely to give birth early.

Stillbirth: Women over 40 are twice as likely to have a stillbirth at 39-40 weeks pregnant, compared to women under 35 - but the chance is still only two in 1000, so relatively low. Some obstetricians recommend inducing at 39 weeks if they believe that going full term would mean an increased risk of stillbirth.  

Prolonged labour, complications and caesareans: Older women may find that their labour is long (12 hours or more) and there is also an increased risk of certain complications. 

If you have any condition (including diabetes or high blood pressure) which may put you, or your baby, at risk during vaginal delivery, your consultant might recommend a caesarean. Sometimes this is decided beforehand; alternatively, if complications arise during the birth an emergency caesarean may be arranged.

Women over 35 are more likely to need an assisted delivery, with about 40% having a caesarean section.

Being pregnant
Being older could mean you feel the strain of tiredness and lack of energy that little bit harder throughout pregnancy. However, with age also comes experience, independence and stability - all of which can improve this parenting lark enormously - so focus on these and sally forth!
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I'm sure I'd still feel as knackered if I were 10 years younger.
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I'm far more aware of what I eat and look after myself better, am financially secure and much calmer and more patient than my younger self. I'm also physically fitter and stronger than I ever was in my 20s, when I spent far too much time drinking in smoky bars.
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I would opt every time to be an older parent than a very young one. I know now that I can devote the necessary time and attention to my child.
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