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Pregnancy

Getting pregnant over 40, risks, etc: who's got the facts and stats?

39 replies

motherinferior · 15/09/2005 13:06

Lovely mate of mine has just taken up with lovely bloke (after EIGHT YEARS of singleness. Indeed of celibacy [shudder]). She is just pondering, as you do, the whys and wherefores of pregnancy at 41ish...Down's risk is up, right, but are other chromosomal abnormalities? And is there anything conclusive about fertility, apart from the fact it's all quite individual but does go down from the decade before we start menopause?

Oh go on, it'd be fab if she had a baby, she's had such a vile time for ages.

OP posts:
Tinker · 16/09/2005 11:13

Agree sobernow about previous generations always having had kids later in life. In the Indie, a female medical person (not got paper in front of me)is quoted as saying that women shouldn't wait for Mr Right but just Mr Good Enough if they want kids! I expect that later "they'll" be carping on about the rising divorce rate again and the negative effects on children

batters · 16/09/2005 11:20

This reply has been deleted

Message withdrawn at poster's request.

motherinferior · 16/09/2005 17:30

Been seething about that piece all day. Actually I would have loved to have a baby at aged 28, but my bloke pssed off. Would have loved to have had a baby at 33, but that bloke pssed off. Got together with DP and got up the duff within five months (and five years and one more baby later he hasn't p*ssed off yet)...but you can't say I didn't try to argue the toss (oh god what an unfortunate metaphor) earlier.

OP posts:
aloha · 16/09/2005 20:32

If you read the sources for this article (about how we are 'defying nature' (huh? surely it's much more 'unnatural' to use birth control to prevent yourself conceiving at 40?) then you can see the outcome for babies is fine! 'Good' even - and that's for the over 45s! The children of over 40s do very well indeed. But that's not very shocking news, is it?

hester · 17/09/2005 10:36

OK, so as a pregnant 41-year-old I am sick to the back teeth with dire media warnings of how I have gone against nature and generally been a silly, selfish girl. BUT there is no denying that, all else being equal, it is better to get pregnant younger. Fertility does decline very sharply after 40 - of course it's individual, but by 43 most women are facing significant problems. Miscarriage rates shoot up, and all other risks start to climb. We all know women who have conceived quickly and had trouble-free pregnancies after 40, but that doesn't make them the norm.

However....

All else is rarely equal. Your friend's choice now is not to get pregnant at 31 or 41; it is whether or not to get pregnant at all. Of course she should go for it if she wants to. She just needs to be aware and realistic about how long it might take and that there is no guarantee of success.

In my own case, I was not in a position to get pregnant before 35 (lack of willing partner). Once that position changed I was eager to get on, feeling that mid-thirties was quite late to be embarking on family life. I never dreamed it would take me until my 40s to get and stay pregnant. Fertility and pregnancy problems are terrible for any woman, but there is a particular agony in facing miscarriage, fetal abnormalities etc when you are in the last chance saloon. The last few years have been very, very painful and frankly they would have been less stressful had I been a few years younger - young enough to qualify for NHS IVF, for example, or to think, "I can always try again". And though i got lucky and am now expecting my baby, I am very aware that a sibling is unlikely.

I felt very ambivalent about the article. I know the main author and have always admired and respected her. I think she is making an important point - that there are public health implications of this demographic trend that need addressing. I also think that she tried to put across the message that we shouldn't blame women but tackle the social forces that disincentivise early childbearing. But that argument didn't come across nearly strongly enough, and as I listened to all the media reports my immediate response was, "Great, here we go again. Naughty me, going on skiing holidays and dipping bonbons in champagne, all the time thinking that the NHS would sort me out in my 50s."

This is a very gloomy post. I think what I'm saying is that your friend needs lots of positive encouragement - of course it would have been better if she'd met her dp before, but she didn't. She has a reasonable chance of succeeding in having a baby and needs lots of positive support with that. If I could take a pill and be 10 years younger I would, but that doesn't mean I regret being pregnant now - after all, the alternative is not to be pregnant at all.

But on a wider social level, we really need to make it easier for women to have real reproductive choices at every age, so that fewer end up going through the stress of trying to have a baby over 40.

hester · 17/09/2005 10:37

What a long miserable rant that was

hester · 17/09/2005 10:43

Oh look, there's some more stats from the same issue of BMJ. It's a Danish study tracking over 1.2m pregnancy outcomes from 1978 to 1992. At age 42 years, more than half of pregnancies intended to be carried to term result in fetal loss. The risk of miscarriage is 8.9% in women aged 20-24 and 74.7% in those aged 45 or more. Risks of ectopic pregnancy and stillbirth also increase with age.

Bear in mind the age of this data, and that obstetric care for older mothers has improved significantly. Also that this population will include a lot of women in poor health, multiple pregnancies, repeated miscarriages etc. So it doesn't tell you much about any individual's risk.

Nevertheless I am going to go now and feed my miracle foetus some chocolate. What a clever girl she is, just to get here

edam · 17/09/2005 11:02

One of the authors was the head of women's health at Guy's and Tommy's. Strange how he neglected to mention that the REAL risk to older, and younger, mothers there are the dangerous staffing levels - one midwife to seven women in both the midwife-led unit and the hospital delivery suite the night I was in. A midwife told me Tommy's has a reputation for being 'lucky' because they haven't managed to kill a woman or baby as a result.

But actually employing a few midwives is obviously less important than slagging women off.

edam · 17/09/2005 11:04

Sorry, so cross about someone from Tommy's having the gall to lecture women, forgot to say anything about your friend. Stats on risk are population-based. So don't apply to any particular individual or her individual pregnancy. It's kind of background info. Does that help at all?

Blu · 17/09/2005 11:05

I am seething at the tone of the news reports about this, too.

'defying nature' - as if simply havingf sex and simply getting pregnant and simply having DS at age 43 makes me a reckless biological freak!

All we need to know is the facts, that OF COURSE the nearer the end of our reproductive capacity there is more difficulty in conceiving, and more chance of certain problems. But if it all goes smoothly, that is as much in line with nature as if it doesn't!

As it happens, I have a strong suspicion that DS's missing bone could well be the result of the build-up of dioxins and PCB's in my body, since they are fat soluble accumultive toxins, and therefore the older you are, the more you will accumulate, presumably.

So at least one of the answers there, as well as shrieking 'defying nature' at older Mums is to shriek (with some legal force) 'defying nature' at the food manufacturers and packagers who lace our daily goods in these highly unnatural toxins!

It just wasn't what I felt was possible or right - or what I would have enjoyed - to have a baby despite lack of suitable / willing partner in my late 20's / early 30's - I wanted a baby in a family, not as a breeding excercise. (that's ME - no attitude at all to women who choose to be Mums without partners - good on them if it is what is right for them).

Blu · 17/09/2005 11:08

MotherInferior - if she wants to try for a baby now, why on earth shouldn't she! I do wish her luck.

asil · 19/10/2005 16:46

I WOULD LIKE TO SAY THAT MY MUM (AGE43) GOT PREGNANT, SHE THOUGHT SHE WAS GOING THROUGH MENAUPAUSE, FOUND OUT SHE WAS HAVING A LITTLE GIRL, AND IT HAD TRIPLE X SYNDROME, NOTHING MUC TO WORRY ABOUT JUST THAT SHE WOULD B SMALLER... SHE WAS DUE DEC 20TH 2005, SHE WAS BORN ON OCT 15TH 2005, 2 MOTNHS EARLY!!!! HE IS DOING VERY WELL, SHE CRIED AS SOON AS SHE WAS BORN, SHE ONLY NEEDED A FEEDING TUBE, AND HER FEEDS ARE BENG PUT UP EVERYDAY.... SHE IS THE BEST LITTLE SISTER
SO I SAY IF U WANT TO HAVE A BABY AT THIS AGE, GO FOR IT

FangAche · 19/10/2005 16:48

Lovely post Asil!

My mum had my youngest Brother on her 40th birthday! He's 13 now.

despair · 27/10/2005 15:00

Hi - I am over 40 and in first pregancy with no problem whatsoever so far. However, it probably is useful for her to start taking FOLIC ACID as soon as possible (i.e. ideally BEFORE YOU CONCEIVE). Also she could have a nuchal scan with integrated blood tests to get an idea about the likelihood of Downs syndrome rather than straight away assuming that she would need amnio/CSV with risk of miscarriage.

Maybe it is also a bit more important to make sure she is fit (i.e. exercise, yoga etc).

Good luck

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