Realistically, how risky is pregnancy at 37?

[Ohanythingwilldo]

I have a family member who is nearly 20 weeks into her first pregnancy. So far, all is well and there have been no problems. However, she seems convinced that something will go wrong.

Having had a baby myself at the same age with no problems I am wondering what really are the risks. I know if we listen to the media we can get scared silly.

Nuchal scan has come back fine and so far all other routine tests have been fine.

What could a 20 week scan show? If someone is normally healthy and had no health scares, how risky do you think it really is?

I need to know how to help her get things into perspective. Maybe I am unsympathetic as I think "I was fine, so why shouldn't you".

Any ideas?

Across a population there is a significant drop off in fertility from about 35, then a higher risk of miscarriage in the first trimester and a raised risk of chromosomal abnormalities.

I would say if she has reached 20 weeks I would say that's a very good sign and there's no reason to worry. No reason more than the next woman. I think the biggest hurdle is getting pregnant in the first place.

Nuchal scan would be the one I would worry about (and did with mine but it was very low, lower than many)

However, this is across a population. It is a guide but it doesn't really speak about the individual.

I had my first child on my 37th birthday and am 37 weeks pregnant at knocking on 40. No problems, but again, this is an anecdote of one. They'll be plenty more to say they gave birth to healthy babies at 45+.

Easy to say, but tell her not to worry! Come round East Dulwich and all the mothers (well, they look) seem to be 40 years old.

The older you are, the higher the risks of Down's and risks of miscarriage are higher. But given she's presumably been tested for down's and she's past the high risk period for miscarriage, the risks are no higher than in any other pregnancy. The main issue for older women is declining fertility.

Oh, I'm a journalist as (a proper one!) and shake my head (as does Ben Goldacre) about the woeful, sensationalist misreporting of health issues in this (and other) countries.

Thank you, it is good to hear some positive points.

She is well into her second trimester and the nuchal test was fine so that is very reassuring.

women have always had babies well into their 30s and early 40s. it's not a new phenomenon, though having your first at this age is. yes there are higher risks of miscarriage and abnormalities but the vast majority are born healthy.

I was 38 with my first, now 19 weeks pg with number 2 at age 41 and will have just turned 42 by the due date. i'm a bit worried about my 20 week scan next week but the combined test was good and we'll see what happens.

otchayaniye - LOL - i am one of the ancient mums of East Dulwich environs.

The statistics give you a broad idea of risks across the whole population but no idea of how you as an individual will fare. Not all 38 year olds are equal, and 38 year old women of today are as a rule likely to be healthier and stronger than those of some decades ago when data started to be collected.

My experience (for all that anecdote is worth) is of having a first child at 40, and being 31+4 with my second at 43. All midwives and doctors who see me start with their doom faces on, having read my notes briefly, then say 'Ah' when I actually enter the room. Because I'm young and fit for my age, my blood pressure is excellent and I'm looking after myself.

None of this can help to determine your chance of experiencing chromosomal abnormalities in pregnancy, but it is relevant to other complications.

As long as your friend is looking after herself and being sensible, she really should not worry too much. Problems are not inevitable, and though they are more likely because of her age, 'more likely' is not the same as 'likely'.

I had DC1 at 36 and DC2 at 38. Both were very straightforward pregnancies with no problems, DC2 even easier than DC1. Both births easy and straightforward - DC2 again even easier, 3.5 hours from start to finish, normal VB with not even a tear, and recovery really quick (felt physically normal in a couple of days). With DC2 I got pregnant quicker too - first month off contraception. Although DC2 is a more difficult baby as awful sleeper, but that has nothing to do with my age! (I hope...). Both pregnancies, I made sure I stayed healthy and fit, didn't gain much weight, blood pressure was low, and kept exercising.

The 20 week scan is very detailed and should show most possible problems, if done by a good sonographer (helps to have a private one). But if the nuchal scan was fine, then the biggest risks are behind her (early miscarriage and Downs).

I don't think her fear has anything to do with risk factors. It's to do with the fact that she has probably been wanting this baby for a long time and is terrified that her dreams could be shattered. Not helped by the fact that she doesn't have loads of child-bearing years left ahead.

I have PCOS, had a miscarriage at age 33, DD at age 34 and now PG with #2 at age 36. I'm so grateful for my amazing DD but nothing will stop me believing that a 2nd child just may never work out for us. I think when you've had a few difficulties along the way it makes you more acutely aware that things can go wrong. I'm not paranoid, and obviously over the moon to be PG again, but just not counting babies before they've hatched.

sorry - meant to say she probably feels as if she doesn't have loads of child-breaing years ahead. It's hard to block out the tick-tick noises, amplified by the media, even though there are loads of new mums in their 40s. Again - down to individuals - some people have more child-bearing years than others, so no guarantees.

I think ceebie might well have hit the nail on the head. There's also been quite a lot in the press in the last 12 months re. stillbirths and late MC's - which may be raising awareness in the population as a whole but isn't very reassuring if you're pregnant.

Also, even without problems, as an older primip she will have seen friends and family start their families and may well have had exposure to more than one case where things were less than straightforward. My sister is 38 and hasn't had children yet - but between her friends and family I think there have been a number of crash CS's, breech, MC and at least one near term stillbirth (mine). She will not have a blissfully naive first pregnancy, however straightforward it might be - and I'm guessing your relative may be in a similar situation.

There are risks that are thought to increase with maternal age and some of them are disucssed here - although there is some interpretation as to where and how the risks may manifest.

At the end of the day, whether you think your relative is rational in her fears or not, that is the way she is feeling. I'm not saying you're wrong to think that she is being overly concerned - but it might be worth taking a step back and considering who it is that needs to get things into perspective. Its great that you want to support her and help her to enjoy her pregnancy but it sounds a little as though you think her fears and concerns are groundless and should be dismissed to a greater or lesser extent (sorry if I've read that totally wrong). I'm currently pregnant again and finding myself getting a lot more worried about things than I did previously - logically I know I'm over-reacting and being a bit neurotic, but what I need is someone to listen and acknowledge how I feel and then support me to try and manage those fears by helping me to work out what the risks actually are and then coming up with plans and strategies to minimise them.

As a pregnant 37yo (this is my second though), they warn you that you have a higher risk of Downs etc - which she's presumably come through, and risk of miscarriage in the first trimester, but otherwise simply you may not have as much energy as someone in their 20s. Or as the MW told me last time, "Baby is just fine - shame it's rough for you!"

But like your family member, I'm having more trouble with the anxiety than the physical stuff - it took ages to get pregnant again and I couldn't do it again I don't think. I hope I'll feel better after the 12-week scan, and your familymember feels better after the 20-week one - lots of people find that nerve-wracking.

FWIW I've found being an older parent has meant I've picked up lots of tips from friends with kids and stuff I've read and simply have more selfconfidence and patience than when I was younger, which has helped loads. Though am a bit envious of those with more energy than me who can pick up their toddlers without thinking!

I had my first at 37 and am now 27 wks with DC2, due 2 weeks before my 41st birthday. Apart from hyperemisis (non-age specific) no problems with either. Nuchal was normal for this one, didn't have one before. No probs conceiving either etc. There are trends yes, and the conception/mc/pg situation does get worse as you get older, but then there are individual cases too. As plenty of people have shown on this thread, it is perfectly possible to carry a healthy baby at 37 yo! Must say I breathed a sigh of relief after a "succesful" 20 week scan.

FWIW too, I have never really noticed or cared about being an "older" mum. My friends are mostly mums of 3 year old - they range from 25 to 45 and having children the same age is the greatest leveller ever.

I'm 40 and expecting my first. I was worried about the risk of our baby having Downs and had a chat with the midwife who is the screening coordinator at the hospital. It might be worth your family member doing that - it really helped me get things into perspective. She told me that the risk of having a Downs baby when you're 40 is 1:80. The nuchal fold and blood test showed my risk was less than this, which helped me worry less about having my baby having Downs. And even if you're risk factor is 1:80, that's still a 79:80 chance of having a baby that doesn't have Downs.

The hospital that we're having our baby at insist that any 40+ year old mums meet with the consultant. She told me that older mums are at risk of high blood pressure, gestational diabetes and still births (which is why they want to induce on or near the due date), but the consultant didn't mention the actual risk factors associated with those. I'm not going to worry myself too much over those as, because I'm an older mum, I think they monitor you more carefully throughout the pregnancy and will, hopefully, pick up any problems early.

Here's a site that your family member might find encouraging:

www.mothersover40.com/

I'm currently 30 weeks pg with DC2, and am 39. Had my DD at 33, with no problems at all - very healthy pg, resulting in a healthy child.
I have had problems with recurrent mc, but this is not age related - I have a problem with my immune system, and this would have happened even if I'd had my children in my 20's.
Incidentally, the risk of Downs when pg with my DD was 1:2600, and this time round, it's 1:16000 - so better with age! I feel much the same as I did with my last pg (no problems with blood pressure or anything else), although I am much more tired - this is more than likely due to already having a child!
Had a long labour with DD, as she was back to back - I have been told that this could be due to the shape of my pelvis.
So far, so good......fingers crossed for the safe arrival of DC2 in October. I am more anxious about the baby arriving safely this time round, but put this down to all my troubles with miscarrying.

I had my first baby when I was 39. Now at tender age of 41 expecting my second.

My 1st pregnancy was very easy. Didn't have any problems during the whole pregnancy and labour was also very fast.

It's not always about your age. It's also about if you've taken care of yourself.