Pregnancy after 40

Pregnancy after 40 lists the issues and precautions a mom over 40 should take to safeguard her pregnancy and child.

Many women have delayed their pregnancies until after their 30s and even 40s. However, this should be no more hazardous for older mothers than being pregnant in your 20s as long as you are fit and healthy.

Click here for Trying to Conceive Tips or looking for an Ovulation Calculator?

Refer to the Pregnancy Guide or Pregnancy Tips for ways on having a fit pregnancy.

Whatever your age, you are likely to have a normal pregnancy and birth, although some problems such as infertility and chromosomal defects such as Down's Syndrome, become more frequent with the increasing age of both parents.

Tests for chromosomal abnormalities like amniocentesis, are always offered to older women and to younger women who fall into a high risk group.

The Age Factor for Pregnancy over 40

The older you get, the longer it takes to conceive, so take your age into account when assessing if you are having problems and should consult a doctor. Then again, the older you are, the less time you have so you should seek advice early.

The number of infertile women increases with age : Between the ages 20 to 24, one in ten women are infertile, but by 40 to 44 years, this increases to nearly 30%. Be aware that all treatments for infertility are significantly more successful in couples under 30.

The overall quality of women's ova diminishes with age as does the number of healthy ova produced at any one time. The receptivity of the uterine environment to implantation of a fertilized ovum decreases with age.

Our age is important but it is only one of several factors that can affect the outcome of your pregnancy. Your nutrition is much more important. If your general health is good, your pregnancy will not be treated any differently from younger women.

However, age is a factor in certain fetal abnormalities, and a mom over 40 has a higher risk of maternal diabetes and placental insufficiency, so you may be screened for these more frequently.

Getting Pregnant at 40

Baby Car Safety Seats are dead important (No pun intended!)

Gimme Food Now!!!

I was determined to have my third child, whether boy or girl as I was approaching and passed my 40th birthday. I prepare for all my pregnancies by exercising religiously, eating a healthy diet rich in iron and folic acid, and I am quite a nutritional supplements fiend. Follow my Tips when you are Trying to Conceive to maximize your chances of having a happy and fit pregnancy.

I found that the only difference between my pregnancy after 40 and my previous pregnancies was that I was DEAD TIRED all the time. When I couldn't move another step, I just crawled into bed and slept, or if I had to ferry my daughters around for their lessons, you would have found me sleeping all over the place, in the waiting area outside my daughter's ballet studio, by the swimming pool while my daughter had her 2 hour training sessions, in my car or just about anyone's sofa.

Maybe also because my stomach muscles weren't what they used to be, each subsequent baby seemed heavier somehow. My belly popped out faster and earlier with each pregnancy. Always remember to do your pelvic floor exercises to prevent weakness of your pelvic floor muscles after childbirth.

What is Down's Syndrome?

This chromosomal disorder occurs when a fertilized egg has 47 chromosomes instead of the usual 46. In most cases, the egg itself is defective, being formed with the extra chromosome. The sperm may be similarly affected. This type of Down's syndrome is known as trisomy.

Down's syndrome can be diagnosed by chorionic villus sampling or amniocentesis. Maternal blood alpha-fetoprotein levels (AFP Test) are generally lower if a mother has a mongoloid fetus. The risk having a Down's syndrome baby increases dramatically over age 35.

Most cases of Down's syndrome occur randomly and are non-recurrent. However, if there is a family history of Down's syndrome, translocation or inheriting faulty chromosomal material is possible.

Statistically, as a Down's baby is born every 2,000 births, and as most babies are born to women under 35 who don't undergo screening for Down's syndrome, there are actually more Down's babies in the pre-35 age group than in the post-35 age group.

Early Pregnancy Tests for Down's syndrome testing

A Nuchal scan is carried out at around 11-13 weeks using a special ultrasound scan. A shadow of a particular size and shape that is present at the back of the fetus' neck may indicate a higher risk of chromosome defects if it is thicker than normal in relation to the age of the mother.

Another pregnancy test that is carried out is Serum Screening (Bart's test or triple test). A sample of the pregnant mother's blood is taken at 16 weeks to measure the levels of 3 substances - Oestriol, human chorionic gonadotrophin and alpha-fetoprotein. The results can be assessed in relation to your age to predict the chance of your baby suffering from Down's syndrome. If the chances seem high (more than 1 in 250), amniocentesis will be offered.

Amniocentesis Test

When you are pregnant over 40, in fact, over the age of 37, your doctor will recommend that you undergo an amniocentesis procedure. If you belong to a high risk group or have a family history of a disorder, you may also be asked to have an amnio. You may be offered an amniocentesis if your serum testing (Bart's test) or if a nuchal scan indicates a risk of Down's syndrome.

Amniotic fluid contains cells from the baby's skin and other organs which can be used to diagnose his condition. The amniocentesis procedure withdraws amniotic fluid from the uterus.

An amniocentesis can reveal other important information which may be helpful in determining the care and progress of your pregnancy. The test may show the following :

• The sex of the baby - cells that slough off the fetus and accumulate in the amniotic fluid can be distinguished as male or female cells. There are gender-linked genetically linked disorders such as haemophilia.
• The chemical composition of the fluid can reveal metabolic disorders caused by missing or defective enzymes.
• The bilirubin content of the fluid helps to determine if a Rhesus-positive baby needs an intrauterine transfusion.
• The amount of oxygen the baby is getting - gases dissolved in the amniotic fluid can be measured, revealing whether the baby is at risk from lack of oxygen.
• The acidity of the fluid - this is another indication of fetal distress often caused by inadequate oxygen flow to the fetus.
• The chromosome count determined by examining discarded cells - Any deviation from the normal chromosomal structure usually means that the baby may have a disability.

An amniocentesis is usually performed at 16-18 weeks. The mother's abdomen is first numbed with a local anaesthetic. Then, guided by ultrasound, a hollow needle is inserted into the amniotic sac through the front of the abdominal wall. About 14g of amniotic fluid is usually withdrawn. It takes about 3 weeks for the cells to be cultured and for the results to come through. This is a very stressful period for couples.

Amniocentesis is only undertaken with ultrasound monitoring to guide the needle into the amniotic sac, so that neither the placenta nor the fetus is harmed. Amniocentesis risks of the procedure inducing a miscarriage in early pregnancy are small, about 1 in 200.

My Experience of Pregnancy at 40 - Having an Amnio

After trying for about 1 year for my third child, I became pregnant the month I quit and left my extremely stressful job. I was already 40 years old, going on 41, so my gynaecologist insisted that I have an amnio done to ensure that the baby was fine.

I was quite apprehensive when I underwent the amniocentesis. I had heard all sorts of stories of miscarriages after the procedure, so I was a little scared. My hubby who is a doctor was very matter-of-factly about it (most doctors are). He told me that if we discovered that anything was wrong with the baby, we would have to decide to abort the baby. It wasn't that we didn't want to look after the baby once he was born, but what would happen to him when we were gone?

The amniocentesis procedure was relatively fast, after the anaesthetic was administered, my gynae used the ultrasound to check where the baby was lying and then he inserted the needle. I couldn't feel anything, but I have ever seen a photograph of a fetus actually trying to move away from and avoid the incoming needle!

I think the baby was kind of stressed out by the procedure. He didn't move for days after that (and he was quite an active chap). I was becoming a little worried, but he gave me an indication that he was OK by moving a little and giving me a small kick after more than 2 days.

My gynae gave me ventolin tablets to reduce any risk of me getting any premature contractions. My stomach was hard for several days with a dull ache in my lower abdomen where the needle had gone in. It felt like those Braxton Hicks' contractions you get towards the end of your pregnancy. After about a week, everything was back to normal. The results later showed nothing wrong with my baby boy. My pregnancy proceeded uneventfully, and my healthy baby son was born 2 weeks early in 2011.

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