It is well known that fertility begins to decline between the ages of 30 and 35. The probability of having a healthy baby can decrease by 3.5% per year after 30, with increased risks of genetic abnormalities, complications prior to and during birth, stillbirth, low birth weights, and other problems commonly cited as barriers to older women having healthy babies. It’s no wonder, then, that if you’re over thirty and contemplating pregnancy, or already pregnant, you’re likely to have concerns about the health of your baby.
However it’s easy to inflate the fears and risks, and lose sight of the fact that many women are delaying their first child past their 20s and still having healthy babies in the majority of cases. In fact, more and more women are choosing to have their first pregnancy after the ago of 30, and in many cases the benefits may well outweigh the risks compared to having a baby earlier in life.
Problems conceiving
One of the major problems with having a baby after the age of 30 may be actually getting pregnant! Ovulation, controlled by estrogen and other hormones, can become increasingly irregular or intermittent as we age, due to decreasing production of these hormones in our bodies. It’s possible to continue to have regular periods, but to ovulate irregularly; to have incomplete ovulation (where the egg doesn’t fully mature before being released from the ovary); or sometimes to not ovulate at all within a monthly cycle. This is why if you’re trying to get pregnant, especially after 30, it’s very important to chart and track your monthly cycle in order to have an idea of when ovulation is most likely to occur for your personal schedule.
Additionally, your partner’s sperm count may decline with age. If you’ve been trying to get pregnant for some time without success, a visit to a family doctor or specialist can help to clarify any fertility issues that could be hindering your ability to conceive.
Potential health effects for the baby
Babies from older mothers, particularly those over 40, have an increased risk of genetic (chromosomal) abnormalities such as Down’s, Patau’s or Edward’s syndromes. They are also more likely to die unexpectedly late in a pregnancy, which means your doctor may be much more vigilant during your third trimester if you’re in this age category. Nonetheless, the approximate rate of stillbirth, in the late 2000s, has been shown to be only about 0.5% for women aged 20 to 39, and 0.9% for women 40 and over. The rate of chromosomal abnormalities is about 0.2% for women between 35 and 39, 0.4% for women 40 to 44, and is highest at about 0.6% for women 45 and over. Additionally, if you choose to you can undergo genetic screening through maternal serum screening, or more accurate chorionic villus sampling or amniocentesis. This will rule out the possibility of chromosomal abnormalities in a fetus, and can help prepare you, in the case of an abnormality, either to terminate the pregnancy if you choose or to accommodate the special needs of the child.
Potential health effects for the mother
As we age, we naturally become more at risk for chronic diseases such as cardiovascular disorder, diabetes, and high blood pressure, all of which can negatively affect a pregnancy and birth in an older mother. There is evidence that the frequency of gestational (pregnancy induced) diabetes, placental problems, and premature birth increase in older mothers. However, older mothers are also more likely to be watched more closely than their younger counterparts, so health problems may be detected before they develop rather than after.
Problems during birth may also be an issue; older mothers tend to have higher rates of intervention by a doctor, nurse, midwife or other specialists during their births. In particular, the likelihood that you will receive an epidural, or have an induced labor, assisted delivery (e.g. forceps, vacuum extraction) or caesarean section increases. Labor may take longer, particularly during the second stage, as your uterine muscles may be weaker.
However, it may also be the case that increased vigilance during your pregnancy and birth leads to higher rates of intervention. Be sure to ask plenty of questions of your healthcare providers, and outline your own wishes ahead of time. This way you can be confident you are receiving appropriate treatment and assistance during your labor.
The positives
There are many positive aspects of having a child later in life. At this stage, you’re more likely to be financially stable, independent, and confident in your abilities and in your own sense of self. Statistically, older women are more likely to own a home, have a stable career and be able to obtain benefits before, during and after their pregnancy. You may be in a more stable and healthy relationship than younger women; or, if not, be more content with being single. Many women report being less materialistic than they were earlier in life; being less influenced by others’ opinions; and less stressed about their futures. By your early thirties you are more likely to maintain a healthy diet, and may be fitter, more active, and more involved in your social circle and community than when you were younger. All of these aspects are positive predictors of both maternal and infant health, and can significantly counterbalance potential negatives of having a baby over 30.
Conclusion
While it’s easy to become overwhelmed by the reported negative risks for you and your baby of getting pregnant after 30, there are also strong positive factors. It’s important to remember that the risks for complications are very small across all age groups. With increasing numbers of women electing to have their first children later in life, you are more likely than ever before to encounter a strong network of social support, greater support from healthcare providers, and more positives than negatives during this exciting time in your life.
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