There are many women who decide to have children when they are old enough and give birth to healthy babies. With advances in technology, pregnancy at an early age is now safer than ever before. However, pregnancy after the age of 40 still carries additional risks and complications for both mother and child. You can condition your body for a smooth pregnancy by preparing yourself before getting pregnant.
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Part 1 of 3: Seeing the Doctor
Step 1. Schedule a pre-conception consultation with your doctor or gynecologist
As you age, the likelihood of common health problems such as high blood pressure and diabetes increases and older women are also more likely to have conditions that impair fertility.
- The doctor will run regular checkups and may do a pap smear and pelvic exam. This exam doesn't take more than 15 or 20 minutes, but you may need to spend some time with your doctor to talk about getting pregnant.
- Ask about ways to increase your chances of getting pregnant and what lifestyle changes you can make to ensure a healthy pregnancy. Be honest about your current lifestyle and be open to recommendations for changes.
- Discuss whether you will be able to continue your current medication while trying to conceive and during pregnancy or breastfeeding. Ask if there are alternative therapies or medications that are safe during pregnancy, and if those alternatives are realistic for your medical history.
- Evaluate with your doctor what health problems it is most important for you to address before becoming pregnant. Because certain health problems, such as blood pressure, become more severe with age, you should discuss how to deal with them with your doctor.
- Get the immunizations your doctor recommends. Your doctor may order blood tests to check your immunity to diseases such as rubella and smallpox. After getting the vaccine, wait one month before conception.
- The doctor may want to do lab tests to evaluate the health of the uterus or the possibility that a healthy egg may still be present.
Step 2. Discuss the risks of gestational diabetes and high blood pressure
The risk for certain health problems associated with pregnancy increases with age. Discuss your personal risks with your doctor and what you can do to reduce those risks.
- High blood pressure sometimes develops temporarily in pregnant women and some studies show the risk increases with age. Women of all ages should monitor their blood pressure regularly during pregnancy, so your doctor can try to make sure your blood pressure is still under control. You may have to take certain blood pressure-regulating medications during pregnancy to ensure a healthy delivery.
- Gestational diabetes is a type of diabetes that only occurs during pregnancy. This risk becomes more common with age. Untreated gestational diabetes will make your baby grow larger than average, so you'll need to control your blood sugar levels with exercise, diet, and possibly medication if you're diagnosed with gestational diabetes.
Step 3. Consider various delivery options
Many women over the age of 40 are able to give birth vaginally. However, because of the increased risk of pregnancy-related complications, the propensity for caesarean section increases with age.
- Consider a specific delivery plan with your doctor and make sure you consider the possibility of a cesarean section. If you have already given birth to one child by cesarean section, some doctors will not allow you to have a vaginal birth. Discuss all your concerns with your doctor and say what birth options you want.
- Pushing will be more difficult if you are not young anymore. Problems related to high blood pressure and problems with the placenta during labor increase with age. Doctors should monitor your health closely during pregnancy. If he thinks you are at risk for complications in labour, your doctor may need to trigger labor and deliver the baby by cesarean section.
Step 4. Consider fertility treatments
Conceiving at 40 is sometimes so difficult that you may need fertility treatment. Talk to your doctor about fertility-enhancing drugs or surgery.
- Oral medications, such as clomiphene or clomiphene citrate, can be taken during the third to seventh or fifth to ninth day of the menstrual cycle. This medicine may increase the chances of conception. However, oral medications also increase the chances of multiple pregnancies. There is a 10% chance of twin pregnancy with these drugs. The success rate for conceiving and giving birth is 50%, but only if the mother is not ovulating. These drugs do not increase pregnancy rates substantially if the mother is already ovulating herself.
- Gonadotropins and Human Chorionic Gonadotropin (hCG) are injectable hormones used to increase fertility in older women. The injections begin on the second to third day of the menstrual cycle and are continued for seven to twelve days. You will need to have a transvaginal ultrasound during treatment to monitor egg size. The rate of multiple births for this treatment is high. About 30% of women who conceive via hormonal injections give birth to twins, and two-thirds of these are twins.
- If there is damage in the reproductive system that makes it difficult to give birth, the doctor may need to perform surgery to correct the problem. If successful, the surgery should greatly increase the chances of getting pregnant.
Part 2 of 3: Changing Your Lifestyle
Step 1. Deal with pre-existing health problems
If you already have health problems, make sure everything is under control before trying to conceive.
- Sexually transmitted infections (STIs) can hinder your ability to conceive, so get tested if there's a risk you might catch an STI. Most STIs can be effectively treated with antibiotics. Get proper treatment for infections and infectious diseases right away and don't try to conceive until you are free of STIs.
- If you are taking medication for a chronic condition, such as hypothyroidism, you should have a blood test before trying to conceive to make sure the condition is under control. You will need periodic tests during pregnancy and your doctor may need to gradually adjust your medication dose.
Step 2. Start eating healthier foods
Dietary changes are very important during pregnancy because you need a lot of certain nutrients while pregnant. Make sure you are ready for a healthier diet.
- More than half of the cereals you eat each day should be whole grains. This means brown rice, whole grain cereals, whole grain pasta, and whole grain bread. You should also eat a variety of fruits and vegetables during pregnancy.
- You should also try to eat extra protein, preferably in the form of lean meats, beans, eggs, and legumes. Fish is a good source of nutrition and is high in protein, but you should avoid fish such as mackerel or king mackerel, shark, swordfish, and tilefish because they are high in mercury.
- Dairy products are also important during pregnancy because of the calcium and vitamin D they contain. You can discuss calcium supplements with your doctor if you can't eat dairy products.
- There are various types of foods that should not be consumed during pregnancy because they can be harmful to the fetus. Raw meat and processed meat can contain contaminants that are harmful to the fetus. Smoked seafood can also be dangerous. All foods that contain raw eggs or raw egg yolks can also be harmful, so make sure the eggs you eat are thoroughly cooked. Soft cheeses, such as brie cheese, are usually made from unpasteurized milk and should be avoided. Caffeine intake should be reduced during the first trimester.
Step 3. Maintain a healthy weight
If you are overweight or underweight, your doctor may advise you to reach a healthy weight before getting pregnant. Talk to your doctor about ways to gain or lose healthy weight and come up with a diet and exercise program that works for you.
- Underweight is determined when the Body Mass Index (BMI) is below 18.5 and overweight is a BMI above 25. A BMI of 30 or more is considered obese. If you are underweight, you are expected to gain it during pregnancy and if you are overweight, you are expected to lose it. Because weight is difficult to control during pregnancy, it would be nice if efforts to achieve a healthier weight is done before getting pregnant.
- Being overweight during pregnancy increases the risk of gestational diabetes and high blood pressure. Being underweight can increase your risk of premature birth and your body may not be strong enough to support pregnancy.
- Plan efforts to achieve a healthy weight in collaboration with your doctor. Talk about exercise, nutrition, and the changes you must make in your lifestyle to achieve a healthy weight.
Step 4. Avoid harmful substances
Tobacco, alcohol, and narcotics of any kind should not be consumed during pregnancy, so you should avoid them when trying to conceive. You should also minimize your caffeine intake as it should only be consumed in small amounts during pregnancy. If you are a heavy caffeine drinker, try to reduce it before trying to get pregnant to minimize caffeine withdrawal symptoms. You should only consume 150 mg of caffeine a day which is about two cups of coffee.
Step 5. Exercise
Exercise is safe and even recommended during pregnancy, and there are various safe exercises for pregnant women that you should do before and during pregnancy.
- Aerobics, endurance, and flexibility are important exercises for pregnant women. Walking, stationary bikes, yoga, swimming, and lifting weights are also generally safe for pregnant women. However, every pregnancy is different, so discuss your health with your doctor beforehand. Your doctor may recommend more or less exercise depending on your overall health.
- Your heart rate should increase during exercise, but if you're over 40, it should be maintained at between 125 and 140 per minute. You can measure your heart rate by checking the pulse on your neck or wrist and counting the beats in a 60 second time frame.
- Be careful when doing abdominal exercises that have to be done lying on your back. This can be dangerous for the fetus as it restricts blood flow.
Part 3 of 3: Understanding the Risks
Step 1. Consider the risk of chromosomal abnormalities
The rate of chromosomal abnormalities is higher in babies born to mothers over the age of 40. Be aware of these risks and be open to getting tested for chromosomal abnormalities.
- Aneuploidy, or an abnormal number of chromosomes, tends to occur as the mother ages and can lead to disorders such as Down's Syndrome. Women are born with a number of eggs, and healthy eggs tend to be released at a young age. Eggs with chromosomal abnormalities tend to be released and then fertilized in their 40s. At the age of 40, the chance of Down Syndrome is 1 in 60 and that number continues to increase with age.
- There are various types of tests that can be done to check for abnormalities. A sample of amniotic fluid or placental tissue may be used for tests. Such tests also have a slightly increased risk of miscarriage, but there are new tests that can be performed without risk to the fetus. A simple blood test, called a Cell Free DNA test, can now be used to detect fetal abnormalities.
Step 2. Consider the higher risk of birth failure
Birth failure is very traumatic and the risk increases with age. You have a risk of miscarriage or stillbirth if you are over 40 years old.
- Consider carefully the possibility of birth failure before trying to conceive. Although many women give birth to healthy babies over the age of 40, miscarriages due to pre-existing health conditions and hormonal abnormalities are becoming increasingly common. Make sure you are prepared to deal with the emotional repercussions of this failure if it occurs.
- Close monitoring of the fetus during pregnancy is especially important if you are over 40 as this can prevent possible miscarriage or stillbirth. Talk to your doctor about personal age-related risks and ask him to increase monitoring during your pregnancy.
- By age 40, the miscarriage rate rises to 33% and that number increases with age. By age 45, the miscarriage rate is 50%. Talk to your doctor about what you can do to avoid miscarriage.
Step 3. Be aware of the increased risk of multiple births
The chances of having twins or triplets increase with age, especially if you are using in vitro fertilization methods or fertility drugs to increase your chances of getting pregnant.
Make sure you are financially able to support multiple pregnancies. Learn about the care of conceiving twins, including delivery options. Many twins have to be delivered by caesarean section
Step 4. Be patient
If you are over 40, it may take longer to conceive. The eggs of older women do not fertilize as easily as younger women, and may take more than six months. If you still can't get pregnant after six months, talk to your doctor.
