The number of women having babies in their 40s is on the rise and it feels like every day a new 40-plus celebrity is announcing their pregnancy, from Janet Jackson at 50, to Gwen Stefani at 44 and Halle Berry at 47.
I am one of these women. And while conceiving at this age is difficult, I came to learn that once pregnant there are also risks that are specific to older women. After a very long IVF journey I finally managed to get pregnant at the age of 43. This was my second child and I was determined for the birth to be natural and drug-free, as the first one had been 10 years earlier.
However, at my first obstetrician’s appointment my age became an issue.
I was told I would need to be induced at 38 weeks to reduce the chance of stillbirth associated with older mums, which doubles to approximately two in 1000 over the age of 40 according to the Royal College of Obstetricians and Gynaecologists in the UK.
This was a huge shock to me. Although I knew about the associated genetic risks associated for the baby such as an increased chance of Down Syndrome, I had no idea about the other impacts of age on pregnancy.
Immediately, fear over my ability to carry my child crept in and left me filled with doubt throughout the pregnancy. Each visit to the midwife I was reminded of the need to be induced early and told that I would need constant heart rate monitoring for myself and the baby during labour.
Then after my daughter’s birth, when I went for my antenatal visits the first thing that flashed up on the screens in bold was my age.
And yet, I kept a diary for both pregnancies. Comparing the two, I noticed that often the way I was feeling at any given point was just like my pregnancy 10 years earlier. And while I feel my body has suffered more post-pregnancy this time around – my recovery time has been longer and the sleepless nights are harder to cope with, despite keeping fit and healthy – I do feel the focus on age was overwhelming.
Professor of Midwifery and spokesperson for the Australian College of Midwives, Hannah Dahlen, who sees numerous older women in her practice, said there were many positive aspects of pregnancy in your 40s.
“Women are financially stable and more able to give to a demanding baby. Psychologically, children born to older mums also do better,” she said.
However, she said there was no doubt age brought more risks.
“There is a small increase in the risk of stillbirth but it is important to put it in perspective. We have not got strong evidence of the impact of age on stillbirth rates to induce women early. Inducing women is not without its risks and all the decisions that need to be made need to be about balancing risks,” she said.
Professor Dahlen said other age-related issues include higher blood pressure, a greater chance of gestational diabetes and an increased risk of congenital abnormalities.
Listen: Megan Malkiewicz speaks about her IVF miscarriages then falling pregnant naturally, and donating her embryos on Hello Bump (post continues after audio...)
“The uterus also might not contract as effectively, but this is controversial. I think it is because women find it harder to let go and go into that primitive state when they are older,” she said.
“If they are frightened and not well supported in birth this will contribute to the uterus not contracting.
“Women in their 40s need good midwifery care. There is so much negativity around it, they need to be reminded that there is nothing wrong with them."
Professor Dahlen, who had her last baby at 40, said she felt there was more negativity around older pregnant women now than there was 12 years ago when she had her last baby.
“We have to move away from the idea that once you turn 40 something catastrophic will happen,” she said.
Professor Dahlen advises her patients to be as healthy as possible to reduce the adverse effects associated with age.
“If you are a fit and healthy woman with no complications it is a different scenario to an unhealthy, overweight woman. Regular exercise to combat diabetes and regular antenatal care are important,” she said.
Brisbane mum Mandy Lauderdale had her first child at 40 and straightaway every doctor treated her with an underlying caution.
“They said, you’re nearly 40 this is an issue. They wouldn’t let me have a water birth because of the risks with older mums. They wanted to monitor me during the labour because of my age,” she said.
“Everything was related to my age and every doctor had a ‘what-could-go-wrong’ story,” Mandy said.
Royal Australian and New Zealand College of Obstetricians and Gynaecologists President, Professor Stephen Robson, said while it was important to have a thorough health check before conceiving, women in their 40s should feel confident about the pregnancy and birth.
“At the end of the day the most likely outcome is a healthy mum and baby,” Professor Robson said.
But he added that statistics show more than half of women over the age of 40 will end up having a caesarean section.
“This tells us that things don’t go so well in labour. Precautions are needed such as close monitoring of the baby’s heart rate during labour,” he said.
At the end of the day, pregnancy at all ages age can carry risks. Any woman fortunate enough to beat the odds and become pregnant in their 40s probably feels very blessed.
Staying physically fit and healthy will help to combat some of the associated risks.
Every woman’s experience of pregnancy and birth will be different. It’s important to consult your doctor about your individual circumstances and to consider attending prenatal classes that focus on building your confidence for the birth, as well as making time for regular antenatal care.
And of course, surrounding yourself with people you trust will go a long way.