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Having a baby after 35: your questions answered

12 Mar 2021

Are you worried about what it means to get pregnant after 35? Dr Elisabeth Rosen, a Kry doctor who specialises in gynaecology and obstetrics, shares her advice on what to think about and how to know when you’re ready

More and more women are choosing to start a family later in life, and the average age of first-time mothers in Europe is now between 29 and 30. Despite this, many women worry about the best age to have a baby and the implications of getting pregnant at an older age.

Dr Elisabeth Rosen acknowledges that it’s good to be aware of any risks, as well as ways to prevent them. But she also points out that focusing too much on potential problems only tends to make us worried.

‘There’s already a huge amount of anxiety and worry around pregnancy and birth. In reality, if you’re generally in good health, there’s a good chance that you’ll have a straight-forward pregnancy and a healthy baby,’ she says. ‘I also think it’s important to emphasise that no one ever feels entirely ready to become a parent!’

What happens to the body and fertility with age?

‘The ovaries are formed at the embryonic stage, and we’re born with a predetermined number of eggs,’ Dr Rosen explains. ‘The eggs then rest until puberty, after which they’re used until they run out, simply speaking. The quality of the eggs deteriorates over time, but to what extent really varies from one individual to another. Some women get pregnant easily at 40 while others struggle when they’re only 30. But generally speaking, fertility decreases quite drastically around the age of 35.’

What are the risks of having a baby after 35 or being a ‘geriatric mother’?

‘The risks of high blood pressure and diabetes increase with age, and pregnancy can increase that risk,’ says Dr Rosen. ‘There are also studies that show increased risk for preeclampsia, premature birth, a low birth weight, miscarriage, chromosomal abnormalities and stillbirth with age. A doctor or midwife will screen for high blood pressure and gestational diabetes, and in most cases, the conditions can be identified and successfully treated or controlled.

‘When weighing up your options, it’s worth considering these risks. It can also be worth knowing you’re more likely to need to use an egg donor for IVF to be successful when you’re older, which again increases the risk for high blood pressure and preeclampsia.’

When you go into labour, you might need a little more assistance since studies show that the risk of complications slightly increases with age, Dr Rosen explains. ‘Complications can include the risk of tearing, which increases slightly as a result of body tissues losing elasticity as we age. You’re also more likely to have to be induced, require a caesarean section or need other interventions.’

I’m worried about miscarriage and chromosomal abnormalities – is this normal?

Many people feel anxious about the increased risk of both miscarriage and chromosomal abnormalities when trying to get pregnant. It can be reassuring to know that, while the risk of miscarriage increases after the age of 30, it starts out very small for mothers aged 25 to 29, at around 10%.

‘The increased risk of miscarriage is a result of the lower quality of eggs,’ says Dr Rosen. ‘Chromosomal abnormalities are linked to this too. You’ll be offered screening tests to determine the risk of these and some of them are performed as routine.

‘It’s a good idea to think about what a potential high-risk result would mean to you before you have those tests. If you’re not sure what kinds of tests you’d like done, or if you’re struggling to process the results you get, a doctor will be able to support and advise you.’

Are there any benefits to having children after 35? How do I know when I’m ready?

‘There’s been a shift in human behaviour across the western world, which is why more people are choosing to start a family later in life. We take gap years and study more, and many people meet their life partners at a later age. As a result, from a psychological perspective, life can be more stable when you have a child later on,’ says Dr Rosen. ‘Some studies suggest that these children do better. But if you’re waiting for everything to be perfect, you might never feel ready.

‘Fertility peaks around the age of 25, but there’s no best age to have a baby. From a fertility perspective, if you’ve met someone you want to have children with, it’s wise not to put it off. If you’re unsure, talk to a doctor about your options.’

What can I do to increase my chance of having a baby after 35?

‘Stop smoking, cut down on alcohol, get some exercise and make sure you eat a well-balanced diet,’ says Dr Rosen. ‘A lot of caffeine will lower your chances of getting pregnant and can increase the risk of miscarriage, so cutting down is a good idea. That said, lectures about exactly what to do and what not to do can just increase your stress levels, which can negatively impact your chances of conception. Just look after yourself.’

If you’re hoping to get pregnant, it’s a good idea to take 400 micrograms of folic acid daily, from before conception and right through the first 12 weeks of pregnancy. This is to help reduce the risk of any developmental issues in the early weeks.

If you’re overweight, losing weight can help increase your chances of conception and minimise risks once you do get pregnant, Dr Rosen explains. ‘Speaking to a doctor to check that you’re generally well can also be worthwhile. Get your thyroid function checked, as an imbalance can impact your chances of getting pregnant, and it’s something that can be easily treated.’

What can I do if I’m struggling to conceive?

‘The help and treatments that a doctor will recommend to you will depend on the cause of your reduced fertility,’ says Dr Rosen, adding that everything from irregular ovulation and sperm quality to difficulty having penetrative sex can contribute to problems with conceiving.

Conditions like endometriosis and polycystic ovary syndrome (PCOS) are other common explanations, and eating disorders can play a role too. ‘Sometimes helping the sperm get through to the uterus is enough, and other times we turn to IVF,’ says Dr Rosen. ‘Sometimes we need to boost the lining of the uterus to help it hold on to a fertilised egg.

‘In around 70% of infertility cases, we’re able to determine the underlying cause. There are a number of different factors that can affect the success of any treatment, but the huge majority of those who want to have a baby do so eventually.’

The different treatments available to you depend on where you live, so a doctor or gynaecologist will be able to talk you through your options.

What should I do to support myself and my baby when I do get pregnant?

‘Exercise, eat well and keep taking folic acid – but don’t panic if you forget. Most people get everything they need from their diet,’ says Dr Rosen.

Many women worry about the impact of exercise, but research has shown that regular, moderate exercise is safe and can even reduce the risk of gestational diabetes.

‘There are lists of things you shouldn’t do or eat, and it’s good to be aware of those, but it’s more important to focus on taking care of yourself,’ says Dr Rosen.

This article has been medically approved by Dr Elisabeth Rosen, a medical doctor at Livi who specialises in gynaecology and obstetrics.

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