There’s a saying that goes: Age is just a number. Yet when it comes to pregnancy, age can’t be ignored.
In the last forty years there has been a significant increase in the number of women who are delaying pregnancy until their mid thirties.
While it used to be very rare for women to become pregnant after their forties, it has become increasingly more common, thanks to advances in fertility and preconception health care.
What Age Is High Risk For Pregnancy?
According to the Centers for Disease Control and Prevention in the US, births for women between the ages of 50 and 54 increased by more than 165% from 2000 to 2013.
News reports of women giving birth in their fifties, sixties, and even seventies, are increasing. In 2016 a 63 year old woman gave birth in Australia. In India, a couple in their seventies had their first child. Just recently a 64 year old woman in Spain gave birth to twins.
So, how old is too old to have a baby?
Many people have strong opinions on the subject. And most health experts agree there are increased risks for women who are older.
Why Are Women Waiting Longer To Have Babies?
Women today have far more options available to them than women in the past ever had. They have greater access to education, they are more likely to pursue travel and careers, and there is less social expectation to have children earlier.
On the other hand, there are still problems with accessing childcare, not enough maternity leave, and a lack of financial support. These issues tend to suggest women can have either a career or motherhood, but not both.
Unlike women 40 years ago, women today have greater access to fertility treatments, and this can give them a sense that time doesn’t run out. In fact, fertility begins to decrease at about the time a woman turns 30. After that time, couples might take longer to conceive and have a higher risk of miscarriage.
For women who choose to delay pregnancy until they are older, declining fertility doesn’t have to be a block to having a baby.
What Effect Does Age Have On Pregnancy?
In decades past, women at 35 had often experienced several pregnancies already. This meant they were at higher risk of complications due to having had multiple previous pregnancies.
There was also a higher chance of having a baby with chromosomal issues, such as Down syndrome.
Today, women who choose to wait until they are older are likely to be more educated about the importance of pre-conception and antenatal health. Even so, there are increased risks for women who have babies when they are older.
Women who are in older age brackets are already at greater risk for developing conditions such as diabetes and problems related to hypertension. These conditions will automatically increase a woman’s chance of being high risk when she becomes pregnant.
Older mothers are at higher risk for other complications, such as:
- Genetic Risks
- Miscarriage
- Stillbirth
- Gestational diabetes
- Placental problems and bleeding during pregnancy
- High blood pressure
- Low birth weight or premature babies.
A study that looked at almost 2.2 million women who gave birth from 1967 to 2006 found the risk of stillbirth at 42 weeks, in women 40 years and older, was 12.37 per 1,000. When looking only at the data for the years between 1987 and 2006, the risk decreased to 2.64 per 1,000.
Miscarriage is more likely to occur in older women, but is related to egg quality rather than the actual ability to stay pregnant. Older women who have fertility treatments using donor eggs from younger women have lower rates of spontaneous miscarriage than those who fall pregnant naturally.
Certain genetic risks, particularly Down syndrome, are more common in pregnancies of older women. The rates increase with age:
- 1 in 1200 at age 25
- 1 in 350 at age 35
- 1 in 100 at age 40
- 1 in 30 at age 45
- 1 in 10 at age 49.
Women who are aged 35 or older are offered screening to determine whether they are at higher risk of having a baby with a genetic disorder. If the tests indicate a high chance of Down syndrome or other chromosomal disorder, you can choose to have more invasive testing to make sure.
These tests are chorionic villus sampling (CVS) or amniocentesis, both of which have risks for miscarriage. You can read more about the CVS test here and amniocentesis here.
What Is Most Likely To Happen?
Older women giving birth are more likely than younger women to experience some form of intervention during labour and birth.
Possible interventions include: inducing labour, augmentation of labour (speeding up contractions), epidurals, assisted birth (forceps or vacuum), and c-section.
All of these interventions increase the chances of needing further assistance, known as the cascade of intervention. Older women are probably at higher risk of having them than younger women. There is also a perception that older women are ‘high risk’ simply because of their biological age, rather than because of their overall health.
Women who access midwifery-led models of care are less likely to experience interventions, and complications related to interventions, than those women in obstetric models of care.
How Can I Reduce My Risk?
The biological clock ticks constantly, but turning 35 doesn’t mean your body suddenly switches over from ‘young’ to ‘old. It is a timeframe when certain factors might have an increased chance of affecting your pregnancy. Most health experts agree that pregnancy itself isn’t necessarily any different as you age, as long as you are healthy.
Today’s older mother is more likely to be aware of how her health affects her biological age. If you are in your forties or fifties, and healthy, you are more likely to have a healthy baby at full term than a woman of the same age with poor health or chronic illness.
If you intend to wait until you are older before beginning your family, it’s worth ensuring you stay as healthy as possible. Discuss with your care provider any hereditary conditions you might be at risk for, and ways to reduce that risk before you become pregnant.
It’s important to consider the impact age has on fertility, and on the increased risk of miscarriage. Many women are able to access fertility treatments, but should be aware that the success rate of IVF also declines as a woman ages.
The vast majority of older mothers have perfectly healthy pregnancies and babies. Although there is an expectation of a higher risk of complications during pregnancy in older women, a higher risk doesn’t necessarily mean those complications will happen.
