There can be innumerable number of reasons why couples would want to delay parenthood to their mid-to-late 30s, or sometimes even later. It can be because of completing advanced education, unstable home atmosphere, unemployment, financial instability, career demands, and so on. In fact, sometimes it’s just a personal choice, where the couple is undecided about making such a big life-changing decision.

So much so, that doctors now rarely use the term Geriatric Pregnancy for women who decide to have their babies at 35 or later in their 40s. Most women deliver healthy babies in this age bracket. However, that doesn’t mean that age doesn’t bring a set of complications for some. TC46 roped in Dr Anitha Rao, Consultant Obstetrician and Gynaecologist at Motherhood Hospital, Bangalore to share her expert inputs and valuable insights on understanding late pregnancy better.

1. Pregnancy in your 30s is on the rise nowadays. What are some of the precautions one needs to take?

Late pregnancies require more attention and care as they are more complicated, and the risks are higher. It is essential to make healthy choices and take good care of oneself which is the best way to take care of the baby. It is important to make preconception appointments with one’s doctor to discuss overall health and lifestyle changes that will aid in the pregnancy. Regular prenatal care is critical to ensure good health of mother and baby and avoid any unforeseen situations. Late pregnancies are especially common in the urban set up as women are prioritising career goals.

During pregnancy, it is important to:

  • Maintain a healthy balanced diet rich in folic acids, calcium, iron, vitamin D and other necessary nutrients. Gaining the right amount of weight will nurture the growth of the baby and help in weight reduction after childbirth. 
  • It is important to stay active and add in physical activity into one’s regular routine. This will prepare mothers for childbirth and labour by increasing stamina and muscle strength. 
  • Alcohol, tobacco and other drugs are strictly off-limits during pregnancy. 
  • Consult the doctor about prenatal testing for chromosomal abnormalities. This will help screen the chromosomal abnormalities in the developing baby. The choices made by the mother before conception are equally important to those made after one is pregnant.

2. We know that from the age of 35 there’s a slight decline in fertility rates among women. Does this mean you will definitely have trouble getting pregnant?

After the age of 30, the egg count and its quality in a woman’s body starts decreasing rapidly, which is why after 35 it gets increasingly difficult to get pregnant. There is a depletion of ovarian reserve with the increase in age. Due to the higher percentage of genetically abnormal eggs, there are higher chances of miscarriages and Down’s syndrome with a lower rate of pregnancy. Age-related fertility decline is a common trait in both men and women, which is why today there are several options to induce pregnancy in women over the age of 35. Treatments like IVF, ICSI and IUI are done to assist women of this category for pregnancy. One of the most powerful tools is egg freezing. It helps a woman have children even after the age of 35 as long as she has a strong and healthy uterus.

3. Does the father’s age matter in late pregnancy?

In pregnancy, the paternal age also plays an important role. Pregnancies from fathers over the age of 40 can cause several risks to the mother and the child. One of the biggest risks in such circumstances is miscarriages or the chances to end up in stillbirth. It also has a slightly increased risk of causing birth defects, including the development of skull, limbs and heart in the developing child. There is also the possibility of autism spectre disorder and schizophrenia in children from father’s over the age of 40. Other risks from increased paternal age include acute lymphoblastic Leukaemia in the child.

4. Is it true that older eggs can have more chromosomal problems and lead to defective birth?

Eggs present in older women tend to be lesser in count and in quality leading to complications during childbirth. This can, however, be avoided when egg freezing is done. Freezing eggs preserves them and keeps them healthy and intact to be used late by the mother even in their older age. Pregnancy with natural eggs in women over the age of 35 presents a higher percentage of genetically abnormal eggs with a higher chance of miscarriages and Down’s syndrome.

5. What are some of the risks involved in pregnancy at a later age?

Women who bear children over the age of 35 tend to face special risks like miscarriages, premature delivery, stillbirth, gestational diabetes, chromosomal abnormalities and foetal growth retardation. Children also have a higher risk of being born with Down’s Syndrome. The chances of having children with birth defects and getting pregnant with multiples is higher. Treatments like IVF, ICSI and IUI might have to be done to induce a healthy pregnancy and do not come without complications.

6. What are some of the benefits of conceiving later?

Studies have shown that having a child later in life boosts one’s brainpower making women mentally sharper than those of their age. The child’s risk of unintentional injuries is drastically reduced. Mothers who conceive later are said to be emotionally prepared, resulting in better parenting skills. Children are more likely to be tech-savvy and better educated. Late pregnancies also come with financial stability that is built over the years. Researchers have also discovered that parents who have had children later in their life led much longer lives than those of their peers.

7. Can you guide our readers through some of the alternate fertility options which are available for women nowadays?

Apart from treatment and procedures like IVF, ICSI and IUI that tackle infertility, people can also attempt complementary therapies and explore their potential to get pregnant. These include acupuncture, mind/body techniques, hypnosis, herbs and yoga. Acupuncture is an ancient traditional Chinese method involving needles to assist a woman’s attempt to get pregnant. Not one method is said to guarantee pregnancy, but these are methods that can be explored before going in for more serious medical procedures.

8. What are the chances of getting pregnant naturally and/or using various other fertility options in the late 30s?

The chances of getting pregnant naturally in the late 30s are quite difficult and complex and come with a lot of care and maintenance. Other fertility options like egg freezing, IVF, ICSI and IUI are procedures that can aid mature women in giving birth. Although these procedures improve and present a higher chance of pregnancy there is no guarantee that can be given, because of the risks faced by both the mother and the child. Overall the lifestyle of the couple plays an important factor in conception. Stress, smoking, alcohol and junk food can impact the chances of fertility adversely.

9. Does the delivery get complicated for a mother in her 30s?

Women over the age of 35 tend to experience a higher chance at a preterm delivery, hypertension, superimposed preeclampsia, eclampsia, postpartum haemorrhage, poor fetal growth and fetal distress. However, they have lower odds of experiencing chorioamnionitis.  The chances of preterm deliveries also increase.

10. What’s your advice for women who are planning on conceiving late?

Conceiving late comes with its own set of pros and cons. There are several treatments and procedures available to help mothers with the technology and medical science advancements that have made significant progress. All it takes is the right kind of nutrition, care, knowledge on the subject, a good doctor and a supporting family to help get through the pregnancy successfully. Maintaining a healthy lifestyle is extremely important. Regular exercise, eating balanced meals and staying fit and active can also make a huge difference.

There is plenty of good news for older women who decide to conceive late. The chances of having a healthy baby are more if you remain in your best shape. Keeping all these options and advice in mind, let’s hope you have a great and healthy pregnancy.