Pregnant and 40? Accentuate the positive.

Pregnant and 40? Accentuate the positive.


A recent study from the Royal College of Obstetricians and Gynaecologists has suggested early induction of older pregnant women (aged 40 or above) may reduce the risk of stillbirth. The paper’s authors recommend that pregnant women in their 40s are given the option to induce earlier. This pragmatic advice should be welcomed.

Over the last 30 years, pregnancies among women in their 40s have tripled to over three per cent of all births. The higher risk of stillbirth and other complications in this pregnancy class is well-known. An earlier study advised that induction should happen at 41 weeks. This new one brings it forward to 39.

But let’s put the ‘negatives’ of older pregnancies into perspective. Older mothers face slightly increased risks, we all know that. However, the likelihood of stillbirth is less than one per cent. As it is for placenta praevia. And don’t even think about postpartum haemorrhage: the chance is 1 in 1000.

Many older mums have IVF. Let’s look at the positives there. Treatment protocols like minimal stimulation cycles are seeing excellent outcomes. Better cultivation and selection of embryos are boosting success rates. PGS testing has become mainstream. And cryopreservation methods are better. Indeed, at our clinic FET success rates are particularly good for older women, higher even than for the fresh cycle.

If you’re 40 or over, falling pregnant is a celebration. It’s also a reminder of a more complex route to motherhood, where social and economic factors have played their part. Whatever your reason for having a baby later in life, you’ve successfully conceived. You’ve accepted the increased risks of complications. But you recognise that those risks are quite small.

The truth is, it’s more likely you won’t miscarry, get gestational diabetes or pre-eclampsia. If you’re an IVF patient, you probably had a single embryo transfer to reduce the chance of a risky multiple pregnancy. That was the right call.

If all looks good at the 12-week scan, you’re probably okay. And even if you had a bumpy ride to to that point, perhaps due to bleeding, things usually settle down by the second trimester. Those older-mum scare stories in the women’s weeklies or the fertility forums? Ignore them.

Fertility patients will, as their due dates approach, have seen off many obstacles. If you were 42 or more when you had IVF, you beat the odds against a live birth by 20 to 1. Donor-egg recipients will have reduced their likelihood of chromosomal issues. Older mothers carrying donated embryos have even higher chances.

Many older mothers are in more stable relationships (or single by choice), financially secure and motivated to succeed. They are emotionally strong and focused. One thing’s for sure. However you got pregnant, naturally or via IVF, you should rejoice a little more and worry a little less. Pregnancy in your 40s is the new normal. Fewer people judge. And it’s medically safer than you think.

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