Forty Years Old And Pregnant:
Arguments In Favor Of Older Moms

by Darline Turner Lee, Physician Assistant, ACSM Exercise Specialist

Article Last Reviewed: Sept. 9, 2006

I’m forty years old and pregnant with my second child. By current medical reports, everything is going great. If the rumbling in my belly is any indicator, this kid is ready to enter the world with a bang. I just can’t wait to see what this little one will be like. Will it be as spirited and dramatic as its older sister? Will it be more laid back and relaxed? Will it like to be cuddled or be very independent?

I have learned to ignore callous remarks and unsolicited advice with this pregnancy. Nothing kills joy faster than “well meaning” comments from those less than in the know. Recently while on a cruise, I engaged in light conversation with another passenger. We both chuckled as we watched my daughter sip her juice at the piano bar while listening to classical music. We were both well into adulthood before we ever cruised. “But things are different,” I said. “When I was young, my parents were young and didn’t have lots of money so we didn’t do a lot in the way of vacations. My husband and I got married older and things are different for us financially. It was actually cheaper to cruise with my daughter than to fly-even to see family.”

“May I ask how old you are?” inquired the woman.

“I’m forty.”

Her eyes widened. “You’re forty and you’re pregnant?” The unspoken ‘Oh my God!’ was behind the statement, but she quickly caught herself. I, having gained a bit of wisdom in my old age, simply smiled back at her (all the while swallowing a venomous string of retorts that had gathered on the tip of my tongue).

According to the National Center for Health Statistics and the United States Census Bureau, between 1978 and 2000 the birth rates for women over thirty have increased forty-four percent overall. In women aged thirty-five to thirty-nine births have increased sixty percent and in women over forty births have increased fifty percent. The American College of Obstetricians and Gynecologists estimates that nearly one third of an obstetrician’s pregnant patients are now over the age of thirty-five.

We women over thirty-five face some challenges. Rates of conception drop as a woman’s fertility begins to decline. Since we are born with all of the eggs that we are ever going to have, by thirty-five our remaining eggs have been around for thirty-five years. These eggs are more likely to develop improperly or to divide improperly which can lead to genetic birth defects such as Down’s syndrome. The number of eggs declines due to all of the menstrual cycles a woman has had to date. Ovulations, the development and subsequent release of eggs from a woman’s ovaries, become less frequent and irregular making conception difficult. Despite all of this, we older ladies are still getting pregnant (on our own and with medical assistance) and giving birth to healthy babies.

Older mothers are offered prenatal screening tests such as amniocentesis (a sampling of the amniotic fluid from the gestational sac) or Chorionic Villus Sampling (a sampling of the cells that have attached the placenta to the uterine wall) to look at the chromosomes of the baby and see if the child is at risk for developing birth defects. There is a slight increase of miscarriage with these tests. The newer Maternal Serum Screening tests have eliminated these risks. They use an ultrasound and small blood sample to evaluate the baby’s development, giving comparable results without the risk of miscarriage.

Increased miscarriage and preterm labor (labor before thirty-seven weeks of gestation) are realities for older moms. The March of Dimes reports that moms thirty-five to thirty-nine years of age face a twenty percent risk of miscarriage and in moms over the age of forty-two the risk jumps to fifty percent. Miscarriage rates are just nine percent among moms in their twenties.

Older pregnant women used to have more difficult pregnancies, experiencing more high blood pressure, more gestational diabetes, more preterm labor and more low birth weight babies (babies weighing less than five and one half pounds at birth). The studies that the March of Dimes quotes show that the risks are very modest, but do increase with each year of age of the mother. In reality, older mothers often fare better than their younger counterparts. Newer data from the American College of Obstetricians and Gynecologists and data from other nations show that we older mothers are entering into pregnancy with better overall health than our younger counterparts. We are more fit, have better nutritional habits, are more financially stable and have more stable home situations. We start prenatal care early and have taken care of most potential problems before conception. We are getting pregnant, faring well, defying the odds and having beautiful babies.

Still, not every woman who wants to conceive a baby will be able to. I myself have had a miscarriage, fibroid surgery, a first child, a miscarriage and now hopefully, a second child. To women still trying, hang in there and get help (if you need it) earlier rather than later. The odds, once not in our favor, are better everyday. Believe me, the outcome is worth it. See you at the Central Market playground!

Darline Turner-Lee is eating well (too well?) and doing prenatal aerobics regularly. Check in on her at darline@nextstepfitness.com