Are you considering having a baby after 35? You are not alone! Worldwide trends suggest that millennials are choosing to delay childbearing; with many starting their families in their 30’s and beyond. This is in part due to women wanting to further their education and careers, social trends, the pandemic, and challenging economic times. Whatever your reason is, we’ve got you covered.
What to be aware of
As one reaches the age when the “biological clock” begins to tick, the conversation around age and pregnancy becomes an important one. By educating yourself about the risks associated with pregnancies at 35 and older, you can take the necessary steps to provide your baby with the best and healthiest start.
It can take you longer to fall pregnant: You are born with a limited number of eggs. The number of eggs gradually lessens with every menstrual cycle. After the age of 30, the decline is more rapid, not only affecting the quantity, but the quality (DNA and chromosomes) of the eggs as well. Due to a lack of ovulation or because of the poor quality of the eggs, fertilisation and thereby pregnancy, can be delayed.
Chromosomal abnormalities are more common: Due to the reduction in the quality of the eggs, there is a higher risk of chromosomal abnormalities such as Downs Syndrome.
Higher rates of pregnancy loss: There is an increased rate of miscarriage, likely caused by chromosomal abnormalities, with 90% occurring in the first trimester. Stillbirths are more common and are often associated with chronic underlying conditions such has hypertension and diabetes.
Higher rates of multiple pregnancies: This can be due to the increased use of IVF technology but can occur naturally due to an increase in hormonal fluctuations at an older age. Although multiple pregnancies can be healthy, they are often complicated by preterm birth and other medical conditions such as gestational diabetes or pre-eclampsia.
Chronic conditions: Pre-existing or gestational diabetes are more common. Uncontrolled glucose levels can lead to premature birth, poor foetal lung maturity, hypertension, or stillbirth. Babies can grow larger than usual leading to possible birth injuries.
Hypertension and pre-eclampsia are more common. These conditions, if uncontrolled or unmonitored, can cause a reduction in placental function that may lead to reduced blood flow to the baby. Adverse outcomes include growth restriction, preterm birth, bleeding behind the placenta or seizures and organ damage in the mom.
Higher rate of caesarean section: Older mothers are more likely to have caesarean sections because of foetal complications and underlying medical conditions.
What can I do?
Seek advice early: If you are older than 35 and struggling to conceive after six months, seek advice early from a gynaecologist or reproductive medicine specialist.
Vitamins: Take a good prenatal vitamin containing folic acid (to prevent spinal cord defects in the baby).
Avoid: Alcohol, cigarettes, and other harmful substances.
Vaccines: Ensure your vaccines are up to date including your Covid 19, Rubella and Flu vaccines.
Chronic medical conditions: Ensure that all your chronic medical conditions such as hypertension, diabetes, or auto-immune conditions etc are well controlled. Strict control of blood pressure and glucose levels lead to healthier foetal outcomes.
Weight: Manage your preconception and pregnancy weight by ensuring a healthy diet and keeping an active lifestyle. Excessive weight gain during pregnancy is associated with a higher rate of both maternal and foetal complications.
Book early: Book your first pregnancy visit at 8 weeks. This ensures adequate time to monitor your chronic conditions, adjust medication and screen for any further underlying conditions.
Foetal screening: Foetal assessments include a combination of ultrasounds (done at 13 weeks and 20 weeks of pregnancy) and blood tests, to assess the risk of chromosomal abnormalities.
Non-invasive Prenatal Testing (NIPT) is the drawing of a sample of the mother’s blood wherein fragments of the babies DNA are identified and examined for chromosomal abnormalities such as Downs syndrome, and Trisomy 13 and 18. This test is 99.8% accurate but comes with a hefty price tag.
Foetal diagnostic tests: Invasive testing such as chorionic villus sampling and amniocentesis are available but have an increased rate of miscarriage compared to the NIPT. Your doctor will be able to guide you in your decision-making process.
Regular antenatal care: Regular antenatal visits are important in the early diagnosis and management of complications. This may lead to an increase in antenatal visits and foetal monitoring.
Preserving your fertility: Freezing your eggs or oocyte cryopreservation is available to women who delay childbearing. Eggs are removed from the ovaries and frozen. They can be used at a later stage during an IVF cycle.
Many women over the age of 35 experience a healthy pregnancy and delivery.
Good luck Mom! You’ve got this!