There are many reasons why more and more women are having babies after their 40th birthday. This issue is highly subjective as each woman’s circumstances differ from one another.
Three fertility experts who practice at Mount Elizabeth Hospital weigh in on this subject.
We also spoke to mums who had babies after 40. Read to the end of this article for their thoughts.
How should a woman prepare herself if she is planning for pregnancy after 40?
Dr Kelly Loi, Fertility Specialist, Mount Elizabeth Hospital gives this advice: “Take prenatal and folic acid supplements to prevent neural tube defects which lead to problems like spina bifida.
“Schedule a preconception appointment to assess overall gynaecological health and fertility status. Seeing a fertility specialist would be useful to determine if fertility treatment is needed and optimise chances of pregnancy.
“Once pregnant, regular prenatal visits are important to monitor for the well-being of both mother and baby. A variety of prenatal tests are now available to screen for conditions such as Down syndrome.
“These include a nuchal translucency ultrasound scan at about 12 weeks gestation, as well as a non-invasive prenatal testing which involves a blood test that examines fetal DNA in the mother’s bloodstream.
“Diagnostic tests such as chorionic villus sampling and amniocentesis provide the most reliable information about baby’s chromosomes or the risk of specific chromosomal abnormalities, but they also carry a slight risk of miscarriage.
“So a discussion with the doctor will be necessary to determine which tests are most suitable”.
Dr Ann Tan, Fertility Specialist, Mount Elizabeth Hospital says that it is of utmost importance to “get checked and assessed as a couple as soon as possible”, while Dr Suresh Nair, Fertility Specialist, Mount Elizabeth Hospital simply advices mothers to try and have babies before 40.
What are some of the biggest risks of getting pregnant after 40?
Some of the risks Dr Suresh Nair cites are increased chances of obesity, thrombosis, heart disease, poor blood flow to the uterus (IUGR), post-partum haemorrhage, shoulder dystocia and increased incidence of neonatal intensive care admission.
Dr Kelly Loi is concerned that “Sometimes, the baby’s growth may be affected and may require early delivery. There is also a higher risk of Caesarean sections due to pregnancy complications such as Placenta previa.
“There is also an increased risk of miscarriage due to genetic problems or pre-existing medical conditions. In addition, there tends to be a higher chance of growth restriction, smaller babies and premature births.”
In addition to the same concerns as Dr Loi, Dr Ann Tan states that there is also an increased risk of multiple pregnancies and an increased risk of fibroids or endometriosis which reduces chances of getting pregnant.
Dr Tan adds, “Times have changed. But unfortunately, fertility is still strongly and negatively associated with a woman’s age. As her age increases, her fertility declines. After 40, the risk of failed pregnancies increases.”
What advice do you have for women who want to get pregnant after 40?
Dr Ann Tan has this advice to give: “If one intends to conceive, then one must stay in optimal health to reduce the risks above mentioned.
“Taking additional supplements to help optimise the quality of their eggs and sperm is likely to improve embryo health…
“Getting into assisted reproduction maybe required should there be proven reduced ovarian reserves or significant male factors. Time is of the essence once a woman crosses 40.”
Mums share their stories...
Melanie found out she was pregnant with baby number three when she was 41. It was a complete surprise, especially because Melanie had to undergo fertility investigations for her first baby and tried for a long time for her second.
Melanie says, “I was very aware of the risks involved, and apart from the usual concerns, I didn’t have any concerns about my age.
“I worried about abnormalities associated with younger or older pregnant women, especially since I'd declined invasive investigations.
“Thankfully I had a very normal and uneventful pregnancy!
My advice to other mums: "[When it comes to] having babies after 40, [one has] to be in good physical shape before and during pregnancy. There is so much on offer these days, in regards to natural therapies and others, to help with an easier pregnancy and birth.”
Another mum, Angela says, "I fell pregnant just before my 40th! I had tried for some time to get pregnant before the big milestone date. When I didn't, I thought that it wasn't meant to be.
"There were definitely concerns like carrying the baby to term and birth defects because of my age. There were lifestyle concerns too as the diaper changing and lack of sleep episodes were well behind us and I didn't know if I had to energy to do it all over again!
"My pregnancy was fine apart from the gestational diabetes that thankfully went away after the pregnancy.
My advice to other mums: "You will find energy reserves that you never knew you had, so really enjoy every moment before and after the baby! And finally...at 40, you are wise enough to know that you can't do it alone, so get as much help as you need!!!"
For more information about the maternity ward services at Mount Elizabeth Hospital and to book a maternity tour, please call (+65) 6731 2000 or visit www.mountematernity.sg. A virtual tour of the rooms is available at https://www.mountelizabeth.com.sg/virtualtour/meh/orchard/single-room.html
Did you have your baby after 40? We'd love to hear about your pregnancy story, so please do take a minute to leave a comment below.