Pregnancy in your 20s &30s 40s

Have a healthy and happy pregnancy at any age. Here is how your body and your baby are affected by your age.

THE RISK OF HAVING A BABY WITH DOWN SYNDROME, FOR INSTANCE, INCREASES FROM 1 IN 350 BY AGE 35 TO 1 IN 100 BY AGE 40.

YOUR BODY THE GOOD TWENTIES

Physically, you are in the golden age for reproduction right now: you will never be more fertile than in your early twenties.

You have a 20 percent chance of conceiving every month.

Your body will recover from the stress of pregnancy and childbirth fast, and, once your baby’s here, your energy levels are higher than an older mom’s. Pregnancy is also safest for you – the rates of gestational diabetes and hypertension (high blood pressure) are lower than at any other age. Whether you feel ready for pregnancy is another matter. Over the past two to three generations, humans have been taking longer to mature, and there is a trend to extend adolescence, live with our parents into adulthood, and focus on careers before babies.

But if you do feel ready for children and choose to have a baby in your twenties, there are some advantages.

“It may be easier to adjust to the disruption of parenting. Later in life, you have become used to your life and routine, and your career may be more established and therefore disrupted by the arrival of a child,” says Joburg psychologist Thomas Burkhalter.

THE BAD

The biggest risk to fertility for you now are sexually transmitted diseases (STDs), says Johannesburg-based gynaecologist Dr Bronwyn Moore. Diseases such as gonorrhoea and chlamydia can damage the reproductive system. If you are HIV positive and pregnant, you will need specialised antenatal and postnatal care, so it’s important you tell your doctor or clinic.

THE UGLY

Early pregnancy is good, but very early pregnancy is not. Extremely young (teenage) mothers have the highest rate of mortality in childbirth, and their babies are most at risk of not surviving their first year either, according to the World Health Organization. Good healthcare is very important.

THIRTIES YOUR BODY

You are in the so-called middle reproductive stage, which lasts from around 20 to 38 and “usually you ovulate regularly,” Dr Moore says. Your levels of follicle-stimulating hormone (FSH) and oestrogen are probably within the usual range. On paper, you should be good to conceive, barring, of course, factors that complicate conception, such as polycystic ovary syndrome, the leading cause of infertility in women.

TESTING, TESTING

After 35, you are also at an increased risk of carrying a baby with a range of birth abnormalities and genetic conditions. The reason is thought to be the older, lower-quality eggs that by this stage of life remain in a your body. The risk of having a baby with Down syndrome, for instance, increases from 1 in 350 by age 35 to 1 in 100 by age 40. “Any pregnancy in older women carries certain risks, to her and her baby,” Dr Moore explains. “There is an increased risk of pregnancy-induced hypertension, preeclampsia and gestational diabetes, for you. The baby faces an increased risk of chromosomal abnormalities and

preterm delivery. While all women should be offered screening for chromosomal abnormalities – which may include a combination of sonar, blood tests and amniocentesis – this is even more important for older moms.”

Dr Moore says if that is detected, the option of terminating the pregnancy will be discussed. “Remember that by having the tests, you are not agreeing to terminate; many couples choose to continue with the pregnancy. But having the information allows you to plan and prepare for any special needs at the time of the delivery,” she adds.

TWO OR MORE

In your late thirties you might be producing somewhat more FSH, and this is why naturally occurring multiple births are more common in this age group. (In vitro fertilisation accounts for the rest of the spike in multiple births, so they are particularly common among this age group.)

IN THE MIND

The thirties is a great time to be a mom because you usually made a conscious choice towards parenthood at this stage – after having played hard and worked hard, to establish yourself as a mature adult with a strong career base.

“As you age, you become more settled emotionally, more mature and experienced, and economically more stable,” Dr Burkhalter says.

In your thirties you have a maturity that is helpful.

“There are pros and cons to parenting at any age – but emotional maturity is always an advantage to parenting.”

YOUR TIME BOMB

If you are still debating when to have a child, you are, unfortunately, running out of time. There is no way to pussyfoot around it: fertility declines sharply after 35. Add to that underlying or silent causes of infertility, and you might just be in for an unpleasant surprise when you do begin trying to conceive and find that it is not happening as fast as you expected. In fact, due to (ahem) “advanced age”, women who begin trying to conceive after 35 are usually “advised to begin investigating fertility after six months of trying on their own,” Dr Moore says. But with the timer running past halfway on your fertility, it is a good idea to visit your gynaecologist to check on your ovulation, whether your cycle is regular, and on the condition of your uterus, even if you are not immediately planning to fall pregnant.

“Remember that the only true test of fertility is when you start trying to conceive,” Dr Moore says.

FORTIES YOUR BODY

You’re in the diplomatically termed “late reproductive stage” from 38 to 42. Menopause is the stage of life after you have had your last menstrual period (and after which you can obviously no longer conceive children).

Although the average age of menopause onset is 51, you’ll likely enter perimenopause, or menopause transition, sometime in your forties.

Your ovulation will decrease (you will release fewer eggs, and there will be some cycles where you don’t ovulate at all) or your menstrual cycle will become less regular and more erratic. It will be more difficult to become pregnant, and to avoid miscarriage and birth defects in this decade.

YOUR BABY

You can be fairly sure that your pregnancy in your forties will be medically managed (as your conception may also have been, via IVF or other methods of assisted conception). Expect to be followed more closely by your doctors. “Expect more regular gynae visits, and screening tests for gestational diabetes and high blood pressure,” Dr Moore says.

“Apart from that, if you’re in your forties, you will also be watched for signs of preterm labour.”

Of course, you can do your bit and must take your own steps towards good health, such as eating healthily and remaining fit, so that you can have a happy, healthy pregnancy.

YOUR HEALTH & WEALTH

On the upside, older parents are generally wealthier and more educated than their younger counterparts, and tend to make responsible choices regarding their health and that of their children.

One example is a recent study that shows older women are more likely to breastfeed their babies.

A last, small glimmer of hope once baby is actually there: the Journal for Sleep Research reported in 2004 that the reaction time of older sleep-deprived subjects slows down less than the reaction time of younger subjects.

Simply put, older people may actually be more resistant to sleep deprivation. So you may just be better at handling those sleepless nights with a newborn than a younger mom. ●