Getting pregnant after 40 is not uncommon.

As a maternal fetal specialist, I often get asked about the chances of getting pregnant after 40, and it is accurate to say that in today’s world, the majority of “mother’s to be” are waiting a little longer to get pregnant. This is sometimes referred to as “delaying childbearing.”

Delaying childbearing is defined as “women aged 35 and older giving birth for the first time.” This article, however, is suited for women who have already given birth and for those who are hoping to add to their family.

In this article, I will go through the chances of getting pregnant later in life, including the perks, risks, tips and finally the best natural methods for getting pregnant after 40.

Dr.-Kelly

Dr. Kelly Orzechowski is a Maternal Fetal Specialist and Vice Chief Medical Officer at Virginia Hospital Centre.


Contents



Getting Pregnant After 40: Is It The Norm These Days?


Over the last 10 years, birth rates have declined among younger women, but birth rates actually increased for women over the age of 40.

In the United States, birth rates for women 30-44 years of age reached a record high over the last 10 years, and the birth rate for teenagers reached a record low.

Today, 55 percent of never-married women aged 40 to 44 have at least one child, up from 31 percent two decades ago.

All told, the share of U.S. women at the end of their childbearing years who ever had a baby now stands at 86%, while 14% are childless.

So, what are some of the reasons that people may choose to wait longer to have children?

There is a number of social and societal reasons that people are waiting longer to have their first child.

A big part of the equation comes down to better access and more education around the use of contraception and safe sex practices. In developed countries, there is more of a concerted effort to ensure that people can receive an education and advance in their careers.

This shift has in turn led to many women focusing more on career development as opposed to starting “settling down” or starting a family.

Another large contributor in people waiting to have children simply comes down to the fact that these days there is more choice and less pressure.

Traditionally, there has been more societal pressure around getting married and starting a family from a young age. Today people are taking more time to focus on personal and professional goals, with becoming a parent as something that people might consider at a slightly later date.

Today, it is more common to build the foundations of your education and following career ahead of starting a family and settling down.

Looking at the global picture, South Korean women are currently the oldest when they first give birth (31.4 years, on average). Close followers include Greece, Luxembourg, Switzerland, Japan, Spain and Italy, where women are also in their 30s when they become mothers.

The most recent statistics released illustrate that for the first time, women aged 40 and older are surpassing teenagers in birth rate in a number of countries.

According to the most recent Canadian statistics, in 2012, women over 40 gave birth to 13,395 children, while teenagers produced 12,915 babies.

In summary, some of the possible reasons that people are waiting longer to have children include:

  • Easier access to contraception
  • More contraceptive choices
  • Pursuit of educational and career goals
  • Wanting to establish financial security prior to parenthood/cost of childcare
  • Delaying marriage
  • Advancements in fertility techniques
  • Change in societal norms and values resulting in delayed childbearing becoming more socially acceptable

what-age-are-mothers-having-children-graph

Source: Pew Social Trends

Looking at other large studies over a longer period of time, it is also clear that the number of “millennial moms” has steadily increased in the last twenty years.

number-of-millenial-moms-increasing

Source: Pew Research Center

Why are parents choosing to have children later in life today?

For many men and women, delayed childbearing may be a consequence of life circumstances, such as not having found the right spouse or life partner. Others may intentionally delay childbearing in order to complete an advanced degree or ensure financial security, or to pursue other life goals and priorities.

The big difference with respect to conception today compared to 20 years ago has to do with advancements in medicine, and increased access to those advancements. In the US, men and women have improved their ability to avoid unwanted pregnancies. Access to contraception is easier, and there are more contraceptive options available.

Access and use of long-acting reversible contraceptive (e.g. IUDs) and emergency contraceptives has increased significantly over the last decade. Additionally, both men and women have more access to assisted reproductive technologies such as in vitro fertilization, ovulation-enhancing medicines, and egg freezing and storage.


Can You Get Pregnant On The First Try?


Fertility operates on a continuum. A woman’s reproductive timeline ranges from the onset of ovulation and her first menstrual cycle, until her last menstrual cycle whereby she enters menopause.

Reproductive potential decreases with advancing age due to the decrease in the number of eggs in the ovaries, generally speaking, fertility ends 5 to 10 years before menopause.

A woman’s fertility peaks between the late teens and late 20s. Fertility starts to slowly decline around age 32 years, with a more rapid decline occurring around age 37 years.

Women under 30 years of age have a 25% chance of pregnancy each menstrual cycle, compared to a 20% chance for women older than 30 years. This number decreases with each passing month of trying to conceive.

At the age of 40, a woman has a 5% chance of getting pregnant with each passing menstrual cycle. At the age of 45, few women will be able to conceive naturally.

probability-of-getting-pregnant-by-age

Source: HuffPost Women

When it comes to getting pregnant, there are no quick fixes or miracles that will guarantee immediate conception. For a lot of couples, it can be very disappointing when pregnancy has not occurred after a few months of actively trying to become pregnant.



There is a very common false impression that unprotected sex will immediately lead to pregnancy but this is not always the case.

While some couples may conceive quickly, the majority of couples will get pregnant after three to six months.

Some couples will need to try for up to a year.

There are a number of variables that come into play when it comes to getting pregnant, some of these factors include how frequently you are having sex, how much you are having sex during your fertile days, your age and whether there are any fertility issues between you and your partner. To simplify this, the factors that will determine how quickly you can get pregnant will largely depend on:

  • Age
  • Weight
  • Fertility Status/Ovarian Reserve
  • Overall Health Status
  • Frequency/timing of intercourse
  • Luck

If getting pregnant is a struggle for you and your partner, it can be a real stressor. Try your best to identify ways in which you and your partner can optimize or improve your overall health. If you are still struggling with conception, it might be the time to start looking at fertility testing or visit your local physician for a consultation.


The Perks Of Getting Pregnant After 40


The perks of getting pregnant after 40 are varied including both social and financial advantages. Reports have shown that the children of older mothers are more likely to get an advanced degree and experience more financial security in their lifetime.

A longer lifespan and a sharper brain

Some data shows that older mothers may live longer, and have a lower risk of age-related cognitive decline. The reasons for this association are unclear. A study carried out by the North American Menopause Society showed that women who have children later in life are more likely to live to the age of 95 or older.

More positive, patient parenting

Older parents are often more focused on their families and the maturity that comes with age may result in more positive parenting. Data has shown that older mothers are better at setting boundaries with their children and were less likely to yell and use harsh punishments. This appears to possibly result in their children having fewer behavioral, social and emotional difficulties. Older mothers may experience a stronger, more long-lasting spike in happiness following the birth of a child, some interesting findings on this can be seen in this Danish study

Financial security and higher education may result in improved outcomes for their children

Parents with advanced education and more financial stability may provide more educational and learning opportunities to their children. Children born to older parents appear to obtain more education, have higher standardized test scores and are more likely to attend college. Since older parents have more education, they use more extensive vocabulary when speaking to their children, which results in the child having improved language development. Children born to older parents also have lower rates of accidental injuries and fewer social and emotional difficulties.

Educational, societal, and technological improvements that can benefit parents and their children

Educational, societal, and technological improvements occur continuously and major changes occur over the years and decades so it makes logical sense that if a woman gave birth to her first child at age 24 in 1994, her child would not have access to the same advancements that he/she would have access to if that same mother gave birth at age 40 in 2004. While this may not be a concrete reason to put off having your first child, it does offer food for thought when family planning.


The Risks Of Getting Pregnant After 40


It’s important to emphasize that the majority of women over the age of 35 will give birth to healthy infants. However, there are increased risks associated with pregnancy in older women. The most common risks include:

Difficulty getting pregnant

Fertility declines with advancing age, women in their late 30s and 40s may take longer to conceive or may experience infertility. It is harder to get pregnant as we age because a woman is born with all the eggs she will ever have. As she ages, her eggs age with her and their number and quality reduces over time. Ovulation, when the egg is released from the ovary, also tends to slow down and occurs less frequently over time.

Increased risk of miscarriage

Women over 35 face higher chances of having a miscarriage due in part to the fact that they have more eggs with chromosomal abnormalities.

Pregnancies complicated by a fetus with chromosome abnormalities therefore are more likely to result in miscarriage. Therefore, older women are more prone to miscarriage because they are more likely to have a fetus with a chromosome abnormality.

Increased risk of having a pregnancy with a chromosome abnormality such as Down syndrome

For a 20-year-old woman, there is a 1 in 526 risk of having a pregnancy with any chromosome abnormality, and a 1 in 1667 risk of having a pregnancy with Down syndrome.

For a 40-year-old woman, there is a 1 in 106 risk of having a pregnancy with any chromosome abnormality, and a 1 in 66 risk of having a pregnancy with Down syndrome.

The increased risk of chromosome problems occurs because females are born with a limited supply of eggs, and as women age, their eggs age too.

Increased chance of having twins/multiples

As an older mother, you have an increased chance of having twins. This is because women over age 35 make more follicle stimulating hormone (FHS) compared to younger women, which may cause more than one egg to be released during ovulation.

Older women are more likely to use fertility treatments such as in vitro fertilzation (IVF) and medications that increase ovulation, both of which increase the likelihood twins.

Increased risk of high blood pressure/preeclampsia

The exact cause of preeclampsia is unknown, but it is well known that older mothers have an increased chance of high blood pressure/preeclampsia. This is because preeclampsia starts in the placenta which is the organ that provides nutrition to the fetus during pregnancy. New blood vessels develop in the first few weeks of pregnancy that send blood to the placenta.

If too few of these blood vessels develop or if they don’t function properly, women can develop preeclampsia. As women get older, they uterus also ages and may not allow for the proper development of these placental blood vessels which increases the risk for preeclampsia.

Increased risk of developing gestational or pregnancy related diabetes

The cause of gestational diabetes is not known, however, a growing placenta causes release of many hormones which may cause the body to become resistant to insulin. Normally, the pancreas is able to make additional insulin to overcome insulin resistance, but when the production of insulin is not enough to overcome the effect of the placental hormones, gestational diabetes occurs. Older mothers have an increased chance of developing gestational or pregnancy related diabetes but experts do not know exactly why this occurs.

The primary downfalls of having children later in life include difficulty conceiving, and increased risks of pregnancy complications, although the average lifespan in developed countries has increased significantly in the past century, some older mothers will have limited time with their children and grandchildren due to illness and death, and many will be less active than they would have been at younger ages. But there are no guarantees at any age.

likelihood-of-getting-pregnant-by-age

Source: KinderZeit


Getting Pregnant After 40 Naturally


Women considering pregnancy at age 40 must bear in mind that conception may not happen naturally.

Older women planning a pregnancy should schedule a preconception consultation with an obstetrician-gynecologist or maternal fetal medicine specialist. During this visit, your physician should:

  • Review your health history and any medical conditions that could affect pregnancy.

  • Review, adjust or discontinue certain medications that could affect pregnancy, and discuss the risks and benefits of any prescription medications that may need to be continued during pregnancy. The list is long but some of the prescription medications that you may need to look at include blood pressure medications, seizure medications and psychiatric medications.

  • Recommend vaccinations you may need prior to pregnancy women; should ensure they are up to date on all vaccines but especially MMR vaccine and varicella since those cannot be administered in pregnancy.

  • Review your family’s health history. Based on your personal and family history, your doctor might refer you for genetic counseling. Genetic counseling helps you understand how genes, birth defects and medical conditions run in families and whether your pregnancy could be at higher risk for these conditions. A genetic counselor can offer certain genetic screening tests and help you understand test results to help you make decisions about your pregnancy.

  • Recommend ways to optimize your health prior to conception.

  • Discuss options for genetic screening/testing


Tips For Getting Pregnant After 40


Avoid all tobacco products, smoking and secondhand smoke

Studies show that smoking increases your chance for infertility. Smoking can extend the time it takes to conceive. Smoking also increases your risk for a miscarriage, and other pregnancy complications such as poor fetal growth and increased chance of the baby being born too early.

Avoid alcohol

Alcohol can impact both female and male fertility, affecting conception and implantation. Alcohol consumption during pregnancy can cause birth defects and developmental delay. There is no safe dose of alcohol in pregnancy.

Maintain a healthy weight

Obesity can affect hormone levels. The hormonal imbalance caused by obesity can result in insulin resistance. Insulin resistance can cause anovulation where the body does not release eggs regularly and this can cause abnormal menstrual cycles. Obesity in men alters testosterone and other hormones that can affect sperm count and sperm mobility.

Take a daily prenatal vitamin with folic acid

A prenatal vitamin is formulated to provide the nutrients needed for optimal hormone function, egg development and fetal development. Prenatal vitamins contain folate, Vitamins A&D, iron, B6 and B12. These nutrients are the building blocks of a healthy pregnancy.

It's important to maintain a healthy lifestyle and diet while trying to conceive. It is an exciting time but it can also be a frustrating time if you are not getting pregnant from the get go. If in doubt, go to your physician's office or consider fertility testing.

Most importantly, try not to stress, this is a very exciting time and you should focus on the journey, just as much as the destination.



Read: When Are You Most Fertile?


Written by Dr. Kelly Orzechowski | Edited by Hannah Kingston