Pregnancy at 40 to 44

Ages 40 to 44
YOUR BODY

First the good news: A recent study shows that women over 40 who have babies without help from fertility drugs or other assisted reproductive technologies tend to live longer than those who don't. Why? One theory is that estrogen, which is still produced in abundance in fertile women, has life-lengthening effects on the heart, bones, and other organs. However, fewer than 1 percent of women ages 40 to 44 have babies. The chance of becoming pregnant during any one month drops to only 5 percent after age 40.

How well you carry and deliver a baby in your 40s depends on several factors, including your level of fitness, overall health habits, and whether this is your first baby. "The biggest complaint I hear among my pregnant patients in their 40s is how tired they feel," says Jennifer Niebyl, M.D., a professor and head of the department of obstetrics and gynecology at the University of Iowa. "Hormonal changes in pregnancy make all women feel tired, but fatigue seems to be more pronounced in older ones and can be compounded if there are young children to care for."

If you've already had a baby, you may also be more prone to hemorrhoids, pressure on the bladder, prolapsed tissues in the uterus and vagina, and sagging breasts than you would have been 20 years earlier, simply because the muscles and other tissues in these areas have already been stretched. You can minimize these effects by making sure not to gain an excessive amount of weight during pregnancy, keeping moderately active, and doing Kegel exercises to keep your vaginal muscles strong.

YOUR EMOTIONAL SELF

By the time you've reached your 40s, you have a wealth of experience and maturity to draw upon when raising a child. Chances are, you'll also be more patient than you would have been in your 20s. But you'll probably have concerns. "What I hear most often is, 'I'll be so old by the time this baby starts college!'" says Glazer. "Or a couple will look down the road and see that their nest won't be empty until they're 60 or 70. Older parents have to balance feelings of loss of freedom and spontaneity with the joy they'll feel in raising the child."

RISKS TO YOUR BABY

About one-third of all pregnancies in women ages 40 to 44 end in miscarriage. There are several reasons: The eggs may be defective to start with, the uterine lining may not be thick enough, or the blood supply to the uterus may not be rich enough to sustain a pregnancy. The risks of placenta previa (in which the placenta lies low in the uterus, partly or completely blocking the cervical opening and creating a high risk of hemorrhage) and placental abruption (in which all or part of the placenta separates from the uterine wall) are also increased. Babies born to women in their 40s are also more likely to have lower birth weights (under 5 1/2 pounds).

Risks of chromosomal birth defects rise steadily with each year into your 40s. If you give birth at age 40, your baby has a 1 in 106 chance of being born with Down syndrome and a 1 in 66 chance of being born with any chromosomal abnormality. But by age 44, those risks rise to 1 in 38 and 1 in 26, respectively.