Articles

Key takeaways

● Many people over age 40 have healthy pregnancies and babies.

● You may receive more frequent antenatal care and monitoring.

● Older parents often have more life experience and stability.

● Healthy lifestyle choices support a positive pregnancy journey.

What does advanced maternal age mean?

If you are pregnant and 40 or older, you might hear your care team use the term 'advanced maternal age'. More people are getting pregnant in their 40s than ever before. Most people over 40 who become pregnant have healthy pregnancies and babies.

There are many positive aspects to having a baby later in life. Research suggests that older parents may experience increased happiness after having a baby. You may also feel more confident due to your life experience.

It is common for older parents to have gained education and social stability. You are also more likely to be emotionally and financially stable. It is also possible that you are eating better and being more active than you were when you were younger. You may also be less likely to smoke.

Potential implications for your pregnancy

Being pregnant at an older age can mean a higher chance of certain health considerations. These are important to be aware of. However, a healthy pregnancy is still the most likely outcome.

Specific health considerations

You may have a higher chance of having high blood pressure that started before pregnancy (chronic hypertension). You are also more likely to develop high blood pressure during pregnancy (gestational hypertension). A serious condition in pregnancy that causes high blood pressure and protein in your urine (pre-eclampsia) is also more likely.

Diabetes that develops during pregnancy (gestational diabetes) is more common in people in their 40s than in their 20s or 30s. If you are over 40, you are also more likely to have a very large baby (macrosomia – over 4.5kg or 10lb). This is also often linked to gestational diabetes.

Chromosomal abnormalities

Chromosomes carry genetic information. The chance of having a baby with a chromosomal abnormality increases with age. The most common syndromes are Down's, Edwards' and Patau's. Because of this, older people are more likely to have invasive procedures in pregnancy, such as amniocentesis. This is a test where a small sample of the fluid around your baby is taken for testing.

Miscarriage and pregnancy loss

Sadly, the likelihood of having a stillborn baby is higher in older people. However, it is important to remember that this risk overall is still low. Miscarriage and a pregnancy that grows outside of the womb (ectopic pregnancy) are also more common in people over 35. Despite this, you are still more likely to have a healthy pregnancy than a miscarriage.

Placental complications

Your age may affect how well the placenta develops. This can make complications more likely.

These include:

● A low-lying placenta, including placenta praevia – where the placenta covers the cervix which is the entrance to the womb.

● Pre-eclampsia.

● A placental abruption – where the placenta comes away from the wall of the womb before birth.

● Having a baby with a low birth weight.

Timing of birth and complications

Being over 40 is associated with an increased risk of stillbirth, especially after 40 weeks. Because of this, doctors may offer to start your labour early (induction) before or around your due date. If an induction is recommended, your doctor or midwife should explain why. They will also discuss what it involves and the potential benefits and risks.

People over 40 are also almost twice as likely to have a caesarean birth.

What to expect from your antenatal care

Your antenatal care may include additional checks and appointments. This is to help monitor your health and your baby's wellbeing.

A specialist pregnancy and birth doctor called an obstetrician will be involved in your care. They will work alongside your midwife and GP.

You may be offered more tests to check that you and your baby are healthy. For example, your blood pressure may be checked more often, due to the higher risk of pre-eclampsia. Your midwife may also arrange extra scans to check your baby's size.

Focusing on a healthy pregnancy

Most pregnant people over 40 have healthy pregnancies and babies. You may have some extra appointments, however, the aim of your antenatal care will be the same: keeping you and your baby healthy.

To support a healthy pregnancy, it is important to:

● Attend all appointments – Go to all your antenatal appointments and have all recommended checks and tests.

● Know your results – Make sure you know when test results are expected. Ask about your results if you have not been informed.

● Stay in touch – Know how to contact your maternity services when you need to speak to a midwife or doctor.

Healthy lifestyle choices

The best thing you can do for a healthy pregnancy at any age is to stay as healthy as possible.

Eating a healthy, balanced diet is important. Aim for at least 5 portions of fruit and vegetables daily. Include starchy foods like wholemeal bread, potatoes, pasta, and rice. British Lion eggs are safe to eat raw or partially cooked; otherwise, cook eggs thoroughly before eating.

Protein is important for your baby's growth. Good sources include:

● meat (avoid liver and liver products)

● fish

● poultry

● eggs

● beans

● pulses

● nuts

Aim for two portions of fish each week, one of which should be an oily fish such as salmon, sardines, or mackerel.

However, avoid certain fish including:

● swordfish

● marlin

● raw shellfish

● shark

Staying active and safe

For most straightforward pregnancies, exercise is safe and healthy. If you have health concerns, consult your midwife or doctor before starting new activities.

Try to stay active throughout your pregnancy and continue your daily physical activity for as long as you feel comfortable. If you were not active before pregnancy, start gently and build up gradually. Aim for at least 150 minutes of moderate-intensity activity each week. Activities such as walking, swimming, cycling and pregnancy yoga can help improve fitness, wellbeing, and sleep.

Avoid smoking and second-hand smoke. Do not drink alcohol or use illegal drugs during pregnancy. Aim to limit your caffeine intake to 200mg a day.

Gaining weight is a natural part of a healthy pregnancy. Eating a balanced diet and staying active can help you feel your best. If you have any questions about weight gain, your midwife is there to support you.

Looking after your mental wellbeing

It is vital to take care of your mental health during pregnancy. Stress, anxiety, and low mood can be common.

Consider mindfulness techniques to focus on the present and reduce worries. These can include meditation, breathing exercises, or visualisation.

Practice self-care by being kind to yourself and taking time to rest. Writing down your thoughts and feelings can also be helpful.

Talk to your midwife, partner, family, or friends about how you are feeling. Antenatal classes can help you learn more about pregnancy, birth, and parenthood, while also giving you the opportunity to meet other expectant parents.

If possible, seek extra support with housework, shopping, or childcare. If you are struggling, consider speaking to your GP or midwife about counselling or other sources of support.

Try to spend some time each day focusing on your baby and preparing for birth. Learning about your options and what to expect can help build confidence and reduce anxiety.